Analysis of the COVID-19 Lockdown Impact on Biological Parameters and Physical Performance in Football Players

The COVID-19 pandemic has caused significant changes in global sustainability, but specifically, this study analyses the impact of lockdown on health and behavior in the game of football. The 2020/2021 Italian football competitive season (indicated as "post-COVID”), taking place following an obliged lockdown and longer than the normal summery season break, was characterized by very short recovery times and was compared to the 2018–2019 "pre-COVID” season, which had a regular course. The comparisons were about anthropometric and hormonal responses, muscle damage, and the physical performance of players in the major league (Serie A), and were made considering two extreme points of the competitive seasons: before the preparatory period (T0) and at the end of the season (T1). Turning to the results, it is significant to note the following: (1) body fat percentage was lower at the start (T0) of the post-COVID season than at the start of the pre-COVID season. During both seasons, serum CK and LDH increased in T1 and were significantly higher in both T0 and T1 of the post-COVID season. (2) Cortisol and testosterone concentrations increased in both seasons from T0 to T1;however, in the post-COVID season, concentrations of both were higher than in the previous season. The testosterone to cortisol ratio increased at the end of the pre-COVID season, whilst strongly decreasing at T1 of the post-COVID season. (3) Blood lactate concentrations significantly decreased during the pre-COVID season but remained unchanged during the post-COVID season. We may conclude that the enforced suspension period and the consequent rapid resumption of all activities influenced the physical and physiological state of professional footballers.

Inflammatory Response in COVID-19 Depending on the Severity of the Disease and the Vaccination Status.

The aim of this study was to analyze the serum concentration of interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, and procalcitonin in COVID-19 patients with different forms of the disease. We performed a prospective cohort study on 137 COVID-19 consecutive patients, divided into four groups according to the severity of the disease as follows: 30 patients in the mild form group, 49 in the moderate form group, 28 in the severe form group, and 30 in the critical form group. The tested parameters were correlated with COVID-19 severity. Significant differences were registered between the form of COVID-19 depending on the vaccination status, between LDH concentrations depending on the virus variant, and in IL-6, CRP, and ferritin concentrations and vaccination status depending on the gender. ROC analysis revealed that D-dimer best predicted COVID-19 severe forms and LDH predicted the virus variant. Our findings confirmed the interdependence relationships observed between inflammation markers in relation to the clinical severity of COVID-19, with all the tested biomarkers increasing in severe and critical COVID-19. IL-6, CRP, ferritin, LDH, and D-dimer were increased in all COVID-19 forms. These inflammatory markers were lower in Omicron-infected patients. The unvaccinated patients developed more severe forms compared to the vaccinated ones, and a higher proportion of them needed hospitalization. D-dimer could predict a severe form of COVID-19, while LDH could predict the virus variant.

Post-COVID-19 Complications and their Laboratory Findings: A Cohort Study.

Type 2 severe acute respiratory syndrome caused by coronavirus infection has become the most well-known pandemic infectious viral disease in the present century. This study aims to find out the post-COVID-19 infection complications via a well-designed observational study. A total of 986 recovered cases (only the period ranged between 2 to 3 months after recovery) were obtained from public and private hospitals in Kirkuk and Erbil governorates\Iraq. The admitted patients were asked to answer a questionnaire through interviews; the laboratory findings were obtained from the patients. The results suggested that approximately half of post-COVID-19 patients (%45.606) were suffering from chest pain, while (%32.357) of the cases suffered headache and chest pain. Liver enzymes (ALT, AST, and ALP) showed abnormal percent values of 38.6,24.07, and 26.09, respectively. Renal function enzymes, mainly urea, were found to be abnormal in 45.37% of recovered individuals. Furthermore, abnormal LDH levels were found in (77.9%) of post-COVID-19 patients. This finding revealed that chest pain was an inflammatory condition and liver and renal enzyme disturbances, while elevation in LDH was the predominant long-term complication in post-COVID-19 patients.

