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Patients on maintenance hemodialysis (MHD) are highly susceptible to SARS-CoV-2 and with high mortality rates due to Coronavirus disease 2019, mainly because of the older age in this group of patients, comorbidities, compromised immune status due to uremia, as well as inability to keep social isolation because of the necessity for regular physical presence in dialysis facility. Several retrospective studies of patients on MHD in Europe, America and Asia, show high susceptibility to SARS-CoV-2 in this group of patients with very high rates of critical course of the disease and high mortality rates, reaching more than 40% The aim of this retrospective observational study was to identify risk factors among patients on intermittent hemodialysis for infection with SARS-CoV-2 as well as predictors of severe COVID-19 and fatal outcome. Materials and methods. We analyzed 69 patients receiving intermittent dialysis in Aleksandrovska University Hospital - Hemodialysis Unit. 34 of them have been tested positive for SARS-CoV-2 in the period from September 2020 (when the first case of the disease was registered for our dialysis center) up to March 2022, and are compared with a control group of 35 dialysis-dependent patients without COVID-19. Data about comorbidities, main laboratory and radiologic findings, need of hospitalization and treatment in ICU, as well as data for conducted treatment, are collected from electronic medical records. To identify predictors of severe COVID and poor outcome we compared the group of survivors with the one of non-survivors. Results. There are no significant differences between patients on MHD with and without COVID-19 except higher frequency of COPD and hypoproteinemia in the positive group. Older age, female gender, history of smoking, lymphopenia with neutrophilia, treatment in ICU and need of mechanical ventilation, signs of malnutrition - hypoproteinemia and lower levels of serum creatinine, are risk factors for severe disease and fatal outcomes. Conclusions. The course of COVID infection in dialysis-dependent patients is severe and with high mortality rate, in line with other studies worldwide. Malnutrition is the main risk factor for COVID and also main predictor for poor outcomes.
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Background: Serum interleukin 6 (IL-6) levels have been studied in the diagnostic evaluation of patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19). Methods: We studied the utility of treatment with tocilizumab in COVID-19 patients (n=19) with a negative nasopharyngeal swab real time reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 who had suggestive computed tomography (CT) findings, namely, COVID-19 Reporting and Data System (CO-RADS) 4,5. Results: Receiver operator characteristic (ROC) curve analysis showed that serum IL 6 at a cut-off of >56.9 pg/L was a predictor of mortality in nasopharyngeal swab RT-PCR negative patients with suggestive CT findings. Tocilizumab had no significant effect on the mortality. Conclusions: In nasopharyngeal swab RT-PCR negative patients with suggestive chest CT findings, elevated serum IL-6 levels > 56.9 pg/L predicted mortality. However, treatment with tocilizumab had no effect on mortality.
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Aim of study. To study the total level of 25-hydroxyvitamin D in children with SARS-CoV-2 infection (COVID-19). Material and Methods. A total of 82 children aged 0-17 diagnosed with SARS-CoV-2 infection were enrolled. Depending on the severity of clinical symptoms, all children were divided into three groups according to the COVID-19 severity: asymptomatic, mild and moderate. The serum level of vitamin D in all patients was tested via the immunochemical method. Results. It was found that children with SARS-CoV-2 infection had lower serum level of vitamin D (29.92 [22.22;28.07] ng/ml) as compared with the control group (36.43 [32.05;44.08] ng/ml;p<0.001). A total of 90% of the children with SARS-CoV-2 infection were diagnosed with insufficiency or deficiency of vitamin D (<30 ng/ml). Only 10 % of the patients had normal levels of vitamin D. The insufficiency of vitamin D was found more often amongst children aged 0-11 and deficiency of total 25-hydroxyvitamin D was more common for children aged 12-17. The difference in serum levels of vitamin D depending on the severity of SARS-CoV-2 infection was not found. Male children with SARS-CoV-2 infection showed lower levels of vitamin D (p=0.013). Conclusion. A total of 90 % of the children with SARS-CoV-2 infection had insufficiency or deficiency of vitamin D regardless of the severity of clinical symptoms.Copyright © 2021, Krasnoyarsk State Medical University. All rights reserved.
