Predictors of severity in COVID-19

Background: In the context of home monitoring of severe acute respiratory syndrome coronavirus-2 disease (COVID-19) patients, it is imperative to evaluate the accuracy of finger pulse oximetry oxygen saturation (SpO2) in the assessment of hypoxia. Methods: Retrospective data analysis was performed on (n = 132) hospitalised COVID-19 patients with various levels of severity, in whom SpO2, haematological, biochemical and arterial blood gas (ABG) parameters were measured within 48 h after admission. Discrepancy between SpO2 and arterial blood oxygen saturation SaO2 was compared between mild, moderate and severe COVID-19 to assess the accuracy of finger pulse oximetry. Results: We found that total white blood cell count, neutrophil %, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, ferritin, C-reactive protein and lactate dehydrogenase (LDH) were significantly increased in severe COVID-19, while lymphocyte % was significantly less when compared to mild and moderate cases. Multivariable analysis suggested that red cell distribution width (RDW) and LDH together account for significant variance in the severity of disease. The SpO2 and SaO2 were significantly less in the severe group. The difference between SpO2 and SaO2 has a clinically meaningful albeit statistically nonsignificant trend with the discrepancy greater in severe COVID-19 cases when compared to mild and moderate cases. Conclusions: Finger pulse oximetry has the potential to underestimate the severity of hypoxia in severe COVID-19 and this has implications in the decision to start oxygen therapy. RDW and LDH constitute the best parsimonious set of variables to predict severity.

Managing Severe Acute Asthma Exacerbation in Pregnancy during the COVID-19 Pandemic: A Case Report from a Resource-limited Setting

BACKGROUND: One-third of pregnant women will experience worsening asthma requiring emergency hospitalization. However, no report comprehensively discussed the management of asthma attacks in pregnant women in impoverished settings. We attempt to illuminate what general practitioners can do to stabilize and improve the outcome of severe acute asthma exacerbations in primary care with resource limitations. CASE REPORT: A nulliparous 29-year-old woman in her 21st week of pregnancy presented severe acute asthma exacerbation in moderate persistent asthma with uncontrolled asthma status along with gestational hypertension, uncompensated metabolic acidosis with a high anion gap, anemia, respiratory infection, and asymptomatic bacteriuria, all of which influenced her exacerbations. This patient was admitted to our resource-limited subdistrict hospital in Indonesia during the COVID-19 pandemic for optimal stabilization. Crystalloid infusions, oxygen supplementation, nebulized beta-agonist with anticholinergic agents, inhaled corticosteroids, intravenous methylprednisolone, broad-spectrum antibiotics, subcutaneous terbutaline, mucolytics, magnesium sulphate, oral antihypertensives, and continuous positive airway pressure were used to treat her life-threatening asthma. After she was stabilized, we referred the patient to a higher-level hospital with more advanced pulmonary management under the supervision of a multidisciplinary team to anticipate the worst scenario of pregnancy termination. CONCLUSION(S): Limitations in primary care, including the lack of sophisticated intensive care units and laboratory panels, may complicate challenges in managing severe acute asthma exacerbation during pregnancy. To enhance maternal-fetal outcomes, all multidisciplinary team members should be well-informed about key asthma management strategies during pregnancy using evidence-based guidelines regarding the drug, rationale, and safety profile.Copyright © 2023 Muhammad Habiburrahman, Triya Damayanti, Mohammad Adya Firmansha Dilmy, Hariyono Winarto.

Is COVID-19 a risk for postoperative delirium and death in elderly patients after emergency surgery?

