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1.
Journal of Clinical Virology Plus ; : 100103, 2022.
Article in English | MEDLINE | ID: covidwho-2028189

ABSTRACT

There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.

2.
World Journal of Critical Care Medicine ; 11(4):269-297, 2022.
Article in English | MEDLINE | ID: covidwho-2025162

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the physiological and immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and rational design of effective therapies. AIM: To describe the interaction of SARS-CoV-2 with the immune system and the subsequent contribution of hyperinflammation and abnormal immune responses to disease progression together with a complete narrative review of the different immunoadjuvant treatments used so far in COVID-19 and their indication in severe and life-threatening subsets. METHODS: A comprehensive literature search was developed. Authors reviewed the selected manuscripts following the PRISMA recommendations for systematic review and meta-analysis documents and selected the most appropriate. Finally, a recommendation of the use of each treatment was established based on the level of evidence of the articles and documents reviewed. This recommendation was made based on the consensus of all the authors. RESULTS: A brief rationale on the SARS-CoV-2 pathogenesis, immune response, and inflammation was developed. The usefulness of 10 different families of treatments related to inflammation and immunopathogenesis of COVID-19 was reviewed and discussed. Finally, based on the level of scientific evidence, a recommendation was established for each of them. CONCLUSION: Although several promising therapies exist, only the use of corticosteroids and tocilizumab (or sarilumab in absence of this) have demonstrated evidence enough to recommend its use in critically ill patients with COVID-19. Endotypes including both, clinical and biological characteristics can constitute specific targets for better select certain therapies based on an individualized approach to treatment.

3.
Disaster Medicine & Public Health Preparedness ; : 1-22, 2022.
Article in English | MEDLINE | ID: covidwho-2000810

ABSTRACT

OBJECTIVE: The article seeks to assess the Brazilian health system ability to respond to the challenges imposed by the Covid-19 pandemic by measuring the capacity of Brazilian hospitals to care for Covid-19 cases in the 450 Health Regions of the country during the year 2020. Hospital capacity refers to the availability of hospital beds, equipment, and human resources. METHODS: We used longitudinal data from the National Register of Health Facilities (CNES) regarding the availability of resources necessary to care for patients with Covid-19 in inpatient facilities (public or private) from January to December 2020. Among the assessed resources are health professionals (certified nursing assistants, nurses, physical therapists, and doctors), hospital beds (clinical, intermediate care, and intensive care units), and medical equipment (CT scanners, defibrillators, ECG monitors, ventilators, and resuscitators). In addition to conducting a descriptive analysis of absolute and relative data (per 10,000 users), a synthetic indicator named Installed Capacity Index (ICI) was calculated using the multivariate principal component analysis technique to assess hospital capacity. The indicator was further stratified into value ranges to understand its evolution. RESULTS: There was an increase in all selected indicators between January and December 2020. It was possible to observe differences between the Northeast and North regions and the other regions of the country;most Health Regions presented low ICI. The ICI increased between the beginning and the end of 2020, but this evolution differed among Health Regions. The average increase in the ICI was more evident in the groups that already had considerably high baseline capacity in January 2020. CONCLUSION: It was possible to identify inequalities in the hospital capacity to care for patients affected by Covid-19 in the Health Regions of Brazil, with a concentration of low index values in the Northeast and North of the country. As the indicator increased throughout the year 2020, inequalities were also observed. The information here provided may be used by health authorities, providers, and managers in planning and adjusting for future Covid-19 care and in dimensioning the adequate supply of hospital beds, health care professionals, and devices in Health Regions to reduce associated morbidity and mortality. We recommend that the ICI continue to be calculated in the coming months of the pandemic to monitor the capacity in the country's Health Regions.

4.
Research in Education and Learning Innovation Archives-Realia ; - (29):102-115, 2022.
Article in Spanish | Web of Science | ID: covidwho-1988415

ABSTRACT

In early 2020, when the coronavirus pandemic began to affect every area of society, the situation in Brazil was no different from that of other countries. Covid-19 brought the implementation of social isolation measures and led to readjustments in living and working conditions. In turn, this led to readjustments in the conditions of employees and users of public services who wished to access those services. In education, it also created new social inequalities resulting from teachers and students' lack of access to the technologies, tools and programmes they needed. Other issues detected were health and financial problems due to unemployment as well as a lack of policies aimed at reducing the number of working hours. In view of this, the Federal University of Pernambuco (UFPE), the Federal University of Paraiba (UFPB) and the University of Pernambuco (UPE), all of which are located in the northeast of Brazil, carried out an inter-institutional study of factors that influenced the participation of undergraduate students in online classes during the period of social isolation. The aim of this article is to present the partial results from this study in relation to student profile and the infrastructure available to those students to aid their participation in the online classes taught on their respective degree programmes.

