The Use of Acute-Phase Proteins Apache Ii and Sofa to Predict the Mortality of Covid-19 Patients

Objective: Acute-phase proteins are a family of proteins synthesized by the liver. With this study, we aimed to investigate the effects of COVID-19 infection on acute phase reactants (AFR) and determine the usability of AFRs as prognostic factors in COVID-19 disease. Material(s) and Method(s): Serum samples taken for routine analysis of the patients admitted to the Emergency Department and diagnosed with COVID-19, were used. AFR levels of 30 patients who resulted in mortality and 30 recovered patients were evaluated. C-reactive protein (CRP), ferritin (FER), ceruloplasmin (Cp), albumin (Alb), prealbumin (Prealb), transferrin (Trf), lactate, Acute Physiology and Chronic Health Evaluation (APACHE), and Sequential Organ Failure Assessment (SOFA) assessment was performed. Result(s): The hazard ratio and 95% confidence interval for FER, CRP, lactate, Alb, Cp, Prealb, Trf, Age, SOFA, and APACHE were 1.001 (1.000-1.001), 1.005 (1.001- 1.008), 1.141 (1.016-1.243), 1.016 (0.740-1.399), 1.016 (0.740-1.399), 1.056 (1.017-1.100), 0.978 (0.917-1.035), 1.000 (0.995-1.006), 1.032 (1.004- 1.064), 1.104 (0.971-1.247), and 1.012 (0.974-1.051), respectively, in univariable model. Only CRP, lactate, and FER found significant in multivariable model. In addition, patients in the nonsurvivors group had significantly higher FER, CRP, lactate, APACHE, age, and SOFA. Nonsurvivors also had lower Alb, Prealb, and serum Trf level compared to survivors. Conclusion(s): CRP, lactate, and FER, which we have shown to be significantly higher in severe COVID-19 patients, will be valuable parameters that will contribute to clinical improvement if they are used in the follow-up of patients due to their easy measurement and predictive values.Copyright © 2023, Nobelmedicus. All rights reserved.

The Importance of Acute Phase Proteins in the Evaluation of Critical Covid-19 Patient Prognosis

Objectives: Identifying COVID-19 patients with risk of adverse outcomes at first admission to the intensive care unit has several diagnostic challenges. The concentration of acute phase proteins synthesized by the liver increases or decreases markedly in the serum following inflammation and infection. This study aimed to investigate the predictive value of acute phase proteins in critically ill COVID-19 patients and to evaluate the efficacy of inflammatory markers in predicting mortality risk in the intensive care unit. Material-Methods: A retrospective study was conducted in critically ill COVID-19 patients treated in the intensive care unit. Overall, 123 patients with ARDS and/or multi-organ dysfunction were included in the first 24 hours of admission to intensive care unit. After 28 days, groups of survived (n=54) and dead patient (n=69) or groups of patients with (n=83) and without (n=40) invasive mechanical ventilation were formed. Serum amyloid A, C-reactive protein, albumin, and prealbumin values considered as acute phase proteins within the first 24 hours of admission to the intensive care unit were compared between groups. Result(s): Albumin and prealbumin levels significantly decreased in dead patients (p=0.011, p<0.001, respectively) and were mechanically ventilated patients (p=0.010, p=0.006, respectively). The Serum amyloid A levels in mechanically ventilated patients significantly increased (p=0.022). Conclusion(s): Low prealbumin and albumin levels and high serum amyloid A levels during admission to ICU can be used as a prognostic marker of disease severity and mortality.

Evaluation of Salivary Galectin-3 Level and its Potential Role in Increasing the Severity of COVID-19 Infection in Patients with Periodontitis