Aim: While recent evidence describes atypical outcomes of coronavirus disease 2019 (COVID-19) in elderly patients, the frequency of delirium and associated outcomes in elderly patients with COVID-19 (coronavirus disease 2019) infection undergoing emergency surgery are not well defined. This study aims to determine the effect of COVID-19 on postoperative delirium and postoperative death in elderly patients undergoing emergency surgery. Material(s) and Method(s): This descriptive and cross-sectional study was conducted in general surgery, orthopedics, and cardiovascular surgery clinics of a public hospital, including 30 days of follow-up between April 1 and May 1, 2021. All patients who were admitted to these clinics for emergency surgery intervention on these dates constituted the study population, while a total of 140 patients aged >=65 years, who met the study criteria, formed the sample of the study. Descriptive Characteristics Form and Nursing Delirium Screening Scale (Nu-DESC) were used as data collection tools in the study. SPSS 25.0 statistical program was used for data analysis. Result(s): Thirty (42.85%) of the SARS-CoV-2 positive (n=70) patients developed delirium in the study. 12.9% (n=18) of the patients died within 30 days of follow-up after surgery. There were 30 (69.8) of 70 SARS-CoV-2 positive patients who developed delirium, and 12 patients (25.5) died after testing positive for COVID-19, with a mean of 8.08T1.56 days within 30 days of admission. Discussion(s): These findings may lead to a poor clinical prognosis for COVID-19 infection delirium and postoperative death in patients over 65 years of age undergoing emergency surgery.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Modeling of Survival Analysis of Recovery Rate of Dengue Hemorrhagic Fever Patients at Dr. M. Djamil Padang Hospital

BACKGROUND: Dengue hemorrhagic fever (DHF) is one of the endemic diseases with the highest cases in Indonesia. According to the World Health Organization data in 2020, the incidence of DHF has increased more than 8 times over the last two decades, from 505,430 cases in 2000, to more than 2.4 million in 2010 and 5.2 million in 2019. AIM: This study aims to analyzed the recovery rate of DHF patients at Dr. M. Djamil Padang Hospital during the COVID-19 period and the factors that influence it. METHOD(S): This study is a quantitative study with a retrospective cohort study design. Data were taken from the medical records of DHF patients during the COVID-19 period (March 2020-February 2022). The sampling technique used was simple random sampling. The analysis used the Kaplan-Meier, Cox Regression method, and the Cox Proportional Hazard analysis. RESULT(S): The average time it takes a patient to recover from DHF at Dr. M. Djamil Padang is 10 days. Patients who experienced the event were 32.7%, with an incidence rate of 0.061%. DHF patients at RSUP Dr. M. Djamil Padang, most of them were >14-years-old, male, duration of fever before hospitalization >4 days, platelet level 100,000, hematocrit level >20%, and patients using insurance. CONCLUSION(S): DHF patients aged >14 years, duration of fever before hospitalization 4 days, hematocrit level 20% had a longer recovery rate. It is recommended to the hospital to be better prepared to handle DHF patients according to risk factors and to collaborate for health education.Copyright © 2023 Masrizal Masrizal, Yudi Pradipta, Sari.

The 'Tic'king Bleeder: A Rare Case of Bleeding Dieulafoy's Lesion in a Jejunal Diverticulum

Introduction: Dieulafoy lesion (DL) is a relatively rare and arguably under-recognized condition, accounting for 1-2% of acute GI bleeding. Most bleeding DLs occur in the stomach, followed by the small intestine, with less than 1% occurring in the jejunum. Bleeding DL on a jejunal diverticulum is even more rare, with a handful cases described in the literature. Here we present a rare case of a bleeding DL in a jejunal diverticulum with its endoscopic management. Case Description/Methods: A 65-year-old female with history of COVID-19 infection one month prior to presentation treated with steroids and therapeutic anticoagulation presented to the ED after having multiple episodes of coffee-ground emesis and two episodes of syncope at home. Last dose of Apixaban was 12 hours prior to admission. Physical exam revealed BP of 90/60 on Norepinephrine infusion, HR of 96, abdominal exam was soft and nontender, DRE revealed melena. Hemoglobin/hematocrit was significantly decreased at 3.6/12.8. Patient was appropriately resuscitated with blood products and fluids, and she was scheduled for an EGD. Initial EGD did not identify a clear source of her bleeding, and she was scheduled for colonoscopy. Colonoscopy with deep cannulation of the terminal ileum up to 40cm revealed significant amounts of fresh blood all throughout the colon and terminal ileum. Decision was made for push enteroscopy, which revealed a jejunal diverticulum containing a Dieulafoy lesion with an overlying clot (Image A). The lesion was first injected with epinephrine at 2 sites followed by a clot removal overlying the lesion using 13-0 circular snare. A clear stigma of recent bleeding was noticed from the lesion after clot removal (Image B), after which 2 metallic clips were placed over the lesion to achieve hemostasis (Image C). The patient had no further episodes of bleeding and was follow up in clinic eventually, recovering well. Discussion(s): Because of the life-threatening nature of Dieulafoy lesions, identification is of paramount importance for treatment purposes. Jejunal DLs are a rare entity but should be considered in cases with negative bidirectional endoscopies. In our case, push enteroscopy helped identify the bleeding lesion. DL in a diverticulum can pose a challenge to the endoscopist due to difficulty of access to the lesion. Epinephrine injection followed by mechanical clipping showed a positive outcome in our case which can be considered while approaching bleeding DLs in a diverticulum. (Figure Presented).