Analysis of c-reactive protein, lactate dehydrogenase, ferritin and d-dimer levels in COVID-19 patients: A retrospective study

Background and Objectives: C-reactive protein (CRP) is an acute-phase protein that manifests in the blood within 6-10 hours in severe states of COVID-19 hyper inflammatory response, which results in a pathological dysfunction of innate host defense mechanisms. One of the biomarkers of inflammation in bacterial or viral infection is the iron storage form known as ferritin. In this retrospective study, our goal was to assess the diagnostic efficacy of CRP, ferritin, LDH, and D-dimer in identifying COVID-19 positive cases in India. Methods: This research was carried out retrospectively at the Malla Reddy Institute of Medical Sciences in Hyderabad, India. A tertiary care teaching institution's electronic medical records from July 2020 and May 2021 were examined for the test results for CRP, LDH, ferritin, and D dimer in 172 patients overall. Results: The results in ROC show that when all these parameters are combined, the area under the curve (AUC) of LDH and D-dimer is 0.62, that of LDH and C-reactive protein is 0.68, that of LDH and Ferritin is 0.96, and that of LDH, FERRITIN, D-DIMER, and C-reactive protein is 0.99. Before moving on to a final RT-PCR diagnosis, the severity of COVID-19 can be evaluated using a combination of common laboratory biomarkers (CRP, LDH, ferritin, and D- dimer) with a recognized sensitivity and specificity. Conclusion: Prior to moving forward with a formal diagnosis by RT-PCR, a combination of common laboratory biomarkers (CRP, LDH, ferritin, and D-dimer) can be used to predict the diagnosis of COVID-19 with a recognized sensitivity and specificity. [ FROM AUTHOR] Copyright of Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research) is the property of Journal of Cardiovascular Disease Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Lymphocytes count, acute phase protein and renal function in COVID-19 patients as disease severity predictors

Coronavirus disease 2019 is an infection caused by severe acute respiratory syndrome coronavirus-2. The clinical spectrum of this illness ranges from asymptomatic infection to acute respiratory distress syndrome (ARDS), circulatory shock, multiorgan failure, and ultimately death. The aims of this study are to assess of lymphocyte count, to study of acute phase proteins inflammatory biomarker which include ferritin, lactate dehydrogenase, and D-dimer, and to study of renal function markers which include blood urea nitrogen and serum creatinine. The data accumulated throughout this selective case control study which were extended from September 1st, 2020, to December 1st, 2020. A total of 176 human serum samples were collected, and subdivided into four groups moderate, sever, critical and control, each group comprised of 44 individuals. Results: The data was analyzed using the SPSS-20 statistical package that was available (Statistical Packages for Social Sciences-version 20). The results showed a highly significant decrease in the mean of Lymphocyte in Covid-19 patients when compared to the control group, p.value = 0.000. But Lymphocyte showed no significant differences among moderate, severe, and critical groups p.value = 0.580, p.value = 192, p.value = 456 respectively, where all of them had low lymphocyte count. The means of lactate dehydrogenase, ferritin, and D-dimer a showed a highly significant increase in Covid-19 patients when compared to the control group, p.value = 0.000, p.value = 0.000, p.value = 0.000 respectively. The results showed a highly significant increase in BUN in COVID-19 patient when compared with control group, p.value = 0.001, but the creatinine doesn't show any significant differences in COVID-19 patient when compared with control group, p.value = 0.405. Lactate dehydrogenase showed highly significant increase in critical group when compared with moderate group, p.value = 0.004, and showed significant differences in severe group when compared with moderate group, p.value = 0.031, but did not show significant differences between severe and critical groups, p.value = 0.690. Ferritin and D-dimer showed highly significant increase in critical group when compared with moderate group, p.value = 0.009, p.value = 0.000 respectively, and severe group, p.value = 0.002, p.value = 0.000 respectively. While, showed no nay significant differences between severe and moderate groups, p.value = 0.579, p.value = 0.075 respectively. Urea showed highly significant increase in critical group when compared with sever group and moderate group, p.value = 0.000. Creatinine showed significant increase in critical group when compared with sever group and moderate group, p.value = 0.031, p.value = 0.034 respectively. Both urea and creatinine showed no significant differences between severe and moderate groups p.value = 0.747, p.value = 0.958 respectively. Conclusions: In COVID- 19 patients, lymphopenia is a prognostic factor, increase levels of acute phase protein lactate dehydrogenase, D-dimer, and ferritin associated with disease severity, and the blood urea nitrogen and serum creatinine among critical group were associated with disease severity. © 2023 Author(s).