Aim: To evaluate and compare the salivary galectin-3 (Gal-3) level in chronic periodontitis patients, coronavirus disease 2019 (COVID-19) patients, and patients with COVID-19 + periodontitis and thus determining the risk of periodontitis in increasing the severity of COVID-19 infection. Materials and methods: For the present study, a total of 77 participants were recruited to the study with 20 healthy controls (group I), 20 patients with chronic generalized periodontitis (group II), 19 COVID-19 patients (group III), and 18 with COVID-19 and periodontitis (group IV). Demographic characteristics and periodontal clinical parameters like plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded for all patients. Saliva samples were collected and Gal-3 levels were assessed using enzyme-linked immunosorbent assay (ELISA) kit. One-way analysis of variance (ANOVA) analysis and Tukey's honest significant difference post hoc tests were carried out for data analysis. Results: Group IV patients had a higher concentration of salivary Gal-3 (15.50 ng/mL) than that of group III (10.247 ng/mL) and group II (12.340 ng/mL), and the mean difference in Gal-3 level was statistically significant with the p-value 0.000. The mean PPD, CAL, and PI were significantly high in groups II and IV compared to groups I and II with a p-value of 0.000. Conclusion: The result of the present study showed that patients with periodontitis and periodontitis + COVID-19 presented significant higher salivary Gal-3 levels in comparison with COVID-19 patients and healthy subjects. Thus periodontitis can be a risk factor in increasing the severity of COVID-19 infection. Clinical significance: This study was carried out to evaluate whether periodontitis is a risk factor for increasing the severity of COVID-19 infection. This study also highlights the importance of maintaining good oral hygiene and periodontal health in preventing COVID-19 severity. © The Author(s). 2023.

Evaluation of Pentraxin 3 Utility in Predicting Mortality in Geriatric Patients with Covid-19: A Prospective Study

Introduction: The clinical spectrum of coronavirus disease (COVID-19) ranges from mild upper respiratory tract infections to fulminant pneumonia. Nevertheless, it is associated with high rates of morbidity and mortality in elderly individuals. The present study aimed to investigate the levels of pentraxin 3 in geriatric patients with COVID-19 and to determine whether it could serve as a marker for predicting mortality. Material(s) and Method(s): This study included patients aged >= 65 years who were diagnosed with COVID-19 infection and admitted to the pandemic ward between October 2021 and march 2022. The patients were classified into two groups: survivors and nonsurvivors. Result(s): Of the 95 geriatric patients included in this study, 20 (21%) died and 75 (79%) were discharged upon full recovery. There was a significant difference between male and female patients in terms of mortality. Shortness of breath was noted in 19 nonsurvivors and 9 survivors (p < 0.05). The median pentraxin 3 level was 5.8 ng/mL (1-20) for all patients, 3.92 ng/mL (1-19.6) for survivors, and 6.3 ng/mL (4.1-20) for nonsurvivors (p < 0.001). The area under the curve in the receiver operating characteristic curve analysis for pentraxin 3 was 0.596 (p = 0.04) to predict mortality. The likelihood ratio test revealed a cutoff value of 4.43 ng/mL (sensitivity: 57.1% and specificity: 70.5%) for pentraxin 3. Conclusion(s): Pentraxin 3 was found to be a novel biomarker for predicting mortality in geriatric patients with COVID-19, and it was investigated for the first time in this special population. Copyright © 2022, Geriatrics Society. All rights reserved.

Cholecalciferol as part of complex therapy for acute COVID-19

During the pandemic of new coronavirus infection, the prevalence of moderate to severe vitamin D deficiency remains high, which is a factor worsening the course of COVID-19. According to some studies, cholecalciferol therapy, added to standard COVID-19 ther-apy, is associated with improving the course and prognosis of the disease. Objective. To evaluate the effect of cholecalciferol therapy at a dose of 100,000 IU on clinical and laboratory parameters in patients with moderate to severe COVID-19 admitted to an infectious hospital. Material and methods. An open single-center interventional study included 129 COVID-19 patients who were further randomized into two groups. Group 1 patients (n=65) received a total dose of 100,000 IU of cholecalciferol in addition to the standard COVID-19 therapy. Group 2 patients (n=64) received standard therapy only. Results. On day 9 of hospitalization, group 1 patients (receiving cholecalciferol) showed a 40.7% increase in serum 25(OH)D level, while group 2 patients (without cholecalciferol therapy) showed a negative trend (p<0.001). In addition, group 1 patients showed higher neutrophil and lymphocyte counts (p=0.047;p=0.025), and a lower level of C-reactive protein (p=0.028). A negative association was found between 25(OH)D levels and CRP values and between 25(OH)D levels and the length of hospital stay. Conclusion. Adding cholecalciferol as a bolus dose to standard COVID-19 therapy has a positive effect on the disease's clinical course and inflammatory markers' levels. Copyright © K.A. GOLOVATYUK, T.L. KARONOVA, A.A. MIKHAILOVA, D.I. LAGUTINA, A.T. CHERNIKOVA, E.YU. VASILIEVA, E.V. SHLYAKHTO.