Acute myeloid leukemia complicated by post COVID-19 multi-system inflammatory syndrome-children

Corona Virus disease 2019 (COVID-19) pandemic has presented a huge challenge to the health care system in terms of magnitude of cases and to pediatric oncology units with varied clinical presentations. Acute myeloid leukemia(AML) is a rare heterogenous cancer of childhood with an induction mortality around 15% in our country due to neutropenic sepsis. Multisystem inflammatory syndrome in children(MIS-C) is an hyperinflammatory syndrome seen 4–6 weeks after COVID-19 infection. COVID infection in some of these children would have gone unnoticed. Here we report a two year eight months old boy diagnosed with AML on induction chemotherapy developed post COVID MIS-C. © 2022

Restrospective study of hemogram profile in effusive feline infectious peritonitis

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..

Clinical, laboratory and radiological parameters of COVID 19 pneumonia: a single-centered retrospective observational study in Pune, India

Background: The severe acute respiratory syndrome coronavirus called the novel coronavirus caused the pandemic coronavirus disease 19 (COVID-19). All over the world, SARS-CoV-2 pneumonia is causing significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients is still unknown. Aims: To assess clinical, laboratory, and radiological parameters of COVID-19 Patients and to correlate radiological findings and disease severity among patients. Methodology: In this retrospective observational study a total of 630 patients with radiologically confirmed pneumonia and COVID-19 RT PCR positive were included from a tertiary care centre in Pune, Maharashtra, following their voluntary informed consent. Patients underwent clinical, laboratory, and radiological investigations. Results: It was observed that the majority 174 (27.6%) were in the age group of 31 to 40 years and male predominance was observed compared to female. The majority of the patients 314 (49.8%) had mild, 232 (36.8%) were moderate and 84 (13.3%) had severe illness as per CT scores (HRCT Chest score). Mean BSL levels were 181 +or- 81.44, mean pulse rate was 94.03 +or- 14.93 bpm, mean respiratory rate was 22.84 +or- 3.71cpm, systolic blood pressure was 129.09 +or- 13.18 mmHg, diastolic blood pressure was 82.80 +or- 9.67 mmHg and mean temperature was 98.56 +or- 1.67 degrees F. The mean ferritin levels were 181 +or- 81.44, the mean LDH level was 94.03 +or- 14.93, mean HbA1C was 7.45 +or- 1.68. The mean NLR was 5.51 +or- 2.41, the mean WBC count was 7238.38 +or- 4942.23 and the mean hematocrit was 39.69 +or- 4.80. The mean D dimer level was 402.29 +or- 424.70, median levels were 260 (170-450). 503 (79.8%) had CRP levels more than 5 and 127 (20.2%) had levels less than 5. The mean duration of hospital stay was 9.18 days +or- 4.34 days. Majority 570 (90.5%) had fever, 493 (78.3%) had cough, 286 (45.4%) had breathlessness, 66 (10.5%) had sore throat. Other symptoms include vomiting, and loose motion in 17 (2.7%). Among 630 subjects included in the present study, the majority 584 (92.7%) have recovered/were discharged from the hospital and 46 (7.3%) succumbed to the illness. The mean SGOT and SGPT levels were 44.86+or- 31.29 and 43.60 +or- 31.25 respectively. Mean serum creatinine and BUN levels were 0.87+or- 0.80 and 13.96 +or- 9.46 respectively. The mean values of pulse rate, systolic blood pressure, diastolic blood pressure, respiratory rate and temperature showed an increasing trend across the grades of severity. Conclusion: We concluded that age, gender, blood sugar level, blood pressure, clinical symptoms, comorbidities, inflammatory biomarkers and CT severity score were independently associated with the severity and mortality based on our findings.