Role of Initial and Follow-up LDH Titer in COVID-19 Pneumonia: A Single Center Experience of 2000 Cases in Tertiary Care Setting in India

Introduction: Robust data of LDH (Lactate dehydrogenase) is available in bacterial infection, and it can be utilized in this COVID-19 Pneumonia pandemic for initial assessment, planning of treatment in indoor setting in association with HRCT severity. Method(s): Prospective, observational, 12 weeks follow up study, included 2000 COVID-19cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, LDH at entry point and follow up.Age, gender, comorbidity and BIPAP/NIV use and outcome as with or without lung fibrosis as per CT severity. Statistical analysis is done by Chi square test. Result(s): HRCT severity score at entry point has significant correlation with LDH titer [p<0.00001] LDH titer has significant association with duration of illness (Doi) [p<0.00001] Comorbidities has significant association with LDH titer. [p<0.00001] LDH titer has significant association with oxygen saturation [p<0.00001] BIPAP/NIV requirement during hospitalization has significant association with LDH titer. [p<0.00001] Timing of BIPAP/NIV requirement has significant association with LDH titer. [p<0.00001] Follow-up LDH titer during hospitalization as compared to entry point (initial) normal and abnormal LDH has significant association in post-covid lung fibrosis [p<0.00001] Conclusion(s): LDH is easily available, and universally acceptable inflammatory marker in COVID-19 pandemic and documented very crucial role in covid-19 pneumonia in predicting severity of illness, assessing response to treatment and analyzing outcome during hospitalization.Copyright © 2023 Patil S.

A Study of Inflammatory and Non-Inflammatory markers in COVID-19 infected Patients

COVID-19 is highly transmissible in humans with mild flu-like symptoms, but some patients, especially the elderly and people with underlying diseases, evolve critical condition and rapidly develop acute respiratory distress syndrome, respiratory failure, multiple organ disorder and death. The rapid viral replication of SARS-COV-2 gives rise to inflammatory response, cellular destruction and induces the release of cytokines and chemokines then activate immune responses, leading to cytokine storms and aggravations. The RT-PCR test remains gold standard as it detect virus nucleic acid but it is time consuming and has a high prevalence of false negative results. Several inflammatory markers have some tracing and detecting accuracy for disease severity and fatality. Para-clinical investigations including laboratory tests and radiologic findings play an important role in early diagnosis and treatment monitoring of severe acute respiratory syndrome and COVID-19. This study aims to explore the evaluation of inflammatory and non-inflammatory parameters in the disease pathogenesis of COVID-19 and assess how their levels vary depending on the severity of the disease. By doing so, it gives clinicians a tool to group patients and predict prognosis and mortality. The inflammatory parameters included Ferritin, Lactate dehydrogenase (LDH), D- dimer, Interleukin 6 (IL6) and non-inflammatory parameters includes Glucose, Urea, Creatinine, SGOT, SGPT in Covid-19 infected patients. Total subjects were divided in three groups that is control, Group 1 is covid-19 positive patients without comorbidities and Group 2 is covid-19 positive patients with comorbidities. As compared to control Ferritin, LDH, IL6, D-Dimer significantly increased in Group 1 & Group 2, and further as compared with Group 1, these inflammatory parameters significantly elevated in Group 2. As compared to control, Blood Glucose, Urea, Creatinine, SGOT, and SGPT statistical not different in Group 1 but when compared with Group -2 these parameters significantly increased. Further as compared to Group 1 Blood Glucose, Urea, Creatinine, SGOT, and SGPT significantly increased in Group 2. As compared to control Total protein and Albumin statistically not different in Group 1 & Group 2, and there was no any statistical difference in the levels of Total protein and albumin in Group 1 and Group 2. This change of levels of parameters is used as an adjunct in clinical practice to guide treatment and admission to Intensive care unit and also it may improve prognosis and decrease the mortality rates. [ FROM AUTHOR] Copyright of Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research) is the property of Journal of Cardiovascular Disease Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