Usefulness of CRP as a prognostic marker in the clinical course of Covid-19 infection during the three waves: A retrospective study

Introduction: COVID-19 is an emerging public health problem. It comprises of a large virus family causing varying infection ranging from common cold to more severe infection. Classification of cases into mid, moderate, severe helps for effective management and treatment. CRP is a highly sensitive biomarker for inflammation, tissue damage. Materials and Methods: A retrospective cohort study was done during March 2020 to Feb 2021. Total 2,239 patients were included in the study. CRP levels were measured in hospitalized patients on the day of admission. Statistical Analysis: Continuous variables are presented as Mean ± standard deviation and Median (Q1, Q3). Qualitative variables are presented as frequency and percentage. The continuous variables were compared using independent t test, one-way analysis of variance or Kruskal-Wallis test. Receiver operating characteristic curves (ROC) were constructed to identify the predictability and best cut-offs of variables to differentiate moderate illness from severe-critical illness, severe illness from critical illness, and survivors from non-survivors. A two-tailed P value <0.05 was considered statistically significant. Results: We found a significant increase in CRP values in patients with critical illness in wave-1 and wave-2. The levels of CRP increased as the severity of disease progressed. The CRP had a sensitivity of 71.3% and specificity of 59.8% in critically ill patients in wave-1. In wave-2, the sensitivity of 70.10% and specificity of 56% in critically ill patients. In wave-3, the sensitivity of 75% and specificity of 20.3% in severely ill patients. This indicates that CRP can be used as a marker for disease progression. The Youden index J is 0.3978 and the association criterion is >1.85. Conclusion: CRP is a simple test that helps in initiating primary care. It indicates the severity of disease in COVID-19 infection. CRP can be used as a marker for disease progression and also indicates the severity of lung involvement. © 2022 by the Author(s).

Plasma markers of COVID-19 severity: a pilot study.

BACKGROUND: SARS-CoV-2 infected patients show heterogeneous clinical presentations ranging from mild symptoms to severe respiratory failure and death. Consequently, various markers reflect this wide spectrum of disease presentations. METHODS: Our pilot cohort included moderate (n = 10) and severe (n = 10) COVID-19 patients, and 10 healthy controls. We determined plasma levels of nine acute phase proteins (APPs) by nephelometry, and full-length (M65), caspase-cleaved (M30) cytokeratin 18, and ADAMTS13 (a disintegrin-like and metalloprotease with thrombospondin type-1 motif 13) by ELISA. In addition, we examined whole plasma N-glycosylation by capillary gel electrophoresis coupled to laser-induced fluorescence detection (CGE-LIF). RESULTS: When compared to controls, COVID-19 patients had significantly lower concentrations of ADAMTS13 and albumin (ALB) but higher M30, M65, α1-acid glycoprotein (AGP), α1-antitrypsin (AAT), ceruloplasmin (CP), haptoglobin (HP), and high-sensitivity C-reactive protein (hs-CRP). The concentrations of α1-antichymotrypsin (ACT), α2-macroglobulin (A2MG) and serum amyloid A (SAA) proteins did not differ. We found significantly higher levels of AAT and M65 but lower ALB in severe compared to moderate COVID-19 patients. N-glycan analysis of the serum proteome revealed increased levels of oligomannose- and sialylated di-antennary glycans and decreased non-sialylated di-antennary glycan A2G2 in COVID-19 patients compared to controls. CONCLUSIONS: COVID-19-associated changes in levels and N-glycosylation of specific plasma proteins highlight complexity of inflammatory process and grant further investigations.