SARS-CoV-2 severity prediction in young adults using artificial intelligence.

Aim: to build, a predictive model for severe COVID-19 prediction in young adults using deep learning methods. Material(s) and Method(s): data from 906 medical records of patients aged. 18 to 44 years with laboratory-confirmed SARS- CoV-2 infection during 2020-2021 period, was analyzed. Evaluation of laboratory and. instrumental data was carried out using the Mann-Whitney U-test. The level of statistical significance was p<0,05. The neural network was trained, using the Pytorch. framework. Result(s): in patients with mild to moderate SARS-CoV-2 infection, peripheral oxygen saturation, erythrocytes, hemoglobin, total protein, albumin, hematocrit, serum, iron, transferrin, and. absolute peripheral blood, eosinophil and. lymphocyte counts were significantly higher than in patients with severe SOVID-19 (p< 0,001). The values of the absolute number of neutrophils, ESR, glucose, ALT, AST, CPK, urea, LDH, ferritin, CRP, fibrinogen, D-dimer, respiration rate, heart rate, blood, pressure in the group of patients with mild and. moderate severity were statistically significantly lower than in the group of severe patients (p < 0.001). Eleven indicators were identified as predictors of severe COVID-19 (peripheral oxygen level, peripheral blood erythrocyte count, hemoglobin level, absolute eosinophil count, absolute lymphocyte count, absolute neutrophil count, LDH, ferritin, C-reactive protein, D-dimer levels) and. their threshold, values. A model intended, to predict COVID-19 severity in young adults was built. Conclusion. The values of laboratory and instrumental indicators obtained in patients with SARS-CoV-2 infection upon admission significantly differ. Among them, eleven indicators were significantly associated with the development of a severe COVID-19. A predictive model based, on artificial intelligence method, with high, accuracy predicts the likelihood, of severe SARS-CoV-2 course development in young adults.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

SARS-CoV-2 severity prediction in young adults using artificial intelligence.

Aim: to build, a predictive model for severe COVID-19 prediction in young adults using deep learning methods. Material(s) and Method(s): data from 906 medical records of patients aged. 18 to 44 years with laboratory-confirmed SARS- CoV-2 infection during 2020-2021 period, was analyzed. Evaluation of laboratory and. instrumental data was carried out using the Mann-Whitney U-test. The level of statistical significance was p<0,05. The neural network was trained, using the Pytorch. framework. Result(s): in patients with mild to moderate SARS-CoV-2 infection, peripheral oxygen saturation, erythrocytes, hemoglobin, total protein, albumin, hematocrit, serum, iron, transferrin, and. absolute peripheral blood, eosinophil and. lymphocyte counts were significantly higher than in patients with severe SOVID-19 (p< 0,001). The values of the absolute number of neutrophils, ESR, glucose, ALT, AST, CPK, urea, LDH, ferritin, CRP, fibrinogen, D-dimer, respiration rate, heart rate, blood, pressure in the group of patients with mild and. moderate severity were statistically significantly lower than in the group of severe patients (p < 0.001). Eleven indicators were identified as predictors of severe COVID-19 (peripheral oxygen level, peripheral blood erythrocyte count, hemoglobin level, absolute eosinophil count, absolute lymphocyte count, absolute neutrophil count, LDH, ferritin, C-reactive protein, D-dimer levels) and. their threshold, values. A model intended, to predict COVID-19 severity in young adults was built. Conclusion. The values of laboratory and instrumental indicators obtained in patients with SARS-CoV-2 infection upon admission significantly differ. Among them, eleven indicators were significantly associated with the development of a severe COVID-19. A predictive model based, on artificial intelligence method, with high, accuracy predicts the likelihood, of severe SARS-CoV-2 course development in young adults.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit

During intensive care unit (ICU) management of COVID-19, blood tests are often conducted for close monitoring of patients, a poor prognostic factor for survival, especially in hypoxemic patients. This study aimed to determine the degree of anemia and its effect on prognosis in ICU COVID-19 patients. This retrospective study included COVID-19 patients admitted to the ICU between 1 October 2020 and 1 May 2021. All the patients included were aged > 18 years and stayed in the ICU for >=14 days. Patients aged <18 years, those with major bleeding, and those recovering from surgery were excluded. The total blood samples (mL) taken in the ICU were calculated. From among the 395 patients screened for inclusion, 112 patients were included in the study. Mean age of the patients was 71.3 +/- 13.2 years (Male/Female: 1.8). Mean hemoglobin (Hb) at admission was 13.2 +/- 1.8 g dL-1. At the end of the ICU stay mean Hb was 9.74 +/- 1.98 g dL-1. During ICU stay, the mean reduction in Hb was 3.47 +/- 2.11 g dL-1. Age (p= 0.049), drawn blood volume per day (p= 0.001), and higher hemoglobin at admission (p= 0.001) were determined by multivariate analysis as independent risk factors for hemoglobin reduction. Hemoglobin reduction (OR: 1.34), and intubation status (OR: 57.50) were independent risk factors for mortality. Considering that most COVID-19 patients are admitted to the ICU due to acute respiratory failure (ARF), it is vital to maintain the Hb level as high as possible, so as to maintain oxygenation.Copyright © 2022, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.

The effect of ACE inhibitors on inflammation and clinical end-points in COVID-19 patients Relationship of ACE inhibitors to COVID-19 patients

Aim: COVID-19 infection has affected the whole world. It has been speculated that the virus might hold on to angiotensin-converting enzyme 2 (ACE 2) surfaces of type 2 alveolar cells. ACE inhibitors and angiotensin receptor antagonists (ARBs) are essential antihypertensive and cardiac failure drugs in the guidelines. In this study, we aimed to find the effect of these drugs on clinical, laboratory courses, and outcomes of COVID-19 patients. Material(s) and Method(s): We included 109 patients in this study. There were 43 patients in the ACE/ARB group and 66 patients in the non-ACE/ARB group. The mean age was 60 years in the ACE/ARB group and 52 years old in the non-ACE/ARB group. Basal symptoms, hemogram, CRP, D-dimer, LDH, Ferritin, AST, duration of hospitalization, percentage of intensive care unit (ICU) need, length of stay in ICU were compared between the groups. Result(s): The mean age in the ACE/ARB group was higher than in the other group and was statistically significant (p=.027). The initial symptoms were not different. There were no differences between the laboratory results of the groups. The ICU need was higher in the patients who do not use the drug than in the users (p<.020). Discussion(s): ACE/ARB usage in COVID-19 patients did not worsen the course of the disease. However, ACE/ARB users before COVID-19 pandemic were taken to ICU at a low rate.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Comparison of Clinical and Laboratory Findings at Different Clinical Stages in Cats Naturally Infected with Feline Coronavirus

