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BACKGROUND: The article reflects the clinical significance of the early diagnosis of toxic hepatitis in patients who have undergone a new coronavirus infection with the determination of clinical and laboratory predictors of the response to therapy. A dynamic analysis of the effectiveness of toxic hepatitis therapy in patients of three experimental groups and a control group is presented. AIM: The aim of the present study is to increase the effectiveness of the treatment of toxic hepatitis in patients who have undergone COVID-19. MATERIALS AND METHODS: On the basis of the newly created infection centers of the Central Clinical Hospital "RZhD-Medicine" and Vishnevsky 3-rd Central Military Clinical Hospital 996 patients with COVID-19, who had clinical and laboratory signs of toxic liver damage (cytolytic and/or cholestatic syndromes) against the background of COVID-19 therapy. RESULTS: On the 14th day from the start of therapy in group 3, there was a significant decrease in the clinical manifestations of jaundice in 163 (72.8%) patients, on the 21st day of treatment, this symptom was stopped in all patients. In groups 1 and 2, the decrease in clinical manifestations of jaundice was significantly lower - 122 (55.2%) and 134 (58.8%); p<0.05. At the end of therapy, no manifestations of jaundice were observed in all experimental groups, while in the control group, symptom reduction was achieved only in 47 (14.5%) patients. CONCLUSION: The use of drugs with hepatoprotective effect in the form of monotherapy in groups 1 (UDCA) and 2 (ademethionine) showed a low therapeutic effect with positive dynamics of clinical and laboratory indicators of toxic hepatitis activity. The use of combined treatment in group 3 (UDCA and ademethionine) demonstrated the maximum therapeutic effect, pronounced positive dynamics in the form of normalization of clinical and laboratory indicators of toxic hepatitis activity.
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COVID-19 , Chemical and Drug Induced Liver Injury , Jaundice , Humans , Drug Therapy, Combination , Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/epidemiology , Chemical and Drug Induced Liver Injury/etiology , Treatment OutcomeABSTRACT
BACKGROUND: The influenza virus and the novel beta coronavirus (SARS-CoV-2) have similar transmission characteristics, and it is very difficult to distinguish them clinically. With the development of information technologies, novel opportunities have arisen for the application of intelligent software systems in disease diagnosis and patient triage. METHODS: A cross-sectional study was conducted on 268 infants: 133 infants with a SARS-CoV-2 infection and 135 infants with an influenza virus infection. In total, 10 hematochemical variables were used to construct an automated machine learning model. RESULTS: An accuracy range from 53.8% to 60.7% was obtained by applying support vector machine, random forest, k-nearest neighbors, logistic regression, and neural network models. Alternatively, an automated model convincingly outperformed other models with an accuracy of 98.4%. The proposed automated algorithm recommended a random tree model, a randomization-based ensemble method, as the most appropriate for the given dataset. CONCLUSIONS: The application of automated machine learning in clinical practice can contribute to more objective, accurate, and rapid diagnosis of SARS-CoV-2 and influenza virus infections in children.