PHYSIOLOGICAL PARAMETERS AND SEVERITY OF CORONAVIRUS INFECTION: CASE STUDY

Preface: Coronavirus has several mechanisms that facilitate its entry into the target cell such as cholesterol by acting concurrently with angiotensin-converting enzyme (ACE2) at entry site, where the virus uses it to increase its entry and spread. We conducted a practical research for measuring Cholesterol, Triglyceride (TG) and Lactate dehydrogenase concentrations in COVID-19 patients. Objectives: The aim of this research is to see the correlation between Cholesterol, TG and Lactate dehydrogenase and the severity of coronavirus infection. Methods: This study is made at Al-Zahra Teaching Hospital during the period from March 2021 to July 2021 and it was performed on two groups: patients group that involved 30 samples (15 male and 15 female), age ranging from 18 to 84 years old and another group consisting of 30 individuals who were not infected with SARS-CoV-2. Results: Our findings show that the high value for markers under this study associated with coronavirus was detected in lactate dehydrogenase (5 0 5. 0 7 ± 2 6. 9 3 4 IU/l), (2 2 7. 8 3 ± 2 4. 6 6 0 Mg/dl) for TG and (2 2 7. 5 3 ± 1 9. 8 0 5 Mg/dl) for cholesterol. High concentration of cholesterol is shown in the age category between 54 and 64 years is represented as (487 Mg/dl and 502 Mg/dl), TG at ages 42, 54 and 64 years is represented as 497, 509 and 521 Mg/dl, Lactate dehydrogenase at ages 80–84 years that represented is as 739, 809 and 812 IU/l. According to physiological parameters which were elevated, a high concentration was observed in almost both sexes, as males were more affected than females when determining cholesterol at (500 Mg/dl), while females had more than males with respect to lactate dehydrogenase and TGs at (520 Mg/dl and 800 IU/l), respectively. In the correlation test, we found the highest significant differences, according to the correlation test, between cholesterol and lactate dehydrogenase at (1) cholesterol and TG at (0.000), TG and lactate dehydrogenase at (0.739). Conclusions: We conclude that COVID-19 patients suffer from increased markers under the studies on cholesterol, TG and lactate dehydrogenase. [ FROM AUTHOR] Copyright of Journal of Mechanics in Medicine & Biology is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Correlation of Inflammatory Markers with Radiological Findings in Novel COVID-19 Diseased Patients in a Tertiary Care Centre in South India

Background: In December 2019, SARS-COV-2 infection emerged in Wuhan, China causing COVID-19 and subsequently spread throughout the globe. Systemic inflammation has been reported as a predictor for COVID-19 outcomes. Elevated levels of inflammatory markers are shown to be associated with endothelial dysfunction, cytokine storm and coagulopathy in COVID- 19. Raised inflammatory markers influences the mortality in severe Covid-19. Objective(s): The aim of the study is to correlate the inflammatory markers with CT severity score among COVID-19 patients. Material(s) and Method(s): Retrospective cross-sectional study conducted among 250 patients admitted in the COVID 19 isolation wards confirmed by RT-PCR. The study was conducted over a period of six months (April 2021 to September 2021) based on data's from the central laboratory registers in Biochemistry & CT Severity Score from the medical records. Result(s): Statistically significant elevation in Ferritin, CRP, LDH and D dimer among the severely affected group of patients is noted, all four markers are positively correlated with CT scores & increases with increase in the disease severity. It is observed that SpO2 decreases with increase in the severity of the disease. Conclusion(s): In this study we found significant correlation of the raised inflammatory markers and the CT severity score and the disease severity which highlights the prognostic significance of the inflammatory markers that would guide us in the diagnosis and management of critically ill patients at the earliest.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Association of Inflammatory Markers with Disease Severity and Outcome in Covid-19 Patients.

Objectives: The coronavirus pandemic was associated with a high mortality rate in the Republic of North Macedonia. Finding early markers of the disease's severity may predict outcomes and guide the treatment of the disease. The aim of our study was to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. Methods: The study included 104 PCR-confirmed COVID-19 patients who underwent hospital treatment at the Institute of Lung Diseases and Tuberculosis in Skopje, North Macedonia, between November 2020 and May 2021. Inflammatory markers were assessed in all patients and correlated with the disease severity and outcome in terms of survival or death. Results: IL-6 and LDH at admission were significantly elevated in patients with a severe or critical form of the disease and among non-survivors. In addition, IL-6 showed 87.9% of sensitivity and 61.8% of specificity for distinguishing non-survivors from survivors with a cut-off value of 21.7 pg/ml in the receiver operator curve (ROC). Procalcitonin was significantly increased in non-survivors. Parallel to the increase of disease severity, the values of CRP and LDH increased significantly during hospitalization. Conclusion: The results of the study indicate that a significant association exists between the highly increased levels of CRP, LDH, IL-6 and procalcitonin and the severity of the disease and mortality in COVID-19 patients. Their measurements and follow-up during the course of the disease could be used as predictors for prognosis and outcome but also as a subject for targeted therapy.