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Background: COVID-19 has caused a considerable number of hospital admissions in China since December 2019. Many COVID-19 patients experience signs of acute respiratory distress syndrome, and some are even in danger of dying. Background: to measure the serum levels of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin in patients hospitalized with severe COVID-19 in Baghdad, Iraq. And to determine the cut-off values (critical values) of these markers for the distinction between the severe patients diagnosed with COVID-19 and the controls. Materials and methods: In this case-control study, we collect blood from 89 subjects, 45 were severe patients hospitalized in many Baghdad medical centers who were diagnosed with COVID-19 infection, and 44 were apparently healthy subjects as a control. The time of collection is from September 15 th to December 31 th, 2021. The optimal cut-off points (critical values) and prognostic relevance of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin were investigated using (ROC) curves analysis. Results: In severe patients hospitalized with COVID-19 the levels of D-dimer, NLR, and neopterin were statistically significantly higher than in control participants (P < 0.005). The D-dimer, NLR, and neopterin tests have areas under the receiver operating characteristic (ROC) curves of 0.920, 0.90, and 0.74 respectively, and their critical values for the differentiation between the severe patients and control were 0.22 micro g/ml, 2.56, and 3.02 nmol/L. Conclusions: D-dimer, NLR, and neopterin levels in sever COVID-19 patients were higher than control, with values of greater than 0.22 micro g/ml, 2.56 and 3.02 nmol/L respectively was linked to a severe COVID-19 infection with good sensitivity and selectivity.
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Background: Monitoring the spread of SARS-CoV-2 has been considered by the World Health Organization (WHO). We examined the prevalence of anti-SARS-CoV-2 immunoglobulin antibodies in southwestern Iran in spring 2020. The circulation of SARS-CoV-2 is high in the general population, especially among health care workers (HCWs) who are in close contact with patients. Objectives: The aim of this study was to determine the prevalence of anti-SARS-CoV-2 antigen in high-risk occupational and low-risk groups to investigate risk factors for serum positivity in Shiraz, southwestern Iran. Methods: A cross-sectional survey was performed on 366 participants (204 from high-risk and 162 from low-risk subjects). IgG and IgM antibodies were detected using Pishtaz Teb COVID-19 ELISA Kits to evaluate SARS-CoV-2-antigen in serum samples. After enzyme-linked immunosorbent assay (ELISA), serum prevalence, as well as IgG/IgM positive factors, was determined using logistic regression. Results: From July to September 2020 (a few months after reporting the first case of COVID-19 cases in Iran), out of 366 survived people, 72 (40.9%) were IgG positive, and 50 (27.5%) were IgM positive. The frequency of positive serology for IgG and IgM antibodies in individuals aged < 30 years was higher in the low-risk group than in the high-risk group. Multivariate logistic regression showed that headache (OR 0.312 [95% CI: 0.136 - 0.717]) and cough (OR 0.427 [95% CI: 0.182 - 1.004]) factors were associated with IgG or IgM positive serology. Conclusions: Between July and September 2020, the prevalence of anti-SARS-CoV-2 antigen was high in Shiraz. The prevalence of SARS-CoV-2 IgG/IgM antibodies in the high-risk group and their family as low risk was shown to increase viral infection due to close contact with COVID 19 patients than in the general population. Several factors were found to be related to the prevalence of anti-SARS-CoV-2 antigen that needs to be considered by policymakers to determine what to do about the SARS-CoV-2 pandemic.
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This journal issue includes s of papers presented at the conference. Topics discussed are: sleeping characteristics among primary school children in Gampaha District, Sri Lanka;cosmetic effects of post thyroidectomy scar and evaluation of patient satisfaction;post-vaccination symptoms of COVID-19 vaccines among adults in Galle;multiple chest trauma in a victim of road traffic collision;anatomical variations of renal vein in a group of Sri Lankan cadavers;hospital acquired infections among patients in Intensive Care Units in Teaching Hospital, Karapitiya;serum Vitamin D level among 1 to 5-year-old children in Galle Municipality and Bope Poddala MOH area.