5.
Social Science & Medicine ; : 115243, 2022.
Article in English | ScienceDirect | ID: covidwho-1984060

ABSTRACT

Background Transplant rates in Ontario rose steeply in the decade prior to the COVID-19 pandemic. Reasons for that increase remain unclear, but the inter-organizational arrangement of organ donation programs may have contributed. However, there is a paucity of literature investigating these inter-organizational arrangements, with a limited understanding of how communication facilitates organ donation. Understanding these arrangements may help to re-establish rising organ donation rates post-pandemic. Objective To describe interprofessional interactions of Organ and Tissue Donation Coordinators (OTDCs) during organ donation cases, within organ donation programs in Ontario, from an organizational perspective (describing structure, context, process). Methods Mixed-method social network analysis (SNA) approach analyzing 14 organ donation cases just before the COVID-19 pandemic. Results Structure: Social network graphs depict the joint work performed by hospital staff and OTDCs, with a great part of the communication being processed through the OTDC. Context: Network density ranged from 0.05 to 0.24 across cases, and health care professionals perceived an atmosphere of shared vision and trust among team members. Process: Most networks had a degree centralization <0.50 suggesting a decentralized information flow, and participants perceived decisions being jointly made. The characteristic path length of cases ranged from 1.6 to 3.2, suggesting potential for rapid information diffusion. Overall, data reinforced the OTDC role of intermediator within the communication process, and hospital staff perceived OTDCs as central players. Hospital staff and OTDCs reported frustration with some aspects of the flow of information during the organ allocation processes. Conclusion Findings from this study provide a network map of communications within organ donation cases and reinforce the importance of the OTDC role. Opportunities for quality improvement within these processes are identified.

6.
European Journal of Neurology ; 29:592, 2022.
Article in English | EMBASE | ID: covidwho-1978455

ABSTRACT

Background and aims: Person-in-a-barrel syndrome (PIBS) is clinically characterized by brachial diparesis, with preserved cranial and crural muscle strength. It is a rare neurological syndrome most commonly caused by bilateral and symmetric injury of the motor neurons that control the upper limb movements, including bilateral injury to the brain hemispheres, brainstem, cervical spinal cord, brachial plexus, or peripheral nerves. Methods: N/A Results: A 70-year-old male patient with a history of hypertension, dyslipidaemia and hyperuricemia was admitted with an acute and rapidly progressive (10 days of evolution) bilateral upper limb weakness. The patient denied respiratory or gastrointestinal symptoms, fever or recent cervical trauma/pain. Two weeks earlier he was given the first dose of the Pfizer-BioNTech™ vaccine for COVID- 19. The neurological examination revealed severe brachial diparesis and generalized hyporeflexia. Ancillary testing revealed positive serum anti-GM1 and GD1b antibodies. The PCR for SARS-CoV-2 was negative (with positive serum T-Spike antibodies). CSF analysis and Brain/Spinal MRI were normal. The electromyography and nerve conduction studies disclosed diffuse motor conduction blocks in the upper extremities, ultimately fulfilling criteria for Acute Motor Axonal Neuropathy (AMAN) with reversible conduction failure. Intravenous human immunoglobulin (0.4g/kg/day, 5 days) and rehabilitation were started, with subsequent motor improvement. Conclusion: To our knowledge this is the first case of AMAN presenting as PIBS. We intend to highlight that AMAN should be added to the list of causes of this syndrome. The role of the COVID-19 vaccine in this case remains uncertain, and it is not possible, at this moment, to infer causality.