Evaluation of fetuin-A, CRP, and CRP/fetuin-A values in COVID-19 patients

Objectives: Fetuin-A, a glycoprotein with several functions, is also a negative acute phase reactant. The purpose of this study was to investigate levels of serum fetuin-A in coronavirus disease 2019 (COVID-19) patients, its association with disease severity, and whether it has superiority over C-reactive protein (CRP). Methods: The research comprised 56 individuals with COVID-19(+) and 30 healthy controls. The COVID-19(+) patient population was split into three subgroups: mild, moderate, and severe. All participants' serum concentrations of fetuin-A, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were measured using ELISA commercial test kits. In addition, CRP and other biochemical values from biochemistry laboratory data were gathered, and the CRP/fetuin-A ratio was calculated. Results: The fetuin-A concentration of the COVID-19(+) patient group was shown to be statistically lower than that of the healthy control group. TNF-α and IL-6 levels were found to be significantly different in both groups. While fetuin-A had a higher area under the curve (AUC) value than CRP (0.875 and 0.800, respectively), CRP/fetuin-A had the strongest AUC (0.933). Conclusion: Low serum fetuin-A concentrations in COVID-19 patients suggest that fetuin-A is a negative acute phase reactant for severe acute respiratory syndrome coronavirus 2. Furthermore, fetuin-A alone and CRP/fetuin-A value are both contenders for being more remarkable markers than CRP. [ FROM AUTHOR] Copyright of International Journal of Medical Biochemistry is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The pathogenicity of COVID-19 and the role of pentraxin-3: An updated review study.

In recent years, the COVID-19 pandemic has become one of the most crucial scientific issues in the world, and efforts to eradicate the disease are still ongoing. The acute inflammatory reaction associated with this disease is associated with several complications such as cytokine storm, multiple organ damage, lung fibrosis, and blood clots. PTX3, as part of the humoral innate immune systems, is one of the acute-phase proteins that perform various functions, such as modulating inflammation, repairing tissue, and recruiting immune cells. PTX3 is increased in people with SARS-CoV-2, and its level decreases with proper treatment. Therefore, it can be regarded as a suitable marker for the prognosis of the COVID-19 and evaluating the effectiveness of the treatment method applied. However, some studies have shown that PTX3 can be a double-edged sword and develop tumors by providing an immunosuppressive environment.

Plasma D-dimer value corrected by inflammatory markers in patients with SARS-CoV-2 infection: Its prognostic value in the diagnosis of venous thromboembolism.

Introduction: D-dimer levels are elevated in COVID 19 and they correlate to the levels of other inflammatory markers such us ferritin, fibrinogen and C-reactive protein. It may be possible to correct D-dimer value in function of inflammatory markers, thus identifying patients at higher risk of venous thromboembolism (VTE). Our objectives are estimating a corrected value of plasma D-dimer as a linear function of ferritin, C-reactive protein and fibrinogen and stablishing a cut-off point of high probability of VTE. Patients and methods: Age and sex matched case-control study of all patients diagnosed with COVID 19 and VTE between March and May 2020 in a tertiary hospital in Madrid (Spain). Using linear regression, the best predictive model will be estimated and residual D-dimer values will be obtained and analyzed using ROC curves to determine its discriminative performance. Results: Thirty-eight cases and seventy-six controls were included. There was 63.2% of men and mean age was 68.2. D-dimer was best predicted by a linear model including fibrinogen, ferritin and C-reactive protein. Using residual values, the optimal cutoff point was 2165 ng/mL, with a sensitivity of 57.9% and specificity of 98.7%. Conclusion: It is possible to estimate a D-dimer corrected value in function of ferritin, C-reactive protein and fibrinogen. Using the observed and estimated value we can obtain a residual value that performs well as a screening method to detect patients who would benefit for further VTE diagnostic testing.

Introducción: El dímero-D está elevado en la COVID-19 y se correlacionan con los niveles de otros marcadores inflamatorios como ferritina, fibrinógeno y proteína C reactiva. Cabe la posibilidad de corregir el dímero-D en función de dichos marcadores inflamatorios, identificando así los pacientes con mayor riesgo de enfermedad tromboembólica venosa (ETV). Nuestros objetivos son estimar un valor corregido de dímero-D como función lineal de ferritina, proteína C reactiva y fibrinógeno, y establecer un punto de corte de alta probabilidad de ETV. Pacientes y métodos: Estudio de casos y controles emparejados por sexo y edad de todos los pacientes diagnosticados con COVID-19 y ETV entre marzo y mayo de 2020 en un hospital terciario de Madrid, España. Mediante regresión lineal, se estima el mejor modelo predictivo y se obtiene el valor residual de dímero-D. Este se analizará con curvas ROC para determinar su capacidad discriminativa. Resultados: Se incluyeron 38 casos y 76 controles. Había un 63,2% de varones y la edad media fue de 68,2 años. El valor de dímero-D fue predicho por un modelo que incluyó fibrinógeno, ferritina y proteína C reactiva. Usando los valores residuales, el punto de corte óptimo estimado de 2.165 ng/ml, con una sensibilidad del 57,9% y una especificidad del 98,7%. Conclusiones: Es posible estimar un valor corregido de dímero-D en función de ferritina, fibrinógeno y proteína C reactiva. Usando el valor observado y estimado podemos obtener un valor residual que funciona bien como método de cribado para detectar pacientes que podrían beneficiarse de más estudios diagnósticos de la ETV.