Feline coronavirus (FCoV) infections occur commonly in cats, with entrocyte and monocyte-macrophage tropism. Most FCoV-infected cats remain asymp tomatic, but up to 10% develop fatal feline infectious peritonitis (FIP). This study aims to investigate the diagnostic utility of clinical and laboratory examinations including serum and effusion AGP levels in cats either with symptomatic effusive FIP or asymptomatic feline enteric coronavirus (FECV). The study included 40 cats with effusive FIP and 10 cats with FECV infection. The FIP group was divided into two subgroups: Abdominal (AE;n=30) and thoracic effusion (TE;n=10). Clinical and laboratory examinations, including serum or effusion AGP measurement, were performed. Among all the groups, TE group had higher body temperature, heart and respiratory rates (P<0.000). Compared with the FECV group, the FIP group had lower pH and HCO3 levels and higher base excess and lactate levels (P<0.05). The leukocyte and lymphocyte counts were higher and the hematocrit was lower in the AE group among all the groups (P<0.023). MCV was lower in the FIP group compared to the FECV group (P<0.002). In the AE group, total protein level was the lowest and the AST, GGT, total bilirubin and cholesterol levels were the highest (P<0.032) among all the groups. Magnesium level was lower in the FIP group compared to the FECV group (P<0.044). Although the serum AGP level was highest in the TE group among all groups (P<0.004), the AGP levels of cats with FECV were similar to the AE group (P>0.05). Since FECV-positive cats will likely develop FIP, differences in clinical and laboratory findings in FECV-positive cats were identified. Among them, pH, HCO3, base excess, lactate, MCV and magnesium were found to be important in the course of the disease, and AGP in the evaluation of the presence of an inflammatory state. It was concluded that clinical, laboratory and serum AGP evaluation could be used in the index of suspicion of development of FIP and FECV.Copyright © 2023 Erdem Gulersoy et al., published by Sciendo.

Lactate and D-Dimer levels in acute pulmonary embolism and COVID-19 Lactate and D-Dimer in COVID-19

Aim: This study aimed to compare clinical data and laboratory results in patients examined for suspected pulmonary embolism (PE) in the emergency department based on three groups: patients with coronavirus disease-2019 (COVID-19), patients with PE and patients with both COVID-19 and PE. Material(s) and Method(s): This retrospective study was approved by the local ethics committee of the university. Patients included in the study were divided into three groups: Group 1, consisting of COVID-19-polymerase chain reaction (PCR) (negative) and PE (positive) patients;Group 2, consisting of COVID-19-PCR (positive) and PE (negative) patients, and Group 3, consisting of COVID-19-PCR (positive) and PE (positive) patients. Result(s): The three patient groups included in the study had no difference in terms of age (p = 0.916) or sex. The laboratory results of the groups were compared using the Kruskal-Wallis test, which showed significant differences in the levels of white blood cells (p = 0.005), lymphocytes (p < 0.001), neutrophils (p = 0.016), D-Dimer (p < 0.001) and lactate (p = 0.001). Receiver operating characteristic curve analysis with a cut-off value of >2590 for D-Dimer showed 71.43% specificity and 78% sensitivity in differentiating Group 1 from Group 2, and with a cut-off value of >3640, it had 80% specificity and 81.82% sensitivity in differentiating Group 3 from Group 2. Discussion(s): COVID-19 leads to increased incidence of PE. In addition to clinical data, D-Dimer and lactate levels can be used in the differentiation of these patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Regional Oxygenation in Neonates with Anemia.

Purpose. Assessment of regional oxygenation in neonates with anemic syndrome and after its correction. Materials and methods. The study included 76 neonates. Depending on the fact of the presence or absence of anemia, which required its correction, all included in the study infants were divided into 2 groups: with anemia - 8 patients and without it - 68 patients. Multiregional monitoring of tissue oxygenation was performed with the help of INVOS 5100C cerebral/somatic oximeter (Covidien, Medtronic, USA). Results and discussion. In comparison with infants with anemia, the comparison group had higher level of minimal cerebral oxygenation (73 [66;80] versus 56 [39;70], p=0.0447), and lower cFTOE values (0.17 [0.11;0.23] versus 0.35 [0,30;0,48], p=0,0021). It was also found that a newborn with RDS and cFTOE> 0.22 is 3.5 times more likely to have anemia, which requires PRBC transfusion. Correction of anemia was accompanied by the increase of hemoglobin level by 51 [36;56] g/l and hematocrit - by 16 [15;17] %. Moreover, only crSO2 and cFTOE showed the differences before and after transfusion: crSO2 before - 60 [55;69] and after - 65 [61;71], p=0.0156;cFTOE before - 0.40 [0.30;0.45] and after 0.34 [0.27;0.38], p=0.0078. Conclusion. Monitoring of regional oxygenation in neonates can be used for early diagnosis of oxygen imbalance in tissues on the background of development of anemia, and assessment of the effectiveness of its correction as well.Copyright © 2020, Professionalnye Izdaniya. All rights reserved.