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The relevance of research on a novel coronavirus infection is associated with an increase in the incidence among children since 2021, which may be due to the accumulation of mutations in the virus genome and its evolution towards increased contagiousness, replicative ability, and evasion of immune protection. While there are many studies in adults, data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2 are limited, particularly regarding adolescents. Objective. To study the clinical and laboratory features of the course of a novel coronavirus infection in hospitalized adolescents in Novosibirsk during the first, second and third waves of the pandemic. Materials and methods. A retrospective analysis of case histories of 125 children treated at Novosibirsk Children's Clinical Hospital No 6 with a confirmed diagnosis of coronavirus infection during three pandemic waves was carried out (June- August 2020, October-December 2020, June-August 2021). Based on these time intervals, three groups of adolescents admitted to the hospital during the first, second, and third waves of coronavirus infection were formed. SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal scrapings was determined using the PCR-RT method. Biochemical and general clinical studies were performed in accordance with the guidelines of the Ministry of Health of the Russian Federation. Statistical processing was carried out using the Satistika 7.0 software package (StatSoft, USA). Differences between the groups were assessed using the Z-test and the Mann-Whitney U test. Differences between the compared series were considered statistically significant with a probability level of 95%. Results. It was shown that during three pandemic waves (June 2020 - August 2021), more than half of the hospitalized children were adolescents. At the same time, regardless of the pandemic wave, intoxication, catarrhal and intestinal syndromes predominated in hospitalized adolescents. CNS injury symptoms were significantly less frequent in the first wave, as were skin rashes. Cough in the third wave was observed in 100% of hospitalized adolescents. The average values of the parameters of complete blood count, as well as CRP, D-dimer and ferritin had no statistically significant differences in different pandemic waves, but there was a significant variation in individual values within the groups in each wave.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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The relevance of research on a novel coronavirus infection is associated with an increase in the incidence among children since 2021, which may be due to the accumulation of mutations in the virus genome and its evolution towards increased contagiousness, replicative ability, and evasion of immune protection. While there are many studies in adults, data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2 are limited, particularly regarding adolescents. Objective. To study the clinical and laboratory features of the course of a novel coronavirus infection in hospitalized adolescents in Novosibirsk during the first, second and third waves of the pandemic. Materials and methods. A retrospective analysis of case histories of 125 children treated at Novosibirsk Children's Clinical Hospital No 6 with a confirmed diagnosis of coronavirus infection during three pandemic waves was carried out (June- August 2020, October-December 2020, June-August 2021). Based on these time intervals, three groups of adolescents admitted to the hospital during the first, second, and third waves of coronavirus infection were formed. SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal scrapings was determined using the PCR-RT method. Biochemical and general clinical studies were performed in accordance with the guidelines of the Ministry of Health of the Russian Federation. Statistical processing was carried out using the Satistika 7.0 software package (StatSoft, USA). Differences between the groups were assessed using the Z-test and the Mann-Whitney U test. Differences between the compared series were considered statistically significant with a probability level of 95%. Results. It was shown that during three pandemic waves (June 2020 - August 2021), more than half of the hospitalized children were adolescents. At the same time, regardless of the pandemic wave, intoxication, catarrhal and intestinal syndromes predominated in hospitalized adolescents. CNS injury symptoms were significantly less frequent in the first wave, as were skin rashes. Cough in the third wave was observed in 100% of hospitalized adolescents. The average values of the parameters of complete blood count, as well as CRP, D-dimer and ferritin had no statistically significant differences in different pandemic waves, but there was a significant variation in individual values within the groups in each wave.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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The relevance of research on a novel coronavirus infection is associated with an increase in the incidence among children since 2021, which may be due to the accumulation of mutations in the virus genome and its evolution towards increased contagiousness, replicative ability, and evasion of immune protection. While there are many studies in adults, data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2 are limited, particularly regarding adolescents. Objective. To study the clinical and laboratory features of the course of a novel coronavirus infection in hospitalized adolescents in Novosibirsk during the first, second and third waves of the pandemic. Materials and methods. A retrospective analysis of case histories of 125 children treated at Novosibirsk Children's Clinical Hospital No 6 with a confirmed diagnosis of coronavirus infection during three pandemic waves was carried out (June- August 2020, October-December 2020, June-August 2021). Based on these time intervals, three groups of adolescents admitted to the hospital during the first, second, and third waves of coronavirus infection were formed. SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal scrapings was determined using the PCR-RT method. Biochemical and general clinical studies were performed in accordance with the guidelines of the Ministry of Health of the Russian Federation. Statistical processing was carried out using the Satistika 7.0 software package (StatSoft, USA). Differences between the groups were assessed using the Z-test and the Mann-Whitney U test. Differences between the compared series were considered statistically significant with a probability level of 95%. Results. It was shown that during three pandemic waves (June 2020 - August 2021), more than half of the hospitalized children were adolescents. At the same time, regardless of the pandemic wave, intoxication, catarrhal and intestinal syndromes predominated in hospitalized adolescents. CNS injury symptoms were significantly less frequent in the first wave, as were skin rashes. Cough in the third wave was observed in 100% of hospitalized adolescents. The average values of the parameters of complete blood count, as well as CRP, D-dimer and ferritin had no statistically significant differences in different pandemic waves, but there was a significant variation in individual values within the groups in each wave.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has become a major health concern worldwide. In that context, the understanding of epidemiological and clinical features associated with the disease and its severity is crucial for the establishment of strategies aimed at disease control and remedy. AIM: To describe epidemiological features, signs, symptoms, and laboratory findings among severely ill COVID-19 patients from an intensive care unit in northeastern Brazil as well as to evaluate predictor factors for disease outcomes. METHODS: This is a prospective single-center study that evaluated 115 patients admitted to the intensive care unit in a northeastern Brazilian hospital. RESULTS: The patients had a median age of 65.60 ± 15.78 years. Dyspnea was the most frequent symptom, affecting 73.9% of the patients, followed by cough (54.7%). Fever was reported in approximately one-third of patients and myalgia in 20.8% of the patients. At least two comorbidities were found in 41.7% of the patients, and hypertension was the most prevalent (57.3%). In addition, having two or more comorbidities was a predictor of mortality, and lower platelet count was positively associated with death. Nausea and vomiting were two symptoms that were predictors of death, and the presence of a cough was a protective factor. CONCLUSION: This is the first report of a negative correlation between cough and death in severely ill severe acute respiratory syndrome coronavirus 2-infected individuals. The associations between comorbidities, advanced age, and low platelet count and the outcomes of the infection were similar to the results of previous studies, highlighting the relevance of these features.