7.
Rev. bioét. (Impr.) ; 30(2): 434-443, abr.-jun. 2022. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1951700

ABSTRACT

Resumo Este estudo busca relacionar as questões bioéticas acerca da quarentena como ferramenta de mitigação da pandemia de covid-19 na sociedade. Trata-se de revisão integrativa da literatura, seguindo os critérios da Preferred Reporting Items for Systematic Reviews and Meta-Analyses nas etapas pertinentes. A busca foi realizada nas bases de dados Biblioteca Virtual em Saúde, PubMed e SciELO, procurando textos publicados entre 2019 e 2020, em inglês, espanhol e português. Dentre os artigos identificados, sete foram selecionados para compor este trabalho, sendo dois dos Estados Unidos, dois da Espanha, um da Finlândia, um da Austrália e um de Bangladesh. Os estudos ressaltam que, apesar de a quarentena e o isolamento serem as únicas estratégias conhecidas até o momento, é necessário desenvolver políticas que levem em consideração os princípios bioéticos, focando, por exemplo, populações em situação de vulnerabilidade social, que necessitam de suporte para estabelecer tal medida.


Abstract This study seeks to relate the bioethical questions about the quarantine as a mitigation tool of the COVID-19 pandemic in society. It is an integrative review, following criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses at the pertinent phases. The search was carried out in the databases Biblioteca Virtual em Saúde, PubMed and SciELO, searching texts published between 2019 and 2020, in English, Spanish and Portuguese. Among the identified articles, seven were selected to be part of this work, of those, two are from the United States, two from Spain, one from Finland, one from Australia, and one from Bangladesh. The studies show that, despite the quarantine and the distancing being the only strategies known up to this moment, developing politics that consider bioethical principles, focusing on, for example, socially vulnerable populations, who need support to establish this measure, is necessary.


Resumen Este estudio pretende relacionar las cuestiones bioéticas sobre la cuarentena como herramienta de mitigación para la pandemia del Covid-19. Esta es una revisión integradora de la literatura basada en los criterios del Preferred Reporting Items for Systematic Reviews and Meta-Analyses en las etapas correspondientes. Se realizó en las bases de datos Biblioteca Virtual en Salud, PubMed y SciELO una búsqueda de artículos publicados entre 2019 y 2020, en inglés, español y portugués. Entre los artículos identificados, se seleccionaron siete: dos de Estados Unidos, dos de España, uno de Finlandia, uno de Australia y uno de Bangladesh. Los estudios destacan que, aunque la cuarentena y el aislamiento son las únicas estrategias conocidas hasta el momento, es necesario desarrollar políticas que tengan en cuenta los principios bioéticos, centrándose, por ejemplo, en las poblaciones en situación de vulnerabilidad social, que necesitan apoyo para cumplir tal medida.

8.
ACTA MEDICA PORTUGUESA ; 35(7-8):606-607, 2022.
Article in English | Web of Science | ID: covidwho-1939526
9.
Curr Med Chem ; 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1923804

ABSTRACT

BACKGROUND AND OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection commonly leads to neurologic manifestations. In the present review, we aimed to investigate potential neuroimaging markers of early diagnosis and prognosis of neurologic manifestations in COVID-19. METHODS: Our study was registered in the Prospective Register of Systematic Reviews (PROSPERO) under the protocol CDR42021265443. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we selected 51 studies for whole-manuscript analysis. RESULTS: Magnetic resonance imaging (MRI) was the most common imaging method. The pattern, sites of lesion, signs, and symptoms of neurologic injury varied. Such manifestations possibly resulted from a direct viral infection or, most likely, from indirect mechanisms including coagulation disturbances, hypoxemia, and immunological responses. CONCLUSION: The heterogeneity of the studies precludes any generalization of the findings. Brain MRI is the most informative imaging exam. Population studies including the entire spectrum of COVID-19 are missing. There is still a need for future population studies evaluating neurologic manifestations of all COVID-19 severities acutely and chronically.

10.
11.
Index de Enfermeria ; 30(3):219-223, 2021.
Article in Spanish | EMBASE | ID: covidwho-1865902

ABSTRACT

Objective: The objective was to analyze the health conditions of people living on the streets, in the COVID-19 scenario, based on the contributions of the Environ-mental Theory. Methods: This is a theoretical-reflexive analysis. Results: Two cate-gories were developed: The dichotomy between living on the street and the Night-ingalian assumptions and;The reality of people living on the street in times of pan-demic by COVID-19. The first category addressed the difference between what is experienced by people on the street and what the Nightingalian assumptions say about health conditions. The second category showed the insertion of these people in the context of prevention measures. Final considerations: It is of fundamental importance to discuss the access to prevention and health promotion strategies by these people and to promote specific actions for the reality in which they live.

