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Objectives: COVID-19 pandemic has affected more than 6 million people globally. Most of the affected patients presents with fever, cough, nausea, vomiting, fatigue and dyspnea. Molecular testing by PCR is gold standard test to diagnose COVID-19 infection but if unavailable, hematological profile of COVID-19 patients is a good prognostic marker for COVID-19 disease. The aim of our review is to summarize the recently available literature regarding hematological alterations in COVID-19 patients along with their trend in the disease course and their prognostic implications in terms of severe disease. Design(s): Systematic review. Method(s): Literature published between 2020 to 2022 on Google Scholar was included in our review by following PRISMA guidelines. Articles were shortlisted on the basis of inclusion and exclusion criteria. Result(s): Total 139 articles were initially identified. After removal of duplicates and screening on basis of present exclusion and inclusion criteria 17 articles were found. Out of these 17 articles, there were 10 retrospective studies, 3 prospective studies, 2 case control studies and 2 cross sectional studies. Conclusion(s): Hematological markers predicts the outcome of COVID in patients irrespective of their age, gender and co-morbidities. There is a positive relationship between disease severity and blood count of neutrophils, leukocytes, NLR, MDW, thrombocytopenia, lymphocytopenia, IL-6 and CRP. Copyright © 2022, Bahrain Medical Bulletin. All rights reserved.
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Background: Optimism is a psychosocial asset associated with healthy ageing. Coronavirus disease 2019 (COVID-19) tremendously impacts people's lives and health. This study explored what optimism means to older Australians and how the pandemic may have affected their perceptions.
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The COVID-19 pandemic dealt the tourist industry a devastating blow, although it has been showing clear signs of recovery in 2022. Furthermore, changes in tourist behaviour are opening up new opportunities for the industry which can benefit sustainability, also for rural communities. This article looks at some of these new developments.
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Background. Coinfection in patients with SARS-CoV-2 has been associated with greater complications. We describe the clinical characteristics and outcomes of 126 pediatric patients with COVID-19 and viral, bacterial, or fungal coinfection. Methods. We retrospectively reviewed and analyzed electronic data of all pediatric patients who tested positive for SARS-CoV-2 from April 16, 2020, to April 15, 2022, in our center. Confirmation of COVID-19 was based on positive RT-PCR. Viral coinfections (VC) were identified using a multiplex RT-PCR respiratory viral panel, bacterial coinfection (BC) was determined by positive bacterial culture (blood, bronchoalveolar lavage, sputum, urine) or clinical/radiological manifestations and antimicrobial assessment by a pediatric Infectious Diseases expert and fungal coinfection (FC) diagnosis based on Consensus definitions of invasive fungal disease. Results. During the study period, among 400 pediatric patients with COVID-19, 126 children had coinfection. Children >10 years were the most affected age group. Underlying disease was present in 69%, hematological malignancies were the most common (17.5%). BC was detected in 76.9% (n=97), bacterial pneumonia (54.6%) was the main diagnosis, followed by oncologic patients with initial febrile neutropenia and posterior SARS-CoV-2 detection (14,4%). Unusual BC as congenital syphilis w detected;acute appendicitis was the initial presentation of COVID-19 in 8 patients. VC was identified in 15.87% (n=20), prevailing rhinovirus (9.5%) and adenovirus (3.96%), One FC presented as proven pulmonary aspergillosis (0.8%). B-V and B-F coinfection were detected in 2 patients. Fever and cough were the most common symptoms, higher fever >40degreeC was mostly observed in the BC group (3%). Twenty-seven patients with BC (27.8%) were admitted to intensive care, with the OR 0.7 IR 95% (0.611-1.008), 4.1% died. One ICU admission was observed in the VC group (5%) and all VC cases resolved without complications. Conclusion. Pediatric patients with COVID-19 coinfection, especially BC were common in our center representing nearly one-third of the infected children, including unusual coinfections. BC was identified as a risk factor for ICU admission OR 0.7 IR 95% (0.611-1.008). Favorable outcomes were observed in most cases.
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Beside lowering the surface tension at air-liquid interface in the alveoli, the pulmonary surfactant has a pivotal role in triggering the elimination of pathogens or any hazardous materials introduced with breathing. Among the components of the pulmonary surfactant, surfactant protein-D (SP-D) is a low abundant (0.6%) hydrophilic protein that is able to promote pathogens clearance binding highly conserved glycosidic residues on their surface. SP-D also cooperates in the maintenance of lung homeostasis by directly modulating immune system activity. Previous investigations on acute respiratory distress syndrome (ARDS) patients demonstrated a significant increment of SP-D serum level compared with healthy donors. Since in physiological condition SP-D is not permeable to alveoli-capillary membrane and poorly express by other tissues, this enhancement is likely due to an impairment of the pulmonary barrier caused by prolonged inflammation. In view of the above, the present work aims to investigate SP-D as diagnostic and/or prognostic marker for COVID-19. In particular, a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (i.e., 79 mild cases plus 123 severe cases) was conducted to assess differences of the hematic levels of this biomarker among COVID-19 patients and healthy donors and if SP-D serum levels resulted a risk factor for disease severity and mortality. The performed analyses, using an Anova-Mixed model, showed a significant difference in the mean of log SP-D between COVID-19 patients and healthy donors: 150 ng/mL was identified as threshold value to best discriminate the mentioned groups. Significant differences were also found between dead vs survived patients, as well among severe vs non-severe cases. In all cases, SP-D serum levels presented significantly higher values for COVID-19 patients, dead and severe cases.Moreover, further analysis conducted with Logistic Mixed models, highlighted that SP-D, in a model with Age, C-reactive protein and cancer status, resulted the strongest significant risk factor of mortality (model predictive accuracy, AUC=0.826), and in a lesser extent for risk of severity.The overall data suggest that SP-D can be a predictive marker of COVID-19 disease and its outcome.