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INTRODUCTION: In the current COVID-19 pandemic, clinicians require a manageable set of decisive parameters that can be used to (i) rapidly identify SARS-CoV-2 positive patients, (ii) identify patients with a high risk of a fatal outcome on hospital admission, and (iii) recognize longitudinal warning signs of a possible fatal outcome. METHODS: This comparative study was performed in 515 patients in the Maria Sklodowska-Curie Specialty Voivodeship Hospital in Zgierz, Poland. The study groups comprised 314 patients with COVID-like symptoms who tested negative and 201 patients who tested positive for SARS-CoV-2 infection; of the latter, 72 patients with COVID-19 died and 129 were released from hospital. Data on which we trained several machine learning (ML) models included clinical findings on admission and during hospitalization, symptoms, epidemiological risk, and reported comorbidities and medications. RESULTS: We identified a set of eight on-admission parameters: white blood cells, antibody-synthesizing lymphocytes, ratios of basophils/lymphocytes, platelets/neutrophils, and monocytes/lymphocytes, procalcitonin, creatinine, and C-reactive protein. The medical decision tree built using these parameters differentiated between SARS-CoV-2 positive and negative patients with up to 90-100% accuracy. Patients with COVID-19 who on hospital admission were older, had higher procalcitonin, C-reactive protein, and troponin I levels together with lower hemoglobin and platelets/neutrophils ratio were found to be at highest risk of death from COVID-19. Furthermore, we identified longitudinal patterns in C-reactive protein, white blood cells, and D dimer that predicted the disease outcome. CONCLUSIONS: Our study provides sets of easily obtainable parameters that allow one to assess the status of a patient with SARS-CoV-2 infection, and the risk of a fatal disease outcome on hospital admission and during the course of the disease.
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Objective: COVID-19 is a disease caused by SARS-COV-2 and early diagnosis and classification of the COVID-19 are critical for the better prognosis. This study aimed to combine laboratory data of COVID-19 patients with Computed Tomography Segmentation-Volume Analysis (CT-SVA). Thus, we hope to contribute to the early diagnosis and classification of the disease. Methods: Patients were divided into two groups according to disease severity as mild/moderate (n=41) and severe/critical (n=42). Some laboratory parameters were recorded and evaluated together with CT-SVA. Results: The results of the study have shown that sodium, C-reactive protein, D-dimer, ferritin, fibrinogen, interleukin 6, procalcitonin, white blood cells, neutrophil, neutrophil-lymphocyte ratio values were significantly higher at first admission in the severe/critical diseased group (p<0.05), while albumin, lymphocyte, and venous blood pH values were significantly lower (p<0.05). CT-SVA results have shown negative correlation with albumin, while having a positive correlation with C-reactive protein, D-dimer, ferritin, fibrinogen, interleukin 6 and procalcitonin. The results of the performed Receiver Operating Characteristics analysis revealed that CT-SVA has a cut-off value of 15.92 with a sensitivity of 87.1% and a specificity of 80.0% in predicting disease severity. Binary logistic regression model has included CT-SVA, D-dimer, ferritin, interleukin 6, and neutrophil-lymphocyte ratio. The model correctly classified 88.1% of cases. CT-SVA, D-dimer, ferritin, interleukin 6, and neutrophil-lymphocyte ratio were detected to be the independent predictors of disease severity. Conclusion: Evaluation of laboratory parameters together with CT-SVA results will help identification of cases with a poor prognosis and accelerate intervention.
