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1.
Infection ; 2022.
Article in English | PubMed | ID: covidwho-2035453

ABSTRACT

BACKGROUND: Coagulopathy is still a serious pattern of coronavirus-19 disease. We aimed to evaluate COVID-19-associated coagulopathy and multiple hemostatic markers in Egyptian patients. In addition, to assess coagulation acute phase reactants and its effect on the outcome. METHODS: The study included 106 COVID-19 patients, and 51 controls. All patients were positive for COVID-19 infection by nasopharyngeal swab for detection of viral RNA by real-time PCR. In addition to baseline data and radiological findings, the coagulation profile was done with special attention to Fibrinogen, D-dimer, Factor VIII, von Willebrand factor (VWF), Protein C, Protein S, Antithrombin III (ATIII) and Lupus anticoagulant (LA)-1 and 2. RESULTS: The results showed significantly higher VWF, D-dimer, and LA1 (screening) and LA2 (confirmation) in patients than a control group. Significantly higher D-dimer FVIII, VWF and LA1-2 were detected in the severe group. ATIII had high diagnostic accuracy in severity prediction. We found a significantly higher international randomized ratio (INR) and VWF among patients with thrombotic events. For prediction of thrombosis;VWF at cutoff > 257.7 has 83.3% sensitivity and 83.3% specificity. CONCLUSION: Patients with COVID-19 infection are vulnerable to different forms of coagulopathy. This could be associated with poor outcomes. D-Dimer is a chief tool in diagnosis, severity evaluation but not thrombosis prediction. Early screening for this complication and its proper management would improve the outcome.

2.
Egyptian Journal of Hospital Medicine ; 88(1):3567-3575, 2022.
Article in English | Scopus | ID: covidwho-1964932

ABSTRACT

Background: There is a wide variety of CT radiological findings of COVID-19 infection, this study aimed to analyze retrospectively the similarities and differences of CT radiological findings between first and second waves in the confirmed coronavirus patients. Materials and methods: comparative retrospective study between two COVID-19 pandemic waves was conducted on 1000 patients who were diagnosed as COVID-19 patients, at Assiut University hospital, 500 patients in the period from May 2020 to August 2020, while the other 500 patients were in the period from October 2020 to January 2021, all underwent MSCT chest and a comparison between similarities and differences of CT radiological findings was done. Results: Both waves showed nearly the same mean and percentage of total CT severity score with no significant difference between them as p-value > 0.05. There is also a positive moderate correlation between age and total MSCT severity score of the lung in the first wave (r=0.51, p-value<0.001), while a significant positive mild correlation in the second wave (r=0.31 and p-value <0.001), atypical findings were encountered in the second wave more than in the first wave with the most common one was pulmonary fibrosis by (7.2%). Conclusion: Great similarity in CT radiological findings between the two COVID-19 pandemic waves was detected. However, the main difference between them was in the severity of lung involvement in different age groups and demonstration of atypical findings which was more common in the second wave. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.

3.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333621

ABSTRACT

BACKGROUND AND AIMS: The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 have consistently been reported as risk factors for unfavorable prognosis. We aim at this study to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for ICU admission or decease. METHODS: Four hundreds and thirty nine adult patients who are admitted through (June and July 2020) in Assiut and Aswan University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or Probable case. Detection of SARS-CoV-2 RNA was done by (TaqMana" 2019-nCoV Control Kit v1 (Cat. No. A47532) supplied by QIAGEN, Germany on the Applied Biosystem 7500 Fast RT PCR System, USA. RESULTS: Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and LRT symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of CVD cases were admitted in ICU followed by DM cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 vs. 10.7%, P<0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% vs. 81%, P<0.001) and death rate was significantly higher in cases with comorbidities (P< 0.001). The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P<0.002 and 0.001 respectively). CONCLUSION: Association of cardiovascular comorbid conditions including hypertension or neurological diseases together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.

4.
JACC: Cardiovascular Interventions ; 15(4):S39-S40, 2022.
Article in English | EMBASE | ID: covidwho-1757493

ABSTRACT

Background: Myocarditis is one of the most suspected etiologies in patients with unexplained heart failure (HF). We studied the in-hospital prevalence of viral myocarditis and recognize the etiologic cardiotropic viruses in patients admitted with unexplained HF during the COVID era. Method: This is a prospective observational study. We recruited patients with unexplained HF presenting at a university hospital from 1st October 2020 till 31st March 2021 (Fig.1). Patients were included if they present with unexplained acute HF associated with normal coronary angiography (CA). All patients were subjected to full history and examination, ECG, echocardiography, cardiac magnetic resonance (CMR) and CA. Sera were obtained from all suspected patients for detection of antibodies against the viruses by using ELISA and polymerase chain reaction (PCR). Results: Fifty-one patients fulfilled the inclusion criteria. 72.5% were males with mean age 39±16 years. We classified patients into 2 categories based on CMR results: Group A (CMR positive myocarditis) 12 patient (23.5%) and group B (CMR negative myocarditis) 35 (68.6%) patients. 51% of the patients presented with dyspnea, 27.5% with chest pain, 33.3% had LVEF >50%,19.6% with cardiogenic shock. 65.9% of patients (n=31/47) were associated with antibodies against the common cardiotropic viruses. Parvovirus B19 22 (46.8%) and Coxackie 16 (34%) were observed. 3 patients died at 6 months clinical follow up;91.5% from patients had recovered left ventricular ejection fraction. Conclusion: The in-hospital prevalence of myocarditis was 5 times higher in the COVID era. CMR is a good positive test for the diagnose acute myocarditis. Parvovirus B19 and Coxackie viruses represent most common pathogens in our locality. (Clinical trial registration no=NCT04312490, STDF grant no=26393 ) [Formula presented]

