ABSTRACT
Background: The severe clinical conditions and fatal outcomes resulting from SARS-CoV- 2 infection have been associated with increased inflammatory and hypercoagulability processes, where an interplay between different comorbidities and genetic factors would be directly involved in the poor prognosis. Aim(s): To study the association of different genetic variants, clinical variables and biological markers involved in inflammation and coagulation with the survival outcome of COVID-19. Method(s): 204 unvaccinated COVID-19 confirmed patients were grouped and compared according to their survival outcome. Inflammatory and hemostatic variables measured upon hospital admission, different clinical variables and the genotypic distributions of the genetic variants Factor II20210A (II20210A), Factor V Leiden (FVL), Fibrinogen Gamma 10034C>T (FGG10034C/T), Factor XI7872C>T (FXI7872C/T) and rs11385942 were compared between patients that either died (n = 63) or survived (n = 141). Differences between continuous variables were analyzed by either a t-test or a U-Mann Whitney test and differences in genotypic distributions were studied by a Chi-square test. Cut off values were set for continuous variables significantly associated with a fatal outcome and their Odds Ratios (OR) of association were calculated through univariate logistic regression. Result(s): The group of patients who died were significantly older, had a higher BMI index and presented with a lower platelet count, lower lymphocytes levels, higher levels of leukocytes and neutrophils, a higher neutrophils/lymphocytes ratio and higher levels of D-dimer, Ferritin and LDH than survivors. No differences were observed in the genotypic distributions of the genetic variants studied between both groups. Conclusion(s): In agreement with previous studies, age, obesity, and the levels of different hematological and plasmatic markers upon hospital admission would be useful predictors of a fatal outcome in COVID-19 patients. Despite the typical exacerbation of inflammation/ coagulation in severe COVID-19, no association was found between the carriage of any of the proinflammatory/prothrombotic genetic variants studied and a higher risk of dying. (Table Presented).
ABSTRACT
BACKGROUND AND OBJECTIVE: Most smell tests are difficult to implement in daily clinical practice owing to their long duration. The aim of the present study was to develop and validate a short, easy-to-perform, and reusable smell test to be implemented during the COVID-19 pandemic. METHODS: The study population comprised 120 healthy adults and 195 patients with self-reported olfactory dysfunction (OD). The 8-Odorant Barcelona Olfactory Test (BOT-8) was used for detection, memory/recognition, and forced-choice identification. In addition, a rose threshold test was performed, and a visual analog scale was applied. The Smell Diskettes Olfaction Test (SDOT) was used for correlation in healthy volunteers, and the University of Pennsylvania Smell Identification Test (UPSIT) was used for patients with OD to establish cut-offs for anosmia and hyposmia. In order to take account of the COVID-19 pandemic, disposable cotton swabs with odorants were compared with the original test. RESULTS: In healthy persons, the mean (SD) BOT-8 score was 100% for detection, 94.5% (1.07) for memory/recognition, and 89.6% (0.86) for identification. In patients with OD, the equivalent values were 86% (32.8), 73.2% (37.9), and 77.1% (34.2), respectively. BOT-8 demonstrated good test-retest reliability, with agreement of 96.7% and a quadratic k of 0.84 (P<.001). A strong correlation was observed between BOT-8 and SDOT (r=0.67, P<.001) and UPSIT (r=0.86, P<.001). Agreement was excellent for disposable cotton swabs, with a k of 0.79 compared with the original test. The cut-off point for anosmia was ≤3 (area under the curve, 0.83; sensitivity, 0.673; specificity, 0.993). CONCLUSION: BOT-8 offers an efficient and fast method for assessment of smell threshold, detection, memory, and identification in daily clinical practice. Disposable cotton swabs with odorants proved to be useful and safe during the COVID-19 pandemic.