12.
Hematology, Transfusion and Cell Therapy ; 43:S524-S525, 2021.
Article in English | EMBASE | ID: covidwho-1859731

ABSTRACT

Introdução: A recuperação intraoperatória de sangue (RIOS) é a prática de transfusão autóloga destinada a recuperar sangue que seria perdido durante cirurgias de médio e grande porte.Sendo as cirurgias cardíacas, vasculares, ortopédicas e transplantes de órgãos sólidos contempladas com este serviço. Com a pandemia da Covid-19 o serviço sofreu um impacto diante do número de procedimentos, onde a quantidade de cirurgias foram afetadas, principalmente por não haver vagas em unidades de terapia intensiva no pós-operatório, vale ressaltar a exposição da equipe nos hospitais que continuam operando mesmo em menor fluxo e atendendo pacientes infectados pela covid. Objetivo: Comparar a demanda dos procedimentos da Rios durante a pandemia da Covid-19 em relação a utilização em anos anteriores. Método: Trata-se de um estudo descritivo analítico em formato de relato de experiência, vivenciado pela equipe composta por enfermeiras em regime de sobreaviso em um serviço de hemoterapia, disponível 24h por dia no Centro de Hematologia e Hemoterapia do estado do Ceará. Usando dados no período de 2018 a junho de 2021. Resultados: Após analisar o número de procedimentos realizados nos anos anteriores a pandemia, identificou-se uma redução na utilização do serviço. Em 2018 foram 1.029 procedimentos, 2019 1.237 procedimentos, 2020 foram 942 procedimentos e 2021 foram 395 procedimentos até junho. Observamos que houve um crescimento de 23 % entre 2018 e 2019, pois houve a conscientização dos profissionais em relação a importância do serviço para os pacientes, no intuito de minimizar os riscos da transfusão sanguínea, e a redução veio em 2020 com o início da pandemia, devido a restrição de cirurgias eletivas, transplantes, equipes e o acesso e disponibilidade aos leitos de terapia intensiva. Considerações finais: A atuação da RIOS é de importância, pois minimiza os riscos transfusionais para os pacientes ao diminuir a quantidade de transfusão alogênica, diante o cenário atual da pandemia da Covid-19, o serviço sofreu uma redução considerável de procedimentos.

13.
Revista Cubana de Informacion en Ciencias de la Salud ; 33, 2022.
Article in Portuguese | Scopus | ID: covidwho-1842691

ABSTRACT

The phenomenon called infodemia refers to the increase in the volume of information on a specific topic, which multiplies rapidly in a short period of time, and has stood out in the context of the health crisis triggered by the COVID-19 pandemic. Too much information can trigger feelings of fear, anxiety, stress, and other conditions of mental distress. The study aims to describe the profile of exposure to information about COVID-19 and its repercussions on the mental health of elderly Brazilians. This is a cross-sectional study carried out with 1924 elderly Brazilians. Data were collected through a web-based survey sent to the elderly via social networks and email, from July to October 2020. The results of the descriptive analysis of the data show that most of the elderly were aged between 60 and 69 years (69.02%), female (71.26%), married (53.79%) and white (75.57%). About 21.67% (n = 417) concluded their graduation, 19.75% (380) concluded their specialization and 16.63% (320) concluded their master's or doctoral degrees. Television 862 (44.80%) and social networks 651 (33.84%) were reported as frequent sources of exposure to news or information about COVID-19. Participants indicated that television (46.47%;n = 872), social networks (30.81%;n = 575) and radio (14.48%;251) affected them psychologically and/or physically. Receiving fake news about COVID-19 on television (n = 482;19.8%) and on social media (n = 415;21.5%) mainly resulted in stress and fear. The disseminated information contributes to awareness, but also affects physically and/or psychologically many elderly people, mainly generating fear and stress. © 2022, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.

