ABSTRACT
Background: The global Coronavirus Disease 2019 (COVID-19) pandemic is superimposed on the ongoing Multidrug-Resistant Organisms (MDROs) pandemic. Bacterial co-infection, particularly those caused by MDROs, is one of the risk factors linked to higher morbidity and mortality rates in COVID-19 patients. This study aims to compare critical priority MDROs profile causing bacteremia in COVID-19 and non-COVID-19 patients during a pandemic. Methods: A hospital-based retrospective cross-sectional study was conducted at Dr. Soetomo General Academic Hospital from April 2020 to December 2021. This study used a consecutive sampling technique, which included and analyzed all identified microorganism isolates from blood specimens that met the inclusion criteria. The Mann-Whitney test was used to compare MDRO profiles between COVID-19 and non-COVID-19 patients, which is significant if p < 0.05. Results: The total proportion of critical priority MDRO isolates in COVID-19 patients was 90/390 (23.08%), while in non-COVID-19 patients were 377/1446 (26.07%) isolates (p=0.228). Carbapenem-resistant Acinetobacter baumannii (CRAB) had a higher proportion of events in COVID-19 patients (12.05% vs. 7.05%, p < 0.001). In contrast, extended-spectrum β-lactamases (ESBL)-producing Klebsiella pneumoniae (ESBL-KP) had a higher proportion of events in non-COVID patients (7.54% vs. 2.82%, p < 0.001). Acinetobacter baumannii exhibited a high level of resistance, with 149/223 (66.82%) of the isolates being CRAB, with the COVID-19 group accounting for 47/59 (79.66%) and the non-COVID-19 group accounting for 102/164 (62.19%;z = 2.438;p = 0.015). Conclusion: The high proportion and resistance rate of critical priority MDROs, CRAB particularly, among COVID-19 patients, highlights the importance of effective AMR control practices and prevention strategies during the pandemic. © 2023, Sanglah General Hospital. All rights reserved.
ABSTRACT
This cross-sectional study was conducted from June 2020 to May 2021. This study recruited 86 patients with confirmed PCR positive for COVID-19 who were treated in the isolation ward of Dr. Soetomo Teaching Hospital, Surabaya, Indonesia. Examination of serum levels of IL-6, CRP, and LDH was performed on the first and the sixth day of hospital admission. Found on the first day of admission the same significant correlation between IL-6 and CRP on males and females with rs=0,475 (p < 0,01) and rs=0,663 (p < 0,01) respectively. Correlation between IL-6 and LDH on the first day of admission on both males and females were also significant with rs=0,403 (p < 0,01) and rs=0,484 (p < 0,01) respectively. IL-6 and CRP on the sixth day of admission showed significant correlation on males with rs=0,621 (p < 0,01), but not on females with rs=0,120 (p=0,586). IL-6 and LDH on the sixth day of admission also showed significant correlation on males with rs=0,544 (p < 0,01), but not on females with rs=0,030 (p=0,893). In conclusion, there were significant positive correlations between IL-6, CRP, and LDH on the first day of admission on both male and female subjects which showed that IL-6 was associated with inflammatory response on the acute phase of COVID-19. However, on the sixth day of admission, IL-6 showed significant positive correlations with CRP and LDH only on male subjects, but not on female subjects.
ABSTRACT
SARS-CoV-2 was first isolated in bronchoalveloar lavage (BAL) fluid from three patients with COVID-19 at Jinyintan Hospital in Wuhan, Hubei Province, China. The cases are increasing quickly with global mortality rate of 2.12%. The main cause of COVID-19 death is hypoxic respiratory failure due to acute respiratory distress syndrome (ARDS). Endothelial cell damage has a central role in ARDS pathogenesis and multi-organ failure in COVID-19. The endothelium, under homeostasis condition, is surrounded by mural cells (pericytes), which maintain vascular integrity and barrier function. These cells prevent inflammation by limiting the interaction of endothelial cells with immune cells and platelets and inhibit coagulation by expressing coagulation inhibitors and blood-clotting enzymes and producing glycocalyx. Vascular endothelial glycocalyx has a crucial role in endothelial function and is degraded systemically in elderly conditions and various comorbidities, which can be a potential mechanism for the development of lethal complications from COVID-19. Glycocalyx degradation due to endotheliopathy in SARS-CoV-2 infection causes increased levels of its fragments such as syndecan-1 and hyaluronan in the blood. Data from previous studies showed that the levels of these two biomarkers increased significantly in septic patient and several viral infections such as Kawasaki and dengue. These biomarkers are also markers of organ damage. Therefore, it can be indicated that hyaluronan and syndecan-1 are significant prognostic markers for morbidity and survival in COVID-19 patient. © 2021 Teikyo University School of Medicine. All rights reserved.