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Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) is the virus causing Coronavirus Disease 2019 (COVID-19). Apart from respiratory disease, this virus can affect different organs. Objectives: Therefore, multiple mechanisms have been hypothesized for Acute Kidney Injury (AKI) in COVID-19. In this study, we evaluate the incidence and prognosis of AKI in COVID-19 patients. Methods: This retrospective cohort study assessed 397 COVID-19 patients hospitalized between April 1, 2020, and September 30, 2021. Patients with a sudden rise of serum creatinine level, more than 0.3 mg/dl in two days or more than 50% of the initial level in one week, were diagnosed with AKI. Demographic, laboratory, and clinical features were compared in AKI patients with patients without AKI. Results: A total of 397 patients with a mean age +or- standard deviation of 55.42 +or- 15.26 years were included in the study. According to diagnostic criteria, 48 (12.1%) patients developed AKI. Old age, a history of hypertension, and chronic renal failure were suggested as risk factors for AKI. High levels of C-Reactive Protein, Erythrocyte Sedimentation Rate, Lactate Dehydrogenase, D-dimer, and serum phosphorus upon arrival were also associated with an increased risk of AKI. In addition, the incidence of hypernatremia and hyperkalemia increased mortality in patients with AKI. Conclusion: The incidence of AKI in admitted COVID-19 patients affects the duration of hospitalization, the chance of ICU admission, and mortality. It is important to limit the use of nephrotoxic drugs and to maintain water-electrolyte balance to prevent the incidence of AKI and improve the outcome.
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Feline Infectious Peritonitis (FIP) is highly mortality disease in cats. The reliable and fast diagnosis is crucial to the best prognosis. The aim of this study to evaluate the hemogram profile in cats infected with effusive FIP. Twenty cats had been diagnosed effusive FIP at Animal Clinic Department of Internal Medicine, Faculty Veterinary Medicine, Universitas Gadjah Mada were used in the study. The diagnosis were based on clinical examination, ultrasound, x-ray, rivalta test, and rapid test. The hemogram profile were analyzed include routine hematology and serum biochemistry. Hemogram profile in effusive FIP showed the decreased hematocrit, hyperproteinemia, and leukocytosis with an average 22.9+or-7.4%;9.0+or-2.2 g/dL;22425+or-4116 cells/mm3 respectively. Erythrocyte, hemoglobin and fibrinogen levels were still in the normal range. The results of differential leukocytes revealed that 90% cats had neutrophilia and 75% lymphopenia with an average 20066+or-3337 cells/mm3 and 1861+or-1818 cells/mm3 respectively. The blood chemistry profile showed 60% of cats experienced increase in SGPT and SGOT with an average 138.4+or-72.3 IU/L and 101+or-60.5 IU/L respectively. Hyperglobulinemia was found in 90% samples with an average 6.7+or-0.8 g/dL. All cats have a low albumin:globulin ratio with an average 0.3+or-0.1. The hemogram profile of effusive FIP were: leukocytosis, neutrophilia, lymphopenia, hyperglobulinemia, and decreased albumin-globulin ratio..