Analýza pacientů se závažnou zlomeninou s a bez infekce COVID-19

PURPOSE OF THE STUDY As in orthopedic trauma patients, a hyperinflammatory response due to cytokine release occurs in patients with moderate and severe COVID-19 infection. In these patients, untimely surgical intervention can create more destructive situations in the postoperative period. Our aim in this study was to investigate the effect of COVID-19, trauma and surgical intervention on acute phase reactants' levels in patients with and without COVID-19 infection. MATERIAL AND METHODS Twenty-four patients diagnosed with COVID-19 infection and major fractures requiring surgical treatment were evaluated retrospectively (Group 1). Twenty-four COVID-19 negative patients with similar trauma were included in the study as a control group (Group 2). These two groups were compared in terms of demographic data, time to surgery, total hospitalization time, and preoperative and postoperative acute phase reactants' [C-reactive protein (CRP), D-dimer, ferritin, fibrinogen and white blood cell (WBC)] values. RESULTS Time to surgery was 8.3 ± 0.7 days and the total hospital stay was 15.2 ± 0.8 days, in Group 1. These values were determined as 3.3 ± 0.4 and 6.5 ± 0.6 days, respectively for the patients in Group 2 (p < 0.001 and p < 0.001, respectively). When the acute phase reactant values studied during admission were examined, a significant difference was found between the two groups in terms of CRP, D-dimer, ferritin and WBC (p = 0009, p = 0.002, p < 0.001 and p < 0.001, respectively). In the preoperative period, a significant difference was observed between the groups in terms of CRP and ferritin (p = 0.011, p < 0.001, respectively). A significant difference was found only in terms of ferritin from the laboratory values studied in the postoperative period (p < 0.001). DISCUSSION To our knowledge, the present study is the first study which compares and investigates the effects of COVID-19 infection, major fracture and surgical intervention on acute phase reactants' values. Surgical treatment is generally recommended as soon as possible in daily orthopedic practice. However, in patients with asymptomatic or mildly symptomatic COVID-19 infection, it remains unclear how long surgical intervention will be delayed after admission and clinical stabilization of patients with a fracture that requires surgical fixation. In a meta-analysis, patients with COVID-19 infection accompanying hip fracture had a mortality rate of 32.6% in the early postoperative period, and the mortality risk of these patients was found to be 5.66 times higher compared to patients without COVID-19 infection. In our study, one patient (4.2%) with COVID-19 infection who underwent partial hip arthroplasty due to femoral neck fracture. CONCLUSIONS The follow-up and treatment of patients with COVID-19 infection with accompanying a major fracture requiring orthopedic surgery is a complex situation. We recommend that acute phase reactants such as CRP, D-dimer, erythrocyte sedimentation rate (ESR), and ferritin should be closely monitored in these patients during the period from admission to surgery, and surgical intervention should be performed while these values are in remission or decline. Key words: COVID-19, fracture, trauma, acute phase reactants, surgical timing.

SARS-CoV-2 Infection Triggers Auto-Immune Response in ARDS.

Acute respiratory distress syndrome (ARDS) is a severe pulmonary disease, which is one of the major complications in COVID-19 patients. Dysregulation of the immune system and imbalances in cytokine release and immune cell activation are involved in SARS-CoV-2 infection. Here, the inflammatory, antigen, and auto-immune profile of patients presenting COVID-19-associated severe ARDS has been analyzed using functional proteomics approaches. Both, innate and humoral responses have been characterized through acute-phase protein network and auto-antibody signature. Severity and sepsis by SARS-CoV-2 emerged to be correlated with auto-immune profiles of patients and define their clinical progression, which could provide novel perspectives in therapeutics development and biomarkers of COVID-19 patients. Humoral response in COVID-19 patients' profile separates with significant differences patients with or without ARDS. Furthermore, we found that this profile can be correlated with COVID-19 severity and results more common in elderly patients.