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Corona Virus (or COVID19) has shown long-term effects on different human body organs, which include lung diseases, kidney malfunctions, heart dysrhythmia, changes in brain nutrient levels, psychological issues, abrupt changes in blood pressure, etc. Due to such a wide variation in the effects on different body parts, it is difficult for researchers to design models that can integrate these effects for treatment recommendations, and future disease prevention scenarios. Thus, this text reviews some of the recently proposed models that efficiently identify effects of COVID19 on different body organs. This review discusses the underlying models in terms of their clinical nuances, functional advantages, contextual limitations, and empirical future scopes. Based on this discussion, researchers will be able to identify optimal models for the identification of different diseases on individual body parts. It was observed that hybrid bio-inspired models, when combined with deep learning-based classification techniques, can efficiently identify these effects. This text also parametrically evaluates these models in terms of their accuracy, precision, classification delay, deployment cost, and scalability parameters, which will allow readers to identify optimal models for their performance specific use cases. To further contemplate this discussion, a novel COVID19 Classification Rank Metric (CCRM), which combines these parameters for comprehensive identification of optimal models is evaluated in this text. Based on this metric, researchers will be able to identify optimal models that can be deployed with high-accuracy, low delay, and high-scalability, along with lower cost for clinical scenarios. Copyright © 2022, Anka Publishers. All rights reserved.
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Background: Coronavirus Disease-2019 (Covid-19) is the cause of a pandemic that has high mortality and global effects. The liver damage in Covid-19 cases in mechanical ventilation was investigated in this study. A total of 60 patients (the Study Group) who were diagnosed with Covid-19 pneumonia, and 65 individuals (the Control Group) were included prospectively in the study. The cases were divided into 3 groups as those who were intubated (severe), those who were not intubated (mild), and the healthy Control Group. The lung tomography results of those who were diagnosed with Covid-19 were examined in the study. The cases with positive RT-PCR (Real Time Polymerized Chain Reaction) test results were recorded from the system. The liver tests of the patients were compared with those of the Control Group. The two groups with and without intubation were also compared. The results were evaluated and analyzed statistically. When all the data were evaluated, it was found that LDH, GGT, AST, and aPTT levels were significantly higher in the mild and severe patient group compared to the Control Group, and the T. Protein and albumin levels were low (p<0.01). The N/L Ratio, and the CRP levels, which are the other acute phase reactants, were significantly higher (p<0.05). No statistically significant differences were detected when all parameters of the groups with and without intubation were compared (p>0.05). Increased D-dimer, GGT, D. Bil, LDH, NLR, and AST levels in Covid-19 patients in invasive mechanical ventilation are associated with mortality. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.
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Background. Acute stroke is a highly specific neurological symptom in the acute phase of COVID-19. Hemorrhagic stroke (HS) is an infrequent, but life-threatening complication of COVID-19. Objective. To analyze etiopathogenetic factors and the course of HS associated with COVID-19. Design and methods. A retrospective analysis of 27 medical histories of patients with HS associated with COVID-19 (the main group) and 14 medical histories of patients with HS not related to COVID-19 (the control group) was performed. In the main group, COVID-19 was confirmed by the positive polymerase chain reaction method. HS developed before COVID-19 symptoms in 10 (37,04 %) patients and after 4-16 days of COVID-19 symptoms onset in 17 (62,96 %) patients. Results. Our study indicates significant differences in blood pressure (BP), respiratory system parameters, laboratory data, neuroimaging data in patients of the main and control groups. Coagulopathy, thrombocytopenia, hypoxia, and the renal and hepatic failure play a significant role in the development of HS associated with COVID-19 compared to the classic HS (without COVID-19), where hypertension seems to be the important. At the same time BP is significantly lower in the main group. Conclusions. The etiopathogenetic factors and the course of HS associated with COVID-19 require pathogenetically different therapy compared to HS without COVID-19. Copyright © 2021 All-Russian Public Organization Antihypertensive League. All rights reserved.
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Background: The COVID-19 pandemic that emerged in Wuhan, China at the end of 2019, spread rapidly around the world with almost 600 million cases and 6.3 million deaths today. The most affected were health workers with at least three times the risk of contracting the disease than the general community. Most studies on seroprevalence in health workers focus on hospital care establishments and what happens in Primary Health Care (PHC) has not been investigated with the same intensity. Aim(s): To determine the prevalence of SARS-CoV-2 using IgG antibodies in primary health care personnel in La Pintana commune, risk factors and clinical characteristics, prior to vaccination in Chile. Method(s): A cross-sectional design carried out in November 2020. Sociodemographic and clinical data were collected through face-to-face interviews, after providing informed consent. Specific IgG was determined by ELISA using N and S proteins. The differences between positive and negative subjects were studied using bivariate analysis and multivariate models, controlling for potential confounding variables. The study was approved by the Universidad del Desarrollo Scientific Ethics Committee. Result(s): 463 employees (51.4%) participated, finding a prevalence of 21.8%. The risk factors found were younger age, being a physician and having been in close contact with a case. 22% were asymptomatic. Among those with anosmia/ageusia, the probability of IgG+ was greater than 70%. Antibody titers increase with severity. Conclusion(s): Prevalence found in primary health care personnel is consistent with previous evidence. Younger age and medical profession are associated with a higher risk of illness. Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.