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Objective: To investigate the serum levels of human cartilage glycoprotein 39 (YKL-40), 25-hydroxy vitamin D3 [25-hydroxy vitamin D3, 25 (OH)D3] and high mobility group protein B1 (high mobility group protein B1, HMGB1) level changes in the diagnosis of neonatal pneumonia infection type and the application of disease assessment. Methods: A total of 105 children with NP who were admitted to the Department of Neonatology, Longhua District People's Hospital of Shenzhen from January to December 2020 were selected as the research objects. According to different infectious pathogens, they were divided into a bacterial pneumonia group of 40 cases and a non-bacterial pneumonia group of 65 cases. According to the severity of the disease, they could be divided into 69 cases of mild pneumonia group and 36 cases of severe pneumonia group, and 85 healthy newborns were selected as the control group during the same period. Serum levels of YKL-40, 25 (OH)D3 and HMGB1 were detected by enzyme-linked immunosorbent assay. ROC curve was used to analyze the differential diagnosis value of YKL-40, 25 (OH) D3 and HMGB1 for NP alone or in combination. Spearman rank correlation was used the relationship between serum YKL-40, 25 (OH) D3 and HMGB1 levels and the severity of the disease in children with NP was analyzed. Results: The serum levels of YKL-40 (46.39 +or- 8.36 ng/ml, 40.28 +or- 8.47 ng/ml)and HMGB1 (23.38 +or- 5.66 ng/ml, 17.32 +or- 4.18 ng/ml) in the bacterial pneumonia groups and non-bacterial pneumonia groups were significantly higher than those in the control group (30.49 +or- 6.35 ng/ml, 12.56 +or- 3.22 ng/ml), and the differences were statistically significant (F=939.480, 99.507, all P < 0.05), while bacterial and non-bacterial pneumonia groups serum 25 (OH) D3 (12.76 +or- 3.57 g/L, 18.33 +or- 4.21 g/L) levels were significantly lower than those in the control group (19.76 +or- 4.87 g/L), and the difference was statistically significant (F=225.752, P < 0.05). The serum levels of YKL-40 (52.56 +or- 9.68 ng/ml) and HMGB1 (26.74 +or- 4.57 ng/ml) in the severe group were significantly higher than those in the mild group (16.63 +or- 5.32 ng/ml, 9.63 +or- 2.38 ng/ml) and the control group (11.63 +or- 3.32 ng/ml, 6.34 +or- 2.06 ng/ml), the differences were all statistical significance (F=265.331, 55.426, all P < 0.05), and serum 25 (OH) D3 (9.76 +or- 3.54 g/L, 31.16 +or- 5.01 g/L)levels in the severe and mild were significantly lower than control groups (35.16 +or- 5.88 g/L) (F=55.426, P < 0.05) . The results of Spearman rank correlation analysis showed that the disease severity was positively correlated with serum YKL-40 and HMGB1 levels (r=0.727, 0.210, all P < 0.05), but negatively correlated with 25 (OH) D3 levels (r= -0.566, P < 0.05). The results of ROC curve analysis showed that the combined detection of YKL-40, 25 (OH) D3 and HMGB1 had the highest efficacy in diagnosing NP, the AUC was 0.912 (95%CI: 0.864-0.932), the sensitivity and specificity were 96.34%, 85.72%, respectively. In the single detection of each index, the differences in AUC were statistically significant (Z=0.746, 2.843, 3.662, all P < 0.05). The combined detection of the three had the highest diagnostic efficiency in distinguishing neonatal bacterial pneumonia from non-bacterial pneumonia, and its AUC was 0.894 (95%CI: 0.832-0.941), the sensitivity and specificity were 97.26%, 80.66%, respectively. Which was higher than the single test of each index, and the difference in AUC was statistically significant (Z=1.573, 3.228, 2.689, all P < 0.05). Conclusion: Serum levels of YKL-40, 25 (OH) D3 and HMGB1 had important clinical value in diagnosis of NP infection types and in reflecting the severity of children's disease, the combined detection of the three has better clinical diagnostic performance.