Latent tuberculosis co-infection is associated with heightened levels of humoral, cytokine and acute phase responses in seropositive SARS-CoV-2 infection.

OBJECTIVES: Latent Tuberculosis infection (LTBI) is postulated to modulate immune responses and alter disease severity in SARS-CoV-2 co-infection. However, no data exist on the effect of LTBI on the immune responses in SARS-CoV-2 co-infected individuals. METHODS: We examined the SARS-CoV-2 specific antibody responses, plasma cytokines, chemokines, acute phase proteins and growth factor levels in LTBI positive and negative individuals with SARS-CoV-2 infection. RESULTS: Our results demonstrated that individuals with LTBI (LTBI+) and seropositive for SARS-CoV-2 infection were associated with elevated SARS-CoV-2 specific IgM, IgG and IgA antibodies, as well as enhanced neutralization activity compared to those negative for LTBI (LTBI-) individuals. Our results also demonstrate that LTBI+ individuals exhibited significantly higher plasma levels of IFNγ, IL-2, TNFα, IL-1α, IL-1ß, IL-6, IL-12, IL-15, IL-17, IL-3, GM-CSF, IL-10, IL-25, IL-33, CCL3 and CXCL10 compared to LTBI- individuals. Finally, our results show that LTBI+ individuals exhibit significantly higher levels of C-reactive protein, alpha-2 macroglobulin, VEGF and TGFα compared to LTBI- individuals. CONCLUSIONS: Thus, our data clearly demonstrates that LTBI+ individuals seropositive for SARS-CoV-2 infection exhibit heightened levels of humoral, cytokine and acute phase responses compared to LTBI- individuals. Thus, LTBI is associated with modulation of antibody and cytokine responses as well as systemic inflammation in individuals seropositive for SARS-CoV-2 infection.

Systemic Inflammation and Microbial Translocation Are Characteristic Features of SARS-CoV-2-Related Multisystem Inflammatory Syndrome in Children.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a rare manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that can result in increased morbidity and mortality. The inflammatory underpinnings of MIS-C have not been examined in detail. METHODS: We examined the plasma levels of acute phase proteins and microbial translocation markers in children with MIS-C, children with acute coronavirus disease 2019 (COVID-19) infection, SARS-CoV-2-seropositive children, and controls. RESULTS: MIS-C children exhibited significantly higher levels of C-reactive protein (CRP), alpha2 macroglobulin (α2M), serum amyloid P (SAP), lipopolysaccharide (LPS), sCD14, and LPS binding protein (LBP) and significantly lower levels of haptoglobin (Hp) in comparison with seropositive, control, and/or COVID-19 children. In addition, COVID-19 children exhibited significantly higher levels of most of the above markers in comparison with seropositive and control children. Principal component analysis using a set of these markers could clearly discriminate MIS-C and COVID-19 from seropositive and control children. MIS-C children requiring pediatric intensive care unit admission and COVID-19 children with severe disease had higher levels of CRP, SAP, and/or sCD14 at admission. CONCLUSIONS: Our study describes the role of systemic inflammation and microbial translocation markers in children with MIS-C and COVID-19 and therefore helps in advancing our understanding of the pathogenesis of different presentations of SARS-CoV-2 infection in children.

Infection-Mediated Clinical Biomarkers for a COVID-19 Electrical Biosensing Platform.

The race towards the development of user-friendly, portable, fast-detection, and low-cost devices for healthcare systems has become the focus of effective screening efforts since the pandemic attack in December 2019, which is known as the coronavirus disease 2019 (COVID-19) pandemic. Currently existing techniques such as RT-PCR, antigen-antibody-based detection, and CT scans are prompt solutions for diagnosing infected patients. However, the limitations of currently available indicators have enticed researchers to search for adjunct or additional solutions for COVID-19 diagnosis. Meanwhile, identifying biomarkers or indicators is necessary for understanding the severity of the disease and aids in developing efficient drugs and vaccines. Therefore, clinical studies on infected patients revealed that infection-mediated clinical biomarkers, especially pro-inflammatory cytokines and acute phase proteins, are highly associated with COVID-19. These biomarkers are undermined or overlooked in the context of diagnosis and prognosis evaluation of infected patients. Hence, this review discusses the potential implementation of these biomarkers for COVID-19 electrical biosensing platforms. The secretion range for each biomarker is reviewed based on clinical studies. Currently available electrical biosensors comprising electrochemical and electronic biosensors associated with these biomarkers are discussed, and insights into the use of infection-mediated clinical biomarkers as prognostic and adjunct diagnostic indicators in developing an electrical-based COVID-19 biosensor are provided.

