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1.
Biochem Med (Zagreb) ; 32(2): 020901, 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1798676

ABSTRACT

Introduction: Several laboratory tests are characteristically altered in Coronavirus Disease 2019 (COVID-19), but are not totally accurate in predicting the disease outcome. The long pentraxin 3 (PTX3) is quickly released directly at inflammation sites by many immune cell types. Previous studies have shown that PTX3 correlated with disease severity in various inflammatory conditions. Our study investigated the use of PTX3 as a potential marker of COVID-19 severity and compared its performance in detecting a more severe form of the disease with that of routine laboratory parameters. Materials and methods: Stored serum samples of RT-PCR confirmed COVID-19 cases that had been obtained at hospital admission were retrospectively analysed. Intensive care unit (ICU) stay was considered a surrogate endpoint of severe COVID-19. Pentraxin 3 was measured by a commercial enzyme-linked immunosorbent assay. Results: A total of 96 patients were recruited from May 1st, 2020 to June 30th, 2020; 75/96 were transferred to ICU. Pentraxin 3 was higher in ICU vs non-ICU patients (35.86 vs 10.61 ng/mL, P < 0.001). Univariate and multivariate logistic regression models demonstrated that the only significant laboratory predictor of ICU stay was PTX3 (OR: 1.68 (1.19-2.29), P = 0.003), after controlling for comorbidities. The Receiver Operator Characteristic curve analysis showed that PTX3 had a higher accuracy compared to C-reactive protein (CRP), lactate dehydrogenase (LD), ferritin in identifying ICU patients (AUC of PTX3 = 0.98; CRP = 0.66; LD = 0.70; ferritin = 0.67, P < 0.001). A cut-off of PTX3 > 18 ng/mL yielded a sensitivity of 96% and a specificity of 100% in identifying patients requiring ICU. Conclusion: High values of PTX3 predict a more severe COVID-19.


Subject(s)
COVID-19 , Biomarkers , C-Reactive Protein/metabolism , COVID-19/diagnosis , Ferritins , Humans , ROC Curve , Retrospective Studies , Serum Amyloid P-Component
2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-304746

ABSTRACT

Background: The early detection of COVID-19 patients with interstitial pneumonia at high risk of dismal outcome is necessary to deliver proper care and optimize management of limited resources. Objective: The aim of this study was to analyse the performance of pre-existing scores in predicting in-hospital mortality and ICU transfer at admission in an Acute Medical Unit. Methods: 106 consecutive patients with acute respiratory failure due to COVID-19 interstitial pneumoni admitted to Acute Medical Unit were enrolled. The performances of NEWS, SIRS, RAPS, REMS, qSOFA, APACHE II, CURB-65 and PSI were analysed by the Area Under the Receiver Operator Characteristic (AUROCs) and standard indices of accuracy. Results: Considering in-hospital mortality PSI and APACHE II had the higher AUROCs, 0.83 (95% CI 0.75-0.91) and 0.80 (95% CI 0.71-0.88), followed by REMS, 0.77 (95% CI 0.67-0.86), and CURB-65, 0.73 (95% CI 0.63-0.82), whereas the AUROCs of the other scores were < 0.7. PSI and APACHE II had good sensitivity (0.92 and 0.97), negative predictive value (0.96 and 0.97) and negative likelihood ratio (0.1 and 0.1), accurately identifying patients at low risk to die. However, the low specificity (0.70 and 0.47) and positive likelihood ratio (3.1 and 1.8) could limit their usefulness in predicting in-hospital mortality. Considering ICU admissions all the scores, except NEWS, SIRS and qSOFA, showed a worse performance. Conclusions: PSI and APACHE II showed good prognostic results in predicting in-hospital mortality but no pre- existing score validated for acute care settings was totally satisfactory to predict adverse outcomes in COVID-19 interstitial pneumonia after admission to Acute Medical Unit. The application setting and selected outcome criteria should always be considered to evaluate and compare scoring systems’ performance analysis.

3.
PLoS One ; 16(3): e0248498, 2021.
Article in English | MEDLINE | ID: covidwho-1388907

ABSTRACT

We report onset, course, correlations with comorbidities, and diagnostic accuracy of nasopharyngeal swab in 539 individuals suspected to carry SARS-COV-2 admitted to the hospital of Crema, Italy. All individuals underwent clinical and laboratory exams, SARS-COV-2 reverse transcriptase-polymerase chain reaction on nasopharyngeal swab, and chest X-ray and/or computed tomography (CT). Data on onset, course, comorbidities, number of drugs including angiotensin converting enzyme (ACE) inhibitors and angiotensin-II-receptor antagonists (sartans), follow-up swab, pharmacological treatments, non-invasive respiratory support, ICU admission, and deaths were recorded. Among 411 SARS-COV-2 patients (67.7% males) median age was 70.8 years (range 5-99). Chest CT was performed in 317 (77.2%) and showed interstitial pneumonia in 304 (96%). Fatality rate was 17.5% (74% males), with 6.6% in 60-69 years old, 21.1% in 70-79 years old, 38.8% in 80-89 years old, and 83.3% above 90 years. No death occurred below 60 years. Non-invasive respiratory support rate was 27.2% and ICU admission 6.8%. Charlson comorbidity index and high C-reactive protein at admission were significantly associated with death. Use of ACE inhibitors or sartans was not associated with outcomes. Among 128 swab negative patients at admission (63.3% males) median age was 67.7 years (range 1-98). Chest CT was performed in 87 (68%) and showed interstitial pneumonia in 76 (87.3%). Follow-up swab turned positive in 13 of 32 patients. Using chest CT at admission as gold standard on the entire study population of 539 patients, nasopharyngeal swab had 80% accuracy. Comorbidity network analysis revealed a more homogenous distribution 60-40 aged SARS-COV-2 patients across diseases and a crucial different interplay of diseases in the networks of deceased and survived patients. SARS-CoV-2 caused high mortality among patients older than 60 years and correlated with pre-existing multiorgan impairment.