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The clinical and epidemiological features of acute kidney injury in severe and extremely severe pneumonia associated with coronavirus disease-2019 (COVID-19) are considered. An observational prospective study was conducted with the inclusion of 117 patients, including 75 men and 42 women, suffering from severe and extremely severe pneumonia associated with COVID-19, who were treated in the intensive care unit of the 1586th Military Clinical Hospital in 2020-2022. Acute kidney injury was diagnosed in 21 (17.9%) patients (stage 1 in 10, stage 2 in 4, and stage 3 in 7 patients), kidney dysfunction was recorded in 22 (8.8%) patients (serum creatinine was higher than normal, but does not reach the diagnostic criteria of Kidney Disease Improving Global Outcomes). Four patients underwent renal replacement therapy. The probability of kidney damage increases with age (the average age of the patients with acute kidney damage is 65 (58;71) years, and those without acute kidney damage was 47.5 (41;55) years;p = 0.0001). Compared with patients without acute kidney injury, patients with acute kidney injury scored higher on the scales NEW (p = 0.000975), SMRT-CO (p = 0.011555), and Sequential Organ Failure Assessment (p = 0.000042). Among those suffering from acute kidney injury, significantly more pronounced manifestations of systemic inflammation were determined (leukocytes, p = 0.047324;platelets, p = 0.001230;ferritin, p = 0.048614;and D-dimer, p = 0.004496). In the general cohort, the mortality rate was 22.2%, whereas a significant intergroup difference in mortality was observed, i.e., 52.4% in patients with acute kidney injury and 15.62% in those without acute kidney injury (Chi-squared criterion, 13.468;p < 0.001). Invasive artificial lung ventilation was performed in 19.66% of the patients, and a significant intergroup difference was identified, with 66.7% in patients with acute kidney injury and 9.38% in patients without acute kidney injury (Chi-squared criterion, 35.810;p < 0.001). The durations of treatment in the intensive care unit in patients with and without acute kidney injury were 9 (7;14) and 6 (4;10) days, respectively. After the treatment, all patients with acute kidney injury had fully recovered kidney function upon discharge. In general, acute kidney injury occurs in almost every fifth patient with severe and extremely severe pneumonia associated with COVID-19, aggravates the condition of patients, and increases mortality. The alertness of doctors regarding acute kidney injury and early diagnosis and timely nephroprotective treatment may reduce the possibility of adverse disease outcomes.
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Background: SARS-CoV-2 infection poses tremendous challenge to the healthcare system of nations across the globe. Healthcare workers (HCWs) are crucial to the ongoing response to the SARS-CoV-2 pandemic. During the course of their work, they are exposed to hazards that place them at the risk of infection. Serological testing for SARS-CoV2 among healthcare workers, which form a high risk group helps in identifying the burden of hidden infection in an institutional setting. The present study aims to investigate the seroprevalence of IgG antibodies against SARS-CoV-2 among HCWs during 1st and 2nd wave. Material & Methods: A prospective study was conducted at Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar during June July 2020 (1st wave)and April May 2021(2nd wave). During this period, 184 blood samples were collected from healthcare workers from Government Medical College and Hospital, Amritsar. Serum was separated and used for detection of Anti-SARS-CoV-2 IgG antibodies by ELISA technique. Results: Out of the 184 samples, 79 (42.9%) were found to be seropositive. Higher seropositivity was seen i.e 60.8% during the 2nd wave (April-May 2021) as compared to 25% during 1st wave. The increase in seroprevalence was observed in almost all categories of HCWs, Doctors 44.4% vz 13.04%, nurses 54.8% vz 34.7%, lab technicians 72% vz 30.4% and housekeeping staff 72.2% vz 21.7%. Also the unvaccinated HCWs showed higher seroprevalence during the second wave and 87.5% of vaccinated HCWs had demonstrable IgG antibodies. Conclusions: High seropositivity was observed among healthcare workers due to their nature of work. Rise of seropositivity among unvaccinated HCWs during 2nd wave concludes that increase in seroprevalence was attributable to natural infection. The vaccine's immunological response was also highlighted in the study.
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Objective: In our study, we aimed to show whether there is a relationship between antiphospholipid antibody (aPL) positivity and complications of COVID-19. Material and Methods: Eighty-three patients who were diagnosed with COVID-19 infection and hospitalized in the intensive care unit (ICU) of Bakirkoy Dr. Sadi Konuk Research and Training Hospital were included in our study as the case group and 79 healthy volunteers as the control group. Only patients with a positive Polymerase Chain Reaction (PCR) test were included in the case group. Serum antiphospholipid antibodies (aPL IgM/G), C-Reactive Protein (CRP), ferritin, procalcitonin (PCT), plasma D-Dimer levels, prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) were analyzed by routine laboratory methods. Results: Both groups were found statistically similar in terms of gender (X2 test, p=0.236). The mean age of the case group and control group was 60.54..16.86 and 51.47..14.64 years, respectively. When aPL positivity was evaluated between the case and control groups, a statistically remarkable difference was found between the groups (p=0.046). The case group showed an aPL positivity of 7.5% and the control group 1%. The correlation between D-Dimer, PT, INR, aPTT levels, and aPL IgM/G positivity in the case group was significant. Conclusion: Our results revealed that aPL positivity in patients with COVID-19 infection relate to the severity of the disease, independent from age and gender. To confirm the result of this study further studies with participation of larger patient groups from national and international hospitals are required.