Plasma D-dimer value corrected by inflammatory markers in patients with SARS-CoV-2 infection: Its prognostic value in the diagnosis of venous thromboembolism.

INTRODUCTION: D-dimer levels are elevated in COVID 19 and they correlate to the levels of other inflammatory markers such us ferritin, fibrinogen and C-reactive protein. It may be possible to correct D-dimer value in function of inflammatory markers, thus identifying patients at higher risk of venous thromboembolism (VTE). Our objectives are estimating a corrected value of plasma D-dimer as a linear function of ferritin, C-reactive protein and fibrinogen and stablishing a cut-off point of high probability of VTE. PATIENTS AND METHODS: Age and sex matched case-control study of all patients diagnosed with COVID 19 and VTE between March and May 2020 in a tertiary hospital in Madrid (Spain). Using linear regression, the best predictive model will be estimated and residual D-dimer values will be obtained and analyzed using ROC curves to determine its discriminative performance. RESULTS: Thirty-eight cases and seventy-six controls were included. There was 63.2% of men and mean age was 68.2. D-dimer was best predicted by a linear model including fibrinogen, ferritin and C-reactive protein. Using residual values, the optimal cutoff point was 2165ng/mL, with a sensitivity of 57.9% and specificity of 98.7%. CONCLUSION: It is possible to estimate a D-dimer corrected value in function of ferritin, C-reactive protein and fibrinogen. Using the observed and estimated value we can obtain a residual value that performs well as a screening method to detect patients who would benefit for further VTE diagnostic testing.

Pathophysiology of coronavirus disease 2019 for wound care professionals.

There is pressing urgency to understand the pathogenesis of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus disease 2019 (COVID-19). The tissue tropism of SARS-CoV-2 includes not only the lung but also the vascular and integumentary systems. Angiotensin-converting enzyme 2 (ACE2) appears to be the key functional receptor for the virus. There is a prominent innate immune response to SARS-CoV-2 infection, including inflammatory cytokines, chemokines, the complement system, and acute phase proteins. The pathophysiologic significance of SARS-COV-2 and host immune system interaction, and COVID-19-associated coagulopathy instigating microvascular injury syndrome mediated by activation of complement pathways, and an associated procoagulant state is important for wound care professionals to understand.

Is periodontal disease a risk factor for developing severe Covid-19 infection? The potential role of Galectin-3.

IMPACT STATEMENT: There could be a close relationship between periodontal diseases (PDs) severity and Covid-19 infections. This relationship could be caused by Galectin-3-mediated increased immune response and increased viral attachment. Keeping PDs under control and maintaining rigorous oral hygiene during this troubled Covid-19 pandemic period is very important.Patients with older age and pre-existing conditions like cardiovascular disease, hypertension, diabetes, and obesity are in the higher risk group for developing severe Covid-19 infections. The inflammatory pathways that are involved in these conditions are the same pathways that we see in periodontal diseases (PDs). This raises a significant question: Is PD a pre-existing condition that can increase the risk of developing severe Covid-19 infection? Several studies have shown that Galectins play a key role in the homeostasis of immune cells, and recently, a relationship was found between Covid-19 and Galectin-3 (Gal-3).It has been determined that an important area in the spike protein of Coronavirus-19 is almost exactly the same as the morphology of Gal-3, and these spike proteins are critical for the entry of the virus into host cells. We suspect that there is enough evidence to support a close relationship between PDs severity and Covid-19 infections. There is accumulating evidence to suggest a relationship between the severity of PD and the risk of infection with Covid-19, which requires further investigation. This relationship could be caused by Gal-3-mediated increased immune response and increased viral attachment. In this context, we want to emphasize the importance of keeping PD under control by maintaining rigorous oral hygiene during this troubled Covid-19 pandemic period. We would also like to point out the possibility that having PD may be a pre-disposition toward developing a severe Covid-19 infection.