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Objective: To investigate the clinical symptoms of coronavirus disease 2019 (COVID-19) patients with and without B.1.1.7 mutation. Method(s): This retrospective observational study included COVID-19 patients who were divided into two groups, the mutation and the non-mutation group. Demographics characteristics, clinical characteristics, laboratory parameters, and mortality rates were recorded and compared between the two groups. Result(s): A total of 196 patients were included in the study. The relationship between the mutant virus status and sex, age, comorbidity, survival status, and disease severity was not significant (P>0.05). No significant differences were found in duration of hospitalization between the mutation and the non-mutation group (P>0.05). However, there was a statistically significant difference between patients with and without mutant viruses in hemoglobin, mean platelet volume, procalcitonin, low density lipoprotein, ironbinding capacity, potassium, calcium, C-reactive protein, folate, creatine kinase myocardial band, D-dimer, and international normalized ratio (P<0.05). Conclusion(s): No significant difference is found in mortality rate, disease severity or duration of hospitalization between the patients with and without variant B.1.1.7. Careful monitoring of COVID-19 patients is required for all variants. Copyright ©2022 Journal of Acute Disease Produced by Wolters Kluwer-Medknow.
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Background: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide with global financial and health care systems consequences. It is already well recognized that immunization against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a precondition for blocking mutations and prevent the emergence of variants. The aim of the study was to investigate the possible relationship between COVID-19 vaccines and the commonly used disease-related blood biomarkers. Methods: Adult patients with confirmed SARS-CoV-2 infection who were hospitalized from November 8, 2021, to December 31, 2021, were included. The retrospective study was conducted in Patras University Hospital, Greece. Two groups of patients were assessed, the ones who were previously vaccinated against SARS-CoV-2 (group A, n = 21), and those who were not (group B, n = 55). After analysis of peripheral blood, we calculated on admission day for each patient the total white blood cell (WBC), absolute lymphocytes count (ALC), absolute monocyte count, D-dimers, C-reactive protein (CRP) plasma levels, lactate dehydrogenase (LDH), ferritin, high-sensitive troponin, as well as the arterial oxygen partial pressure/fractional inspired oxygen (PO2/FiO2) ratio. Results: The median age of all patients was 65.3 ± 15.2 years old; 68.4% were men and 31.6% were women. Comorbidities were present in 51 patients (67.1%). Hypertension and diabetes were observed as the most common comorbidities (33.3%). About 72.4% of the patients were unvaccinated or have received the first dose of vaccine, and 27.6% were completely vaccinated. No statistical difference was found in the total WBC count and ALC between the two groups (group A vs. group B: 8,168.95 ± 7,584.4 vs. 8,521.9 ± 6,571.3, P = 0.848 and 3,052.1 ± 7,230.7 vs. 1,279.6 ± 1,218.6, P = 0.087). Monocytes count in both groups did not show statistical difference: group A vs. group B: 672.6 ± 384.7 vs. 637.9 ± 477.8 (P = 0.754). Similarly, no difference for D-dimers (1,348.5 ± 1,397.6 vs. 1,850.9 ± 3,877.5, P = 0.575), ferritin (1,082.8 ± 1,399.5 vs. 1,327.4 ± 1,307.8, P = 0.508), high-sensitive troponin (113.6 ± 318.1 vs. 157.5 ± 48.8, P = 0.252), and CRP (6.92 ± 4.9 vs. 7.4 ± 5.9, P = 0.732). For LDH plasma levels, the statistical difference was significant (274.2 ± 85.6 vs. 387.5 ± 223.4, P = 0.003), as well as for the PO2/FiO2 ratio (355.6 ± 129.7 vs. 260.5 ± 123.3, P = 0,006). Conclusions: In a mixed population hospitalized for COVID-19, only LDH plasma levels and the PaO2/FiO2 on admission day showed statistically significant difference between vaccinated and unvaccinated patients. Although unvaccinated patients are more likely to develop severe illness, they did not express significantly higher values of commonly used plasma biomarkers such as ferritin, CRP, and D-dimers which are related to disease severity.