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Background: Patients with COVID commonly have mild symptoms or even be asymptomatic, a notable proportion of patients may develop severe pneumonia, acute respiratory distress syndrome, multiorgan failure and, death. NT-proBNP reflects haemodynamic stress and has proven useful for risk stratification in heart failure (HF) and other conditions such as pulmonary embolism and pneumonia. NT-proBNP is an important biomarker for the diagnosis and estimation of prognosis in cardiac insufficiency. Therefore, in the current study, we are aiming to investigate the association between the serum NT pro BNP levels in covid-19 patients and to correlate the same with the severity of COVID-19 infection. Methods: A cohort study involving 68 covid patients whose NT pro BNP levels was estimated at the time of admission and compared with other covid biomarkers. Patients classified as moderate and severe according to ICMR guidelines were included. Serum NTproBNP levels & other covid biomarkers like CRP, IL6, Ddimer, Ferritin, LDH were estimated. Results: Serum NT pro BNP levels were high in severely ill covid patients compared to moderately ill covid 19 patients and was found statistically significant. Serum NT pro BNP levels was positively correlating with other biomarkers. Mortality rate of 4.41% was reported. Conclusion: Serum NT-proBNP levels of COVID 19 patients can be used to predict the prognosis of covid which can help in early diagnosis and management of complications.
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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-a), 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-a 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.
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Background: Scrub typhus is an acute febrile illness caused by the bacteria - Orientia tsutsugamushi, transmitted through the bite of an infected chigger. This infection is endemic in tropical countries like India, Pakistan, and Bangladesh. It usually presents with fever, headache, myalgia, nausea, vomiting, abdominal pain, and tender lymphadenopathy. The presence of an eschar clinches the diagnosis clinically. Commonly encountered complications in scrub typhus include acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), acute liver injury, and rarely acute pancreatitis. Case Presentation: We report a case of a 70 year-old teetotaller male, who presented with acute febrile illness and respiratory distress during the peak period of the COVID -19 pandemic. During the course of illness, the patient developed acute pancreatitis as evidenced by elevated serum amylase and lipase as well as features of pancreatitis in the CT abdomen. Common causes of acute pancreatitis were ruled out with necessary investigations. He tested negative for malaria, dengue fever, enteric fever, and leptospirosis, but his IgM and IgG ELISA for scrub typhus were positive with high titres. He also had AKI, ARDS, and acute liver injury. The patient was treated symptomatically and with doxycycline. His condition improved gradually. Conclusion: Even though acute pancreatitis is one of the rare manifestations of scrub typhus, it should be suspected early and treated promptly.
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BACKGROUND: Corona virus disease-19 (COVID -19) infection is an acute infectious disease caused by a newly discovered beta corona virus, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). While the primary target organ is the lungs, involvement of many other organs is often evident in patients with COVID-19. There is emerging evidence to suggest association of SARS-CoV-2 infection with development of many liver abnormalities. The purpose of this study was to evaluate the prevalence of abnormal liver parameters in COVID-19 patients and their variation in moderate and severe cases. METHODS: This is a retrospective study. All patients with COVID -19, between the ages 20-75 years, encountered between April and May 2021, were included for the study and compared with age-matched controls. Severity of infection was defined based on the presence of symptoms, oxygen saturation, need for respiratory and intensive care support. Liver parameters such as serum total bilirubin (TBIL), serum aminotransferases, alanine aminotransaminase (ALT) and aspartate aminotransaminase (AST) were analysed. Inflammatory markers such as C-reactive protein (CRP) and D-dimer were also included for assay. RESULTS: A total of 52 patients were encountered during the study period. Of these, 29% (15/52) required intensive care. Abnormal liver parameters were observed in 14 (27%) patients, and were significantly elevated compared to healthy controls. Liver dysfunction was markedly profound in severe infection than those with moderate disease. Higher levels of CRP and D-dimer were noted in severe patients of COVID-19. CONCLUSIONS: Mild liver abnormalities in the form of elevated ALT and AST are seen in COVID-19 patients suggesting mild or no liver injury. These abnormal parameters do not generally lead to significant liver function impairment/failure and no specific treatment is required.