Prognostic Factors for Predicting COVID-19 Severity and Mortality

Background: COVID-19 has become a serious health problem worldwide. Objective(s): The current study investigated the prognostic factors associated with demographical parameters, clinical and vital signs, and laboratory results for predicting severity and mortality in patients infected with COVID-19. Method(s): This retrospective analysis was conducted on the medical records of 372 COVID-19-positive patients hospitalized at the Khatam al-Anbiya Hospital, Shoushtar, Iran, from Sep 2020 to Sep 2021. The association of demographic parameters, clinical and vital signs, and laboratory results with severity and patients' outcomes (survival/mortality) was studied. The patients were divided into the non-severe group (n = 275) and the severe group (n = 97). COVID-19 disease severity was determined based on the severity of pulmonary involvement using CT chest images. The collected data were analyzed using IBM SPSS software for Windows (version 18). Logistic regression analysis was employed using the Forward LR method to predict COVID-19 severity and mortality. Result(s): The rates of mortality and the severe form of the disease were 87.1% (n = 324) and 12.9% (n = 48), respectively. A prognostic value was observed in predicting COVID-19 severity and mortality for some clinical and vital signs (diabetes (P < 0.001, P = 0.019), hypertension (P = 0.024, P = 0.012), pulmonary diseases (P = 0.038, P < 0.001), and anosmia (P = 0.043, P = 0.044) and paraclinical parameters (FBS (P = 0.014, P = 0.045), BUN (P = 0.045, 0.001), Cr (P = 0.027, P = 0.047), Neut (P = 0.002, P = 0.005), and SpO2 (P = 0.014, P = 0.001)). Cardiovascular disorders (P = 0.037), fever (P = 0.008), and dyspnea (P = 0.020) were also effective at predicting disease-related mortality. Multiple logistic regression analyses showed that diabetes disease, the place of residence, PCO2, and BUN with R2 = 0.18, and age, pulmonary diseases, and BUN with R2 = 0.21 were involved in predicting the severity and mortality, respectively. Conclusion(s): It seems that in addition to the BUN, diabetes and pulmonary diseases play a more significant role in predicting the severity and mortality due to COVID-19, respectively.Copyright © 2023, Author(s).

Comparison of scoring systems' mortality prediction ability in COVID-19 intensive care patients over 80 years of age

Aim: In this study, we aimed tto compare the 30-day mortality prediction abilities of the acute physiology and chronic health evaluation II (APACHE II), CURB-65, pneumonia severity index (PSI), A-DROP, Infectious Diseases Society of America/American Thoracic Society severity criteria, and I-ROAD scores in patients aged over 80 years admitted to the intensive care unit with COVID-19 pneumonia. Material(s) and Method(s): The study was conducted with a single-center retrospective observational design and included patients aged 80 years and older who were admitted to the intensive care unit due to COVID-19 pneumonia between March 2020 and August 2021. Patient demographic data, imaging findings, blood test results, discharge status, length of stay in the intensive care unit, duration of mechanical ventilation, inotropic drug administration status, presence/ absence of mortality and vital signs at the time of admission were obtained from the hospital automation system. Then, the above-mentioned scores were calculated and compared statistically. Result(s): The study was completed with 119 patients, 60 (50.4%) women and 59 (49.6%) men. The mean age of all patients was 84 (80-98) years, and the mortality rate was 84.03% (n=100). Among the scoring systems, I-ROAD had the highest area under the curve (AUC) value (0.703), APACHE II had the highest specificity (94%), and A-DROP had the highest sensitivity (64%). Discussion(s): According to our results, the I-ROAD scoring system is an effective tool that can be used in the prediction of mortality related to COVID-19 pneumonia among intensive care patients aged >=80.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Post-COVID-19 non-traumatic iliopsoas hematoma: A case report