5.
European Review for Medical and Pharmacological Sciences ; 25(23):7526-7542, 2021.
Article in English | Web of Science | ID: covidwho-1576114

ABSTRACT

Infectious diseases, especially viral infections, have emerged as a major concern for public health in recent years. Recently emerged COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has been declared a pandemic by World Health Organization since March 2020. It was first identified in Wuhan, China, in December 2019 and has since claimed more than a million lives. Complicated symptoms are associated with rising incidence and fatality rates, while many of the vaccine candidates are in the final stages of clinical trials. This review encompasses a summary of existing literature on COVID-19, including the basics of the disease such as the causative agent's genome characterization. modes of transmission of the virus, pathogenesis, and clinical presentations like associated immune responses, neurological manifestations, the variety of host genetic factors influencing the disease and the vulnerability of different groups being affected by COVID-19.

6.
Drug Metabolism and Personalized Therapy ; 36(2):99-111, 2021.
Article in English | EMBASE | ID: covidwho-1278223

ABSTRACT

Hydroxychloroquine (HCQ) has been used as an off label for the management of coronavirus disease (Covid-19) infection with other drugs. However, different genetic variants can affect the metabolism of HCQ leading to inter-individual differences in its efficacy. In this study, we investigated the effects of variants in CYP2D6, CYP3A4 and CYP3A5 on the risk of Covid-19 infection among patients receiving HCQ for controlling rheumatoid arthritis (RA). A total of 60 patients were genotyped for CYP2D6∗2XN, CYP2D6∗4, CYP3A4∗1B and CYP3A5∗2. They were receiving HCQ for the treatment of RA. The patients were evaluated clinically for fever and dry cough, radiologically via chest computed tomography (CT) and immunologically via anti-Covid-19 IgG and IgM titers. Variants in CYP2D6 significantly affected the grade of ground glass (CYP2D6∗4 AA carriers showed the higher risk for grade 3) and the risk of positive anti-Covid-19 IgM (CYP2D6∗2XN CC and CYP3A4∗1B AA had the lowest risk), the duration of HCQ, the use of corticosteroids or gender did not affect the Covid-19 status significantly. In general, the outcome of the studied patients receiving HCQ was good (no deaths, no intubation needed). CYP2D6 variants could affect the outcome of Covid-19 infection.

7.
Eur Rev Med Pharmacol Sci ; 25(10): 3923-3932, 2021 May.
Article in English | MEDLINE | ID: covidwho-1264769

ABSTRACT

Angiotensin converting enzyme 2 (ACE2) has potentially conflicting roles in health and disease. COVID-19 coronavirus binds to human cells via ACE2 receptor, which is expressed on almost all body organs. Boosting the ACE2 receptor levels on heart and lung cells may provide more cellular enter to virus thereby worsening the infection. Therefore, among the drug targets, ACE2 is suggested as a vital target of COVID-19 therapy. This hypothesis is based on the protective role of the drugs acting on ACE2. Therefore, this review discusses the impact and challenges of using ACE2 as a target in the current therapy of COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/antagonists & inhibitors , Antiviral Agents/chemistry , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/chemistry , Adenosine Monophosphate/metabolism , Adenosine Monophosphate/therapeutic use , Alanine/analogs & derivatives , Alanine/chemistry , Alanine/metabolism , Alanine/therapeutic use , Angiotensin-Converting Enzyme 2/metabolism , Anti-Inflammatory Agents, Non-Steroidal/chemistry , Anti-Inflammatory Agents, Non-Steroidal/metabolism , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antiviral Agents/metabolism , Antiviral Agents/therapeutic use , Azithromycin/chemistry , Azithromycin/metabolism , Azithromycin/therapeutic use , COVID-19/drug therapy , COVID-19/virology , Humans , Hydroxychloroquine/chemistry , Hydroxychloroquine/metabolism , Hydroxychloroquine/therapeutic use , SARS-CoV-2/isolation & purification , Vitamin D/chemistry , Vitamin D/metabolism , Vitamin D/therapeutic use
8.
Eur Rev Med Pharmacol Sci ; 25(4): 2131-2145, 2021 02.
Article in English | MEDLINE | ID: covidwho-1116634

ABSTRACT

The world is currently facing the COVID-19 pandemic, caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Due to a lack of specific treatment and prophylaxis, protective health measures that can reduce infection severity and COVID-19 mortality are urgently required. Clinical and epidemiological studies have shown that vitamin D deficiency can be linked to an increased risk of viral infection, including COVID-19. Therefore, in this review, we looked at various possible roles of vitamin D in reducing the risk of COVID-19 infection and severity. We describe in this article that individuals at high risk of vitamin D deficiency should consider taking vitamin D supplements to keep optimal concentrations. Moreover, we discuss different possible mechanisms by which vitamin D can efficiently reduce the risk of infections through modulation of innate and adaptive immunity against various types of infections. It is advisable to perform further studies addressing the observed influence of vitamin D levels to reduce the risk of COVID-19 infection and mortality.


Subject(s)
COVID-19/drug therapy , Protective Agents/therapeutic use , SARS-CoV-2 , Vitamin D Deficiency/prevention & control , Vitamin D/therapeutic use , Adaptive Immunity/drug effects , Bystander Effect , COVID-19/immunology , COVID-19/mortality , COVID-19/transmission , Dietary Supplements , Humans , Immunity, Innate/drug effects , Protective Agents/administration & dosage , Severity of Illness Index , Vitamin D/administration & dosage , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/immunology
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