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Objective: To investigate the clinical significance of serum interleukin 6 (IL-6) in elderly patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant and its correlation with underlying diseases. Methods: A total of 22 elderly patients (> 80 years old) infected with omicron variant, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. to Jun. 2022 and tested positive for SARS-CoV-2 RNA, were included. The level of serum IL-6 was measured by flow cytometry, and the level of serum C reactive protein (CRP) was measured by immunonephelometry. Patients were divided into pneumonia group (16 cases) and non-pneumonia group (6 cases) according to the imaging examination results, and were divided into severe group (severe and critical type, 5 cases) and non-severe group (mild and normal type, 17 cases) according to the condition. Binary logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the correlation between serum IL-6 and CRP levels and the severity of the disease and whether it would progress to pneumonia. Meanwhile, the relationships between underlying diseases and serum IL-6 level were explored. Results: Among the 22 patients, 6 were mild, 11 were normal, 3 were severe, and 2 were critical. The baseline serum IL-6 level in the pneumonia group was significantly higher than that in the non-pneumonia group ([20.16+or-12.36] pg/mL vs [5.42+or-1.57] pg/mL, P=0.009), and there was no significant difference in baseline serum CRP level between the 2 groups (P > 0.05). There were no significant differences in baseline serum IL-6 or CRP levels between the severe group and the non-severe group (both P > 0.05). Logistic regression analysis showed that the baseline serum IL-6 and CRP might be related to pneumonia after infection with omicron variant (odds ratio [OR]=2.407, 95% confidence interval [CI] 0.915-6.328;OR=1.030, 95% CI 0.952-1.114). ROC curve analysis showed that the area under curve values of serum IL-6 and CRP in predicting the progression to pneumonia were 0.969 (95% CI 0.900-1.000) and 0.656 (95% CI 0.380-0.932), respectively, with statistical significance (Z=2.154, P=0.030). There were no significant differences in the baseline serum IL-6 level or proportions of severe patients or pneumonia patients among patients with or without hypertension, diabetes mellitus, coronary heart disease, chronic kidney disease or chronic obstructive pulmonary disease (all P > 0.05). The baseline serum IL-6 levels of the omicron variant infected elderly patients with 1, 2, and 3 or more underlying diseases were 12.50 (9.15, 21.75), 23.55 (9.63, 50.10), and 10.90 (5.20, 18.88) pg/mL, respectively, with no statistical significance (P > 0.05). Conclusion: For omicron variant infected patients, serum IL-6 level is significantly increased in patients with pneumonia manifestations and is correlated with disease progression. Serum IL-6 level is of great guiding significance to judge disease progression and evaluate efficacy and prognosis of elderly coronavirus disease 2019 patients.
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Background and purpose: The Coronavirus Disease 2019 (COVID-19) pandemic, caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide emergency. Various studies show conflicting and diverse results on the role of inflammatory cytokines in predicting the severity and prognosis in patients with COVID-19. The aim of this study was to compare the serum levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in predicting the severity of COVID-19 and prognosis in patients admitted to Qaemshahr Razi Hospital. Materials and methods: In this cross-sectional prospective study, the serum levels of interleukin 8 and 6 were measured in 51 patients with COVID-19 and compared with 25 healthy individuals in Qaemshahr Razi Hospital, 2021. ELISA method was used to measure these cytokines and data analysis was performed in SPSS V25. Results: The serum levels of IL6 and IL8 in the patient group were about 4 times and 6 times higher than those of the control group, respectively. Average levels of IL-6 (P=0.004) and IL-8 (P<0.001) were significantly higher in patients with severe COVID-19 compared to moderate form and control group. There was no correlation between the duration of hospitalization and the level of IL-6 (P=0.1), while there was a significant correlation between the length of hospital stay and the level of IL-8 (P=0.012). Conclusion: IL-6 and IL-8 serum levels in patients with COVID-19 can be helpful in predicting the severity of disease and prognosis of patients.