Background: Critically ill COVID-19 patients have an elevated risk of experiencing hypercoagulable conditions. Currently, many COVID-19 patients have been administered anticoagulation or antiplatelet therapies to lower the risk of systematic thrombosis. Iliopsoas hematoma is a potentially fatal and rare complication of bleeding disorders or anticoagulation therapy which sometimes grows to become clinically significant. The main purpose of this case review is to emphasize the importance of diagnosing iliopsoas hematomas and the possibility of antiplatelet contribution to its development. Case Presentation: We are reporting a rare presentation of non-traumatic iliopsoas hematoma in a non-anticoagulated patient. The patient is a 59-year-old male, with known type-2 diabetes, on oral hypoglycemic medications, 3-weeks post-COVID-19. He had started aspirin 81 mg orally, once daily, to prevent thrombotic events associated with COVID 19 infection, with no anticoagulant use and no other medications. He came in through the ED, presenting with two weeks history of progressive right lower limb weakness in which an iliopsoas hematoma diagnosis was confirmed based on radiological investigation. Conclusion: The possibility of iliopsoas hematoma should be considered in non-anticoagulated patients with no inherited or acquired coagulation disorders presenting with limb weakness. The link between antiplatelet use in a COVID-19 patient and the development of soft tissue bleeding (e.g., iliopsoas hematoma) must be studied further. © 2022 [The Author/The Authors]

The importance of LDH/Albumin, LDH/Lymphocyte, and LDH/Platelet ratios in the evaluation of COVID-19 B.1.1.7 variant

Objectives: The aim is to investigate the usefulness of lactate dehydrogenase (LDH)/Albumin, LDH/Lymphocyte and LDH/Platelet ratios on the prognosis of coronavirus disease (COVID-19) Alpha (B.1.1.7) variant pneumonia. Method(s): A total of 113 patients who were diagnosed with COVID-19 pneumonia and 60 healthy control group were included in this study. The cases were divided into 2 as classic COVID-19 group, and COVID-19 B.1.1.7 variant group. Complete blood count (CBC) and biochemical parameters of the patients were analyzed retrospectively. Patients with COVID-19 B.1.1.7 variant group were also grouped according to the length of stay in the hospital and the days of hospitalization. Result(s): LDH/Albumin, LDH/Platelet, and LDH/Lymphocyte ratios were found to be higher in COVID-19 B.1.1.7 variant group when compared to the control group (p<0.001). The ferritin, neutrophils/lymphocyte (NLR) ratio, procalcitonin (PCT) and LDH/Albumin had the highest area under the curve (AUC) values in the COVID-19 B.1.1.7 variant group (0.950, 0.802, 0.759, and 0.742, respectively). Albumin, Lymphocytes and hemoglobin values were significantly higher in the COVID-19 B.1.1.7 variant group than in the classic COVID-19 group (p<0.05). Conclusion(s): LDH/Albumin and LDH/Lymphocyte ratios may be useful for clinicians in predicting the risk of progression to pneumonia in COVID-19 B.1.1.7 variant patients. Copyright © 2022 the author(s), published by De Gruyter.

An IoT-based smart optical platform for colorimetric analyzing multiple samples of biomarkers

In this work, we have designed, implemented, and characterized an IoT-enabled optical platform that serves as a highly efficient colorimetric analyzer for disposable rapid diagnostic test kits. We have taken color images of the test chip using an external camera module connected to an IoT-enabled single-board mini-computer, which are then analyzed using an image processing algorithm. To prevent image burning and to reduce the impact of ambient lighting, we have proposed a unique light-diffusing model and have maintained a strategic distance within the white acrylic imaging enclosure of the platform. In order to ensure even and uniform distribution of light on the sample within the platform, we have carried out a study with the incorporation of a highly bright single LED, an LED array, and attaching a PDMS-made light diffuser on the LED array at varying light incident angles on custom-made single-channel test kits containing blood hematocrit. Finally, based on the optimized lighting conditions, we have successfully applied the proposed platform for the detection of blood hematocrit, β-hCG, and SARS-CoV-2 antigen, and were able to identify their different levels of concentration. Since the device is portable in size and cost-effective to implement, it can also be used for analyzing other biomarkers in resource-limited communities for point-of-care (POC) applications.