14.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816919

ABSTRACT

Cancer patients display immunomodulation related to malignancy and anti-cancer therapies, but how these factors impact COVID-19 remains unknown. To investigate immune responses in cancer patients with COVID-19, we undertook a prospective case-control study, enrolling hospitalized solid tumor patients with acute COVID-19, as well as age-, gender-, and comorbidity-matched COVID-19 patients without cancer as controls. Using biospecimens collected during hospitalization, we performed virologic measurements as well as in-depth immunophenotyping of cellular, antibody and cytokine responses. We enrolled 17 cancer patients (cases) admitted to Yale-New Haven Hospital between March 15 and June 30, 2020 with COVID-19, as well as 17 matched non-cancer patients (controls) admitted with COVID-19. No significant differences were observed between cases and controls based on patient characteristics (age, gender, race, co-morbidities, smoking history, days from symptom onset to COVID-19 diagnosis) or outcomes (COVID-19 severity, length of hospital stay, rate of intubation or mortality). The most common primary tumor sites were lung (4/17) and gastrointestinal (4/17);all cases had received cancer-directed therapy within 6 months of COVID-19 diagnosis, with 13/17 receiving treatment less than 1 month prior to hospitalization. Three of 17 cases had received immune checkpoint inhibitor therapies. Despite having similar SARS-CoV-2 viral RNA loads at the time of COVID-19 diagnosis when compared with controls, cancer cases had increased viral RNA abundance during hospitalization, suggesting slower clearance. Antibody responses against SARS-CoV-2 were preserved in cancer cases, with cases displaying similar levels of IgM and IgG antibodies directed against SARS-CoV-2 epitopes compared to controls. Cytokine profiling revealed higher plasma levels of CCL3, IL1A and CXCL12 in cancer cases compared to controls. Using flow cytometric immunophenotyping, we found that innate immune and non-T cell adaptive immune parameters were similar between cases and controls hospitalized with COVID-19. However, among cancer cases on conventional therapies, T cell lymphopenia was more profound, and these cases demonstrated higher levels of CD8+ exhausted (CD8+CD45RA-PD1+TIM3+ ), CD8+GranzymeB+ and CD4+CD38+HLA-DR+ and CD8+CD38+HLA-DR+ activated T cells when compared with controls;interestingly, these differences were not observed in patients who had received immune checkpoint inhibition. Thus, we found reduced viral RNA clearance and specific alterations in T cell and cytokine responses in cancer patients hospitalized with COVID-19 compared with matched controls with COVID-19. This dysregulated T cell response in cancer patients, which may reflect immune modulation due to chronic antigen stimulation as well as cancer therapies, may lead to altered virologic and clinical outcomes in this population.

15.
Wounds UK ; 18(1):34-41, 2022.
Article in English | EMBASE | ID: covidwho-1812598

ABSTRACT

Background: Understanding the burden of surgical site infection (SSI) requires comprehensive, reliable and comparable data. However, many hospitals do not routinely collect information on wound healing after the patient leaves hospital. Aim: To evaluate five post-discharge surveillance strategies that collect patient/carer reported outcomes on wound healing following adult and paediatric surgery. Method: Between March 2020 and February 2021, colleagues from five specialist hospitals in England collaborated to collect baseline and compliance data for the different methods of postdischarge surveillance. The five methods included were telephone follow-up;postal questionnaires;postal questionnaires and contacting non-responders by telephone to asking patients to install a postoperative app on their personal smartphone (Medopad, Huma) and using a SSI surveillance text link, which did not need to be installed (Isla, Islacare Ltd). Results: Overall, 1432 patients out of 2116 patients provided information about their wound after discharge. The group of patients who were asked to install an app on their smart device had the lowest return rate for information on their wound, while the system that used a text link and did not need to be installed had one of the highest return rates. Conclusion: Understanding baseline practice and evaluating different methods of discharge surveillance may help to drive improvement in this area. Our early findings suggest that in practice, a SSI surveillance approach using a text link and photos, such as Isla, which is used in hospital before discharge by staff and post-discharge by patients warrants further attention.

16.
Humanidades & Inovacao ; 8(62):167-185, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1790574

ABSTRACT

The present research investigated, from the perceptions of (denominated) articulating teachers of a continuing formative teacher process carried out in Rondonia State, by Emergency Remote Teaching, learnings, difficulties and the incidence of Collaborative Work (CW). The Vygotskian perspective on the importance of the other for learning process and the systematizations of CW by Costa and Damiani were adopted. The data, collected through online questionnaire and participant observation, analyzed through discursive textual analysis, suggest that: the most relevant learnings were those related to the use of technologies;the content about BNCC was also mentioned by them, but with less incidence;the main adversities pointed out were the precarious internet in the cities and the teachers difficulties on the use of emerging technologies;most of them (82%) answered that there were CW activities during the training, highlighting key-expressions such as: teamwork, mutual help, shared leadership, dialogue, exchange of experiences and collective learning.