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Objective: To explore the value of liver function indexes on evaluation of the illness condition of coronavirus disease 2019 (COVID-19). Methods: 261 patients with confirmed COVID-19 which collected from Huangshi Hospital of Traditional Chinese Medicine from January to March 2020 were investigated and separated into:group of critical type, group of severe type and group of common type, and the data of the patients about age, gender, past medical history and the results of liver function test were collected. Chi-square test, analysis of variance, univariate and multivariate logistic regression analysis were adopted to explore the relationship between liver function indexes and illness condition of COVID-19. Results: 50.2% of COVID-19 patients had abnormal liver function. Compared with the group of severe type, the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), P-glutamyl transferase (GGT) and total bilirubin (TBIL)in the group of critical type was significantly higher, while the level of albumin(ALB)was significantly lower, and the differences were statistically significant (all P < 0.05);compared with the group of common type, the levels of ALT, +AST, and GGT in the group of severe type were significantly higher, while the level of ALB was significantly lower, and the differences were statistically significant (all P < 0.05). The proportions of patients with abnormal liver function or liver damage in the group of critical type were significantly higher than those in the group of severe type (P < 0.05), and the proportions of patients with abnormal liver function or liver damage in the group of severe type was significantly higher than those in the group of common type (P < 0.05). The incidence ratio of abnormal liver function in patients with underlying disease was higher than that of without underlying disease (P < 0.05). ALT, AST, ALP, TBIL, and ALB were all risk factors for severe progress of COVID-19 disease (all P < 0.05);multivariate logistic regression analysis inidicating that TBIL (OR=10.862, P < 0.05) and ALB (OR=11.733, P < 0.05)were the independent risk factors. TBIL level was positively correlated with the severity of COVID-19 (r=0.367, P < 0.05), and ALB level was negatively correlated with the severity of COVID-19 (r=-0.613, P < 0.05). Conclusions: The abnormal liver function, especially the obvious abnormality of TBIL and ALB, could be used as the reference index of COVID-19 severity. The COVID-19 patients with underlying disease were easily suffered liver injury.
ABSTRACT
Objective To analyze IgG test results of serum SARS-CoV-2 antibody in people after booster vaccinations against SARS-CoV-2, and to provide a basis for the booster vaccination. Methods There were 314 healthy individuals who had been vaccinated with the COVID-19 vaccine. Depending on their inoculation situation, they were divided into three groups:the booster injection group(1 week to 2 months after booster vaccination)of 205 cases, <180 days after two doses group(<180 days after two doses of COVID-19 vaccine)of 49 cases, and >180 days after two doses group(>180 days after two doses of COVID-19 vaccine)of 60 cases. The positive rate of IgG in serum of the three groups was measured using the colloidal gold method. Results The serum COVID-19 antibody IgG positive rates were 83.9% in the booster injection group, 18.4% in the <180 days after two doses group, and 5.0% in the >180 days after two doses group, with statistically significant difference between any two groups(all P < 0.05). In the booster injection group, the serum COVID-19 antibody IgG positive rate was 85.2% in people who received a booster injection more than a month, while those who received a booster injection less than a month had a positive rate of 75.9%, and there was no significant difference between these two groups(P > 0.05). In the booster injection group, the positive rates of serum COVID-19 antibody IgG were 85.1% in males and 82.4% in females, with no significant difference(P > 0.05). In the booster injection group, people at the age of 18 and 50 had a positive serum COVID-19 antibody IgG rate of 86.0%, while those over 50 had a positive rate of 58.3%, and there was significant difference between them(P < 0.05). Conclusions Compared with two injections of the COVID-19 vaccine, the booster injection can significantly increase the positive rate of the antibody IgG of COVID-19, which results in a stronger immune response. There is a lower IgG positive rate of COVID-19 antibodies in those aged over 50 years following the booster dose of COVID-19 vaccine than in those aged 18- 50 years.