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Mucormycosis in COVID-19 patients of severe type has been reported. This study was intended to evaluate ESR, CRP, LDH, CPK, D-Dimer, BS and FBS levels in COVID-19 patients with mucormycosis. Information was recorded including gender, age, hospitalization and recovery. The laboratory parameters contained ESR, CRP, LDH, CPK, D-Dimer, BS and FBS levels. There was a significant relationship between LDH and CPK level with hospitalization, and also, between CRP and gender. Finally, there was a significant difference between the age groups in terms of ESR. Our study showed that LDH and CPK, CRP and ESR should be considered as laboratory tests in the hospitalized COVID-19 patients with mucormycosis. © 2022, Health Biotechnology and Biopharma.
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Objective: In smokers, COVID-19 may have a more severe course due to impaired mucociliary activity, increased permeability, and inflammation of the airway epithelium. However, data on the impact of smoking in patients with COVID-19 pneumonia are conflicting. The study aimed to evaluate the effects of smoking on laboratory parameters, intensive care unit (ICU) length of stay, length of hospital stay, and mortality in COVID-19 patients hospitalized in the intensive careunit. Method(s): Medical records of 576 patients who were followed up in the ICU for COVID-19 between January and September 2021 were analyzed retrospectively. Demographic data, comorbidities, laboratory parameters (hemoglobin, white blood cell (WBC), lymphocyte, neutrophil, thrombocyte, AST, ALT, CRP, D-dimer, ferritin, BNP, albumin), ICU and hospital stay of the patients were recorded. The patients were divided into 2 groups according to whether they smoked or not. Result(s): The data of 576 patients were evaluated in the study. The mean age of the patients was 69 14.8 years, and 53.8% were male. The smoking rate was 30%, and the smoking rate in men was 76.9%. The intensive care unit admission age of smokers was lower than non-smokers (p=0.01). The presence of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and malignancy was significantly higher in smokers. Among the laboratory parameters, white blood cell count (WBC) and neutrophil were higher in smokers (p=0.01). There was no relationship between ICU length of stay, length of hospital stay, and mortality in smokers (p=0.769, p=0.699, p=0.852, respectively). Conclusion(s): We did not find any significant association between smoking and COVID-19 mortality. We recommend clinicians to monitor WBC and neutrophil count closely as markers of possible progression to critical illness in patients hospitalized in the ICU due to smoking COVID-19. Copyright © 2022 Anestezi Dergisi. All rights reserved.
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Objective: Coronavirus disease causes a wide spectrum of clinical picture in pregnant women. There are still a few studies concerning laboratory parameters to differentiate the severity of coronavirus disease-19 in pregnant patients. This article aims to identify the cut-off on laboratory parameters between pregnant women with asymptomatic/mild/moderate and severe/critical coronavirus disease-19 illness. Methods: All coronavirus disease-19 pregnant women coming to Dr. Cipto Mangunkusumo hospital between January and August 2021 were recruited into this cross-sectional study. All data extracted from medical records were classified into demographic characteristics and laboratory parameters. We defined demographic characteristics as age, parity, systolic, and diastolic blood pressure, heart rate, temperature, respiratory rate, and oxygen saturation. Laboratory parameters measured in this study consisted of complete blood count, renal function test including urea, creatinine, liver function test including aspartate transferase, alanine transferase, infection marker test including procalcitonin, C-reactive protein, interleukin-6, cycle threshold values, ferritin, coagulation test including d-dimer, fibrinogen, random blood glucose, albumin, electrolytes. Data analysis was performed using SPSS statistics. Results: There were 159 cases assessed in this study consisting of 130 (81.8%) patients with asymptomatic/mild/moderate illness and 29 (18.2%) patients with severe/critical illness of coronavirus disease-19. Of 28 laboratory parameters, 12 of them were significant statistically; thus, it resulted to make a cut-off using receiver operating characteristic curve and show relative risk, and 95% confidence interval. In multivariate analysis that aspartate transferase, D-dimer, and albumin were laboratory parameters impacted to the severity of coronavirus disease-19 in pregnant women. The area under receiver operating characteristic curve was 0.834 (95% CI 0.736-0.932). Conclusion: Of all laboratory parameters, urea, aspartate transferase, alanine transferase, procalcitonin, C-reactive protein, lactate dehydrogenase (LDH), ferritin, D-dimer, random blood glucose, cycle threshold values, albumin, and chloride differs between asymptomatic/mild/moderate, and severe/critical illness coronavirus disease-19 in pregnant women; aspartate transferase, D-dimer, and albumin were laboratory parameters impacted the most to the severity of coronavirus disease-19 in pregnant women.