17.
European Journal of Obstetrics & Gynecology & Reproductive Biology ; 270:N.PAG-N.PAG, 2022.
Article in English | Academic Search Complete | ID: covidwho-1748059
18.
19.
Open Forum Infectious Diseases ; 8(SUPPL 1):S256, 2021.
Article in English | EMBASE | ID: covidwho-1746694

ABSTRACT

Background. Since the onset of the 2019 coronavirus disease 2019 (COVID-19) pandemic, the rapid increase in community-acquired pneumonia (CAP) cases has led to an excessive rate of intensive care units (ICU) admissions, a rate varying between 5-18%, depending on the country. Consequently, the study of serum biomarkers, such as D-dimer, have been utilized to identify patient with severe disease. However, further data is needed to confirm the association between this serum concentration of D-dimer and the risk of ICU admission. Thus, the aim of this study was to determine if serum concentration of D-dimer predict the risk of ICU admission in patients with COVID-19 and CAP. Methods. A prospective observational study was carried out at the Clinica Universidad de La Sabana, Colombia. Patients older than 18 years old, hospitalized for COVID-19 or CAP were included. Then, patients were stratified into ICU and non-ICU patients. Plasma samples were collected within the first 24 hours of hospital admission to quantify D-dimer using the PATHFAST system. Concentrations were compared among groups and to assess the biomarker capacity to predict ICU admission risk, ROC curves were used. Finally, a DeLong test was applied to compare their differences. Results. A total of 240 patients diagnosed with lower respiratory tract infection were included in the study. 88 patients were COVID-19 negative (CAP) and 152 were positive. Plasma concentrations of D-dimer (μg/ml) were significantly higher in COVID-19 patients admitted to the ICU when compared with non-ICU COVID-19 admitted patients (Median [IQR];1.54 [0.9-3.25] Vs. 1.13 [0.69-1.69], p=0.005). The area under curve (AUC) ROC to predict ICU admission was 0.62 among COVID-19 patients. DeLong's test p value was 0.24. Serum D-dimer an ICU admission Conclusion. D-dimer seems to be a promising tool to identify COVID-19 patients with disease. However, this predicting capacity was not observed in CAP patients. Further studies are needed to identify the mechanisms underling the elevation of D-dimer in COVID-19 patients.

20.
Open Forum Infectious Diseases ; 8(SUPPL 1):S265, 2021.
Article in English | EMBASE | ID: covidwho-1746674

ABSTRACT

Background. Lower respiratory tract infections such as community-acquired pneumonia (CAP) and coronavirus disease 2019 (COVID-19) are the main current causes of mortality worldwide. Several scores and biomarkers have been proposed to identify patients at risk of dying, with unclear results. Presepsin is a glycoprotein expressed on the surface of the membrane of monocytes and macrophages and its utility has been proven in sepsis as a predictor of severity and treatment response. However, it is unknown the utility of this biomarker as a mortality predictor among COVID-19 and CAP patients. Thus, the aim of this study was to determine the utility of serum presepsin to identify patients at risk of dying due to COVID-19 and CAP. Methods. A prospective observational study was conducted at Clinica Universidad de La Sabana, Colombia. We included 240 patients who required hospital admission due to CAP or COVID-19. Plasma samples were collected within 24 hours of admission. The presepsin concentration was quantified using the PATHFAST system. Afterwards, a two-tailed test was used to compare mortality rates among patients and their presepsin plasma concentration. Lastly, the ROC was calculated to determine presepsin's sensibility as a mortality predictor. Results. A total of 88 patients with CAP and 152 patients with COVID-19 were included in the study. The median [with IQR] in Presepsin plasma concentration was higher in all patients who died (920 [573 - 2340] vs 573 [307,5 - 1052,5], p-value< 0.0001). Furthermore, comparing to the study group, the median concentration of presepsin was higher in patients deceased by COVID-19 than those who survived. (1358 [642,8 - 2976,8] vs 570 [333,2 - 1007,5], p-value< 0.0001). In addition, the area under the curve (AUC) ROC of presepsin to predict risk of mortality was 0.769. DeLong's test comparing ROC curves in COVID-19 and CAP patients had a p-value=0.073. Conclusion. Plasma concentrations of presepsin plasma were higher among COVID-19 patients who died. Moreover, serum concentration of presepsin were not useful to identify CAP patients at risk of dying. However, practical use of Presepsin as a prognostic biomarker of severity is yet to be assessed as further studies are needed.

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