Subject(s)
COVID-19/pathology , Comorbidity , Adolescent , Adult , Aged , Aged, 80 and over , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , C-Reactive Protein/analysis , COVID-19/drug therapy , COVID-19/mortality , COVID-19/virology , Child , Child, Preschool , Female , Hospitalization/statistics & numerical data , Humans , Italy , Male , Middle Aged , Risk Factors , SARS-CoV-2/isolation & purification , Treatment Outcome , Young Adult
4.
Gastroenterol Hepatol Bed Bench ; 13(4): 393-395, 2020.
Article in English | MEDLINE | ID: covidwho-1008308

ABSTRACT

AIM: We propose the Modified Corona Score (MCorona score), an alternative approach to identifying new likely Covid-19 patients without positive chest images, but with gastrointestinal onset. BACKGROUND: In April, 2020, a total of 104,291 laboratory-confirmed cases had been documented in Italy; Lombardy, the Northern Italian Region, recorded over 60,000 Covid-19 cases. METHOD: The MCorona score is built by several laboratory parameters linked between age and gender, ranging from 0 to 10. RESULTS: Using the preliminary score cut-off of 4, we successfully identified likely Covid-19 patients with gastrointestinal onset. However, more caution is needed, and a larger sample size is required to verify the accuracy and specificity of the score. CONCLUSION: We propose the complete validation of the MCorona score, an instrument able to diagnose likely Covid-19 patients with symptoms other than respiratory distress.

5.
Auton Neurosci ; 229: 102734, 2020 12.
Article in English | MEDLINE | ID: covidwho-778433

ABSTRACT

We describe clinical and laboratory findings in 35 patients tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction on nasopharyngeal swab experiencing one or multiple syncope at disease onset. Clinical neurologic and cardiologic examination, and electrocardiographic findings were normal. Chest computed tomography showed findings consistent with interstitial pneumonia. Arterial blood gas analysis showed low pO2, pCO2, and ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) indicating hypocapnic hypoxemia. Patients who presented with syncope showed significantly lower heart rate as compared to 68 SARS-CoV-2 positive that did not. Such poorer than expected compensatory heart rate increase may have led to syncope based on individual susceptibility. We speculate that SARS-CoV-2 could have caused angiotensin-converting enzyme-2 (ACE2) receptor internalization in the nucleus of the solitary tract and other midbrain nuclei, impairing baroreflex and chemoreceptor response, and inhibiting the compensatory tachycardia during acute hypocapnic hypoxemia.


Subject(s)
COVID-19/complications , Syncope/virology , Adult , Aged , Aged, 80 and over , Female , Heart Rate/physiology , Humans , Hypocapnia/virology , Hypoxia/virology , Male , Middle Aged , SARS-CoV-2
6.
Biochem Med (Zagreb) ; 30(3): 030402, 2020 Oct 15.
Article in English | MEDLINE | ID: covidwho-709641

ABSTRACT

After December 2019 outbreak in China, the novel Coronavirus infection (COVID-19) has very quickly overflowed worldwide. Infection causes a clinical syndrome encompassing a wide range of clinical features, from asymptomatic or oligosymptomatic course to acute respiratory distress and death. In a very recent work we preliminarily observed that several laboratory tests have been shown as characteristically altered in COVID-19. We aimed to use the Corona score, a validated point-based algorithm to predict the likelihood of COVID-19 infection in patients presenting at the Emergency rooms. This approach combines chest images-relative score and several laboratory parameters to classify emergency room patients. Corona score accuracy was satisfactory, increasing the detection of positive patients' rate.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Emergency Service, Hospital , Pneumonia, Viral/diagnosis , Reverse Transcriptase Polymerase Chain Reaction/methods , Biomarkers/metabolism , COVID-19 , COVID-19 Testing , Cohort Studies , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/metabolism , Emergency Service, Hospital/standards , False Negative Reactions , Humans , Negative Results , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/metabolism , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction/standards , SARS-CoV-2 , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/standards
7.
Arch Med Res ; 51(6): 598-599, 2020 08.
Article in English | MEDLINE | ID: covidwho-423996

ABSTRACT

Infection of novel Coronavirus has been declared pandemic by the WHO and now is a world public health crisis. Laboratory activity becames essential for the timely diagnosis. Few parameters, such Lymphocytes count, SaO2 and CRP serum level can be used to assess the severity of COVID-19 in emergency room.


Subject(s)
Biomarkers/blood , Coronavirus Infections/diagnosis , Lymphocyte Count , Oxygen/blood , Pneumonia, Viral/diagnosis , Betacoronavirus , C-Reactive Protein/analysis , COVID-19 , Coronavirus Infections/blood , Emergency Service, Hospital , Humans , Neutrophils , Pandemics , Pneumonia, Viral/blood , Public Health , SARS-CoV-2
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