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Objective: The aim of this study was to explore association of initial laboratory parameters of hospitalized patients with COVID-19, with the severity and death incident. Methods: In this retrospective study, patients were classified based on mortality outcome (survivor and non-survivor) and disease severity (non-severe, severe, and critical). The initial laboratory data (within the first two days of hospital admission) were compared between these categories. Results: Of 362 COVID-19 patients hospitalized between January-2021 and May-2021, 39.0% were non-severe, 32.2% severe, and 28.7% critical. 77.3% were lived and 22.7% died in hospital. Non-survivors were significantly older than survivors. There was a statistically significant association between exceeding the cut-points of laboratory parameters and the severity of the disease or even death. These laboratory parameters included D-dimer, C-reactive protein, prothrombin time, ferritin, white blood cells, neutrophil count, aspartate aminotransferase, creatinine, blood urea nitrogen, lymphocyte count, and albumin. Also, exceeding the cut-points of these parameters showed high odds of death. The highest odds ratio was reported for albumin <3.5 g/dL (OR=14.318 [4.784-42.851], p<0.001). Conclusion: The cut-points of the laboratory parameters could effectively be used as predictors to assess the severity and risk of death to improve the management of COVID-19 patients.
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Purpose: Various parameters have been proposed to predict the outcome of patients with coronavirus disease. The aim of this study was to evaluate the utility of the age-adjusted CCI score and biochemical parameters for predicting outcomes for COVID-19 patients on admission. Patients and methods: A total of 511 patients were included in the study. Only swab or serological tests positive patients were included. The clinical characteristics of the patients were compared between survival and non-survival COVID-19 inpatients. Hemoglobin, platelet, sedimentation, creatinine, AST, ALT, LDH, CK, albumin, ferritin, lymphocyte, neutrophil, CRP (1-5;5-10;10-20 × upper limit), procalcitonin (5-10;10-20; > 20 × upper limit), D Dimer (> 2 × upper limit), age, gender, chronic diseases and CCI scores were compared between the two groups. Results: 68 patients died and 443 patients survived. Mean age was 74.3±7.3 years in survival group and 76.7±8.0 in nonsurvival group. Age, male sex, ischemic heart disease (CHD), chronic kidney disease and active malignancy was statistically higher in non-survivor group. The biochemical parameters was compared in survival and nonsurvival group. CCI score, AST, LDH, CK, Ferritin, CRP are significantly higher and albumin, lymphocyte levels are significantly lower in nonsurvival group. D-dimer and procalcitonin levels are significantly higher in nonsurvival group. CCI score and neutrophil, creatinine, ALT, AST, d-dimer and procalcitonin elevations were correlated. Low albumin and lymphocyte levels were correlated with the CCI score. There was no significant correlation between ferritin, sedimentation, CRP levels and CCI score. A multivariate logistic regression analysis indicated that anaemia, elevated CRP (> 10-20 × upper limit), procalcitonin (> 5-10 × upper limit), ALT, AST levels and higher CCI score were independent risk factors for mortality in COVID-19 patients. Conclusion: Anaemia, elevated CRP, procalcitonin levels, ALT, AST levels and higher CCI score were found independent risk factors for mortality in COVID-19 patients.
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Objective: Infectious diseases cause inflammation in the human body and produce numerical and functional changes in peripheral blood cells. Coronavirus disease-19 (COVID-19) is also an infectious disease diagnosed by the Polymerase Chain Reaction (PCR) test. However, PCR testing may not always be available. The aim of this study is to show the effect of numerical and functional changes in blood parameters on the diagnosis of COVID-19 in children. Methods: In this retrospective study, 296 patients and 286 healthy children were included. Nasopharyngeal swabs were collected. The swabs were analyzed by Real-time PCR. Independent-t/Mann-Whitney-U tests were applied;Receiver Operating Characteristic (ROC) curves and logistic regression modelling were evaluated. Results: Gender and age distributions of the groups were similar (p>0.05). There were significant differences between the two groups in terms of white blood cell (WBC) (p<0.001), neutrophil (p<0.001), thrombocyte (p<0.001), lymphocyte (p<0.001), mean platelet volume (MPV) (p=0.009), lactate dehydrogenase (LDH) (p=0.003), C-reactive protein (CRP) (p<0.001) and aspartate aminotransferase (AST) (p=0.002). It was found in ROC curve analyses, while LDH (p<0.001) and CRP (p<0.001) values were higher in patients, MPV (p=0.03), platelet (p=0.04), and neutrophil (p<0.001) values of them were lower. The best model in logistic regression was the model that included hemoglobin, neutrophil, lymphocyte, thrombocyte, LDH and CRP. Conclusions: Rapid diagnosis of COVID-19 are crucial for public health. PCR, required for definitive diagnosis, may not always be achieved, so easier and cheaper methods are needed. This study supports the diagnosis of COVID-19 in the children in the absence of PCR.
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Background: Laboratory parameters play a key role in triaging, predicting disease course, severity and may determine prognosis COVID-19 patients. Material and methods: Aim and Objectives: To study the relation of clinical and laboratory parameters (total WBC count, neutrophil: lymphocyte ratio, serum ferritin, serum D-dimer, serum LDH, CRP, ESR) with severity and outcome of Corona Virus Disease (COVID-19) confirmed by real-time RT-PCR. Sample size: It was a time-bound study conducted over 3 months (1st April to 30th June, 2020). A total of 206 patients will be included in this study satisfying the inclusion criteria. Study design: This was a prospective, observational and non-interventional study conducted on patients with laboratory-confirmed COVID-19 admitted in a tertiary care teaching hospital. Statistical Analysis: Data will be analyzed for mean, percentage, standard deviation, and chi-square test for quantitative data by using appropriate statistical tests using INSTAT software version 8.0 (trial version) and p-value < 0.05 will be considered statistically significant. Results: Total of 206 patients of both genders were included in the present study. Total 141 (68.44%) patients were males and 65 (31.55%) patients were females (Chi Sq. 56.07;DF:1;p < 0.001). Among all the groups according to the severity of illness, 'D' group was the most common group (n = 99;45.06%). Age > 60 years (17.48%), obesity (13.11%), hypertension (10.19%), COPD (5.83%), and diabetes mellitus (5.83%) were the most frequent risk factors or comorbidities associated with COVID-19 disease. Many patients had multiple risk factors in the present study. The majority (3/4th) of the patients were in C and D group (moderate) with co-morbidities and about 1/4th were in the severe group. Total 5 (2.43%) patients with COVID-19 patients succumbed to death with an overall case fatality rate of 2.43%. The case fatality rate was significantly higher among the patients with risk factors or comorbidities (p = 0.0124). Late presentation, associated comorbidity, advancing age, High level of ferritin, D-dimer, CRP, PaO2/FiO(2) ratio less than 100 at the time of admission were associated with mortality. The terminal event in patients who have succumbed was bradycardia followed by cardiorespiratory arrest. The cause of death was ARDS with bilateral extensive pneumonia. Conclusions: Late presentation, associated comorbidity like diabetes mellitus, advancing age, High level of ferritin, D-dimer, CRP, PaO2/FiO(2) ratio less than 100 at the time of admission were associated with mortality. The terminal event in patients who have succumbed was bradycardia followed by cardiorespiratory arrest. The cause of death was ARDS with bilateral extensive pneumonia.
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Background: The pandemic coronavirus disease (COVID-19) dramatically spread worldwide. Considering several laboratory parameters and comorbidities may facilitate the assessment of disease severity. Early recognition of disease progression associated with severe cases of COVID-19 is essential for timely patient triaging. Our study investigated the characteristics and role of laboratory results and comorbidities in the progression and severity of COVID-19 cases. Methods: The study was conducted from early-June to mid-August 2020. Blood samples and clinical data were taken from 322 patients diagnosed with COVID-19 at Qala Hospital, Kalar, Kurdistan Region of Iraq. Biological markers used in this study include complete blood count (CBC), D-dimer, erythrocyte sedimentation rate (ESR), serum ferritin, blood sugar, C-reactive protein (CRP) and SpO2. Results: The sample included 154 males (47.8%) and 168 females (52.2%). Most females were in the mild and moderate symptom groups, while males developed more severe symptoms. Regarding comorbidities, diabetes mellitus was considered the greatest risk factor for increasing the severity of COVID-19 symptoms. As for biological parameters, WBC, granulocytes, ESR, Ferritin, CRP and D-Dimer were elevated significantly corresponding to the severity of the disease, while lymphocytes and SpO2 showed the opposite pattern. Higher RBC was significantly associated with COVID-19 severity, especially in females. Conclusion: Gender, age and diabetes mellitus are important prognostic risk factors associated with severity and mortality of COVID-19. Relative to non-severe COVID-19, severe cases are characterized by an increase of most biological markers. These markers could be used to recognize severe cases and to monitor the clinical course of COVID-19.
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BACKGROUND: Convalescent plasma (CP) might be an additional treatment modality in COVID-19. The aim of this study was to compare CP-related clinical characteristics and perinatal outcomes in pregnant women with mild or moderate-severe COVID-19. METHODS: This prospective cohort study included 36 pregnant women (12 mild and 24 moderate-severe), who underwent CP therapy. The CP obtained from recently recovered donors was transfused to patients together with maximum supportive care and antiviral agents. The groups were then compared in respect of clinical characteristics, laboratory parameters, obstetric complications, and neonatal outcomes. RESULTS: Significant differences were determined between the groups in respect of systemic corticosteroids in COVID-19 treatment (41.7%, 87.5%, p = 0.004), oxygen (O2) support (0%, 91.7%, p < 0.001), chest imaging (41.7%, 58.3%, p = 0.02), intensive care unit admission (0%, 20.8%, p = 0.03) and length of hospitalization (5.5 versus 9.5 days, p < 0.001). The O2 saturation levels before and after administration of CP were significantly lower in the moderate-severe COVID-19 group (p < 0.05). The O2 therapy time before and after administration of CP and total O2 therapy time were significantly lower in the mild COVID-19 group (p < 0.05). Platelet, plateletcrit and lymphocyte counts were significantly higher in both the mild and moderate-severe COVID-19 groups after treatment compared to the pretreatment values (p < 0.05). DISCUSSION: Although data on the results of CP treatment in pregnant women are somewhat limited, it has been suggested that early CP treatment may be associated with improvements in laboratory and ventilatory parameters in pregnant women with mild and moderate-severe COVID-19. Nevertheless, there is a need for further, randomized controlled studies on this subject with the inclusion of greater numbers of patients.
Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Female , Humans , Infant, Newborn , Pregnancy , COVID-19/therapy , Immunization, Passive/methods , Pandemics , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Prospective Studies , SARS-CoV-2 , COVID-19 Drug Treatment , COVID-19 SerotherapyABSTRACT
Objectives: The world is experiencing unprecedented challenges from the coronavirus pandemic. There is a sparse data on Coronavirus disease-2019 (COVID-19) outcomes in pregnant women from India, especially during the second wave. We aimed to compare maternal clinical characteristics and prognostic markers during first and second waves of COVID-19 and to know the correlation of the laboratory markers with disease severity and to assess maternal and perinatal outcomes. Materials and Methods: This prospective study of COVID-19 positive pregnant women was conducted at a tertiary care hospital in India from the 1st of August 2020 to the 30th of June 2021. Data on epidemiological history, clinical presentation, laboratory results, and maternal-fetal outcome in the first and second waves of the COVID-19 pandemic were collected and analyzed. Results: One hundred eighteen patients participated in our study, with 64 belonging to the 1st wave and 54 in the 2nd wave. Fever and sore throat were common presenting symptoms, most women with bronchial asthma and cardiac disease progressed to severe/critical illness. C-reactive protein, lactate dehydrogenase (p < 0.05 in both waves), ferritin (p < 0.01 in 2nd wave), and procalcitonin (p < 0.05 in 1st wave) positively correlated with the severity of the disease. Conclusion: Our study showed that the clinical characteristics and severity of the disease did not differ significantly in both the waves. The adverse fetal outcome was significantly more in mothers with severe and critical disease. Laboratory markers correlated significantly with the severity of the maternal disease, hence can be used as prognostic indicators. © 2022 Royal Thai College of Obstetricians and Gynaecologists. All rights reserved.