Correlation of Patient Profiles and Biomarkers with Outcomes in Covid-19 Icu Patients: A Retrospective Analysis.

Background: COVID-19 is a novel disease with a highly variable and unpredictable clinical course. Various clinicodemographic factors and numerous biomarkers have been identified in studies from the West and marked as possible predictors of severe illness and mortality which may be used to triage patients for early aggressive care. This triaging becomes even more significant in resource-limited critical care settings of the Indian subcontinent. Methods: This retrospective observational study recruited 99 cases of COVID-19 admitted to intensive care from 1 May to 1 August 2020. Demographic, clinical and baseline laboratory data were collected and analysed for association with clinical outcomes, including survival and need for mechanical ventilatory support. Results: Male gender (p=0.044) and diabetes mellitus (p=0.042) were associated with increased mortality. Binomial logistic regression analysis revealed Interleukin-6 (IL6) (p=0.024), D-dimer (p=0.025) and CRP (p<0.001) as significant predictors of need of ventilatory support and IL6 (p=0.036), CRP (p=0.041), D-dimer (p=0.006) and PaO2FiO2 ratio (p=0.019) as significant predictors of mortality. CRP >40 mg/L predicted mortality with sensitivity of 93.3% and specificity of 88.9% (AUC 0.933) and IL6> 32.5 pg/ml with a sensitivity of 82.2% and specificity of 70.4% (AUC 0.821). Conclusion: Our results suggest that a baseline CRP >40 mg/L, IL6 >32.5 pg/ml or D-dimer >810 ng/ml are early accurate predictors of severe illness and adverse outcomes and may be used to triage patients for early intensive care.

Diagnostic performance of lactate dehydrogenase (LDH) isoenzymes levels for the severity of COVID-19.

Background: Lactate dehydrogenase (LDH) levels predict coronavirus disease 2019 (COVID-19) severity. We investigated LDH isoenzyme levels to identify the tissue responsible for serum LDH elevation in patients with COVID-19. Methods: Hospitalised COVID-19 patients with serum LDH levels exceeding the upper reference limit included. LDH isoenzymes were detected quantitatively on agarose gels. The radiological severity of lung involvement on computed tomography was scored as 0-5 for each lobe (total possible score, 0-25). Disease severity was determined using the World Health Organization (WHO) clinical progression scale. Results: In total, 111 patients (mean age, 59.96 ± 16.14), including 43 females (38.7%), were enrolled. The serum levels of total LDH and all five LDH isoenzymes were significantly higher in the severe group. The levels of all LDH isoenzymes excluding LDH5 positively correlated with the WHO score. LDH3 levels correlated with chest computed tomography findings (r2 = 0.267, p = 0.005). On multivariate analysis, LDH3 was an independent risk factor for the deterioration of COVID-19. Conclusions: LDH3 appears to be an independent risk factor for deterioration in patients with COVID-19. LDH elevation in patients with COVID-19 predominantly resulted from lung, liver and muscle damage.

Evaluation of ferritin level in COVID-19 patients and its inflammatory response.

The importance of ferritin as an inflammatory marker is well recognized. However, it is unknown whether this differs between Covid-19 and non-Covid-19 patients. The blood levels of ferritin, white blood cells (WBC), C-reactive protein (CRP), and lactate dehydrogenase may all be measured to check whether there is a difference. The researchers want to see if the inflammatory process changes between these two kinds (LDH). Methodology: Blood samples were collected from 119 COVID-19 patients in the hospital and 50 healthy persons. Corona virus was discovered when a nasopharyngeal swab was collected and tested using the RT-PCR technique. Ferritin, LDH, WBC, and CRP were also tested using Min Vidus, AccEnT 200, Ruby system, and Latx in that sequence. The study revealed that COVID-19 patients had higher levels of ferritin, WBC, CRP, and LDH in their blood than healthy people, with values of 539,08 ng/mL, 44.7109/L, 22.95 mg/L, and 403.95 U/L for COVID-19 patients versus 77.103 ng/mL, 4.9.4109/L, 6.53 mg/L, and 171.56 U/L for healthy people. According to the existing data, males are more likely to be infected with COVID-19 (81%) than females (32%), and females had greater ferritin, CRP, WBC, and LDH levels than males. Because they are related to an optimum test for predicting COVID-19 infection, the recommended cut-off values for ferritin, WBC, CRP, and LDH are 109.8 ng/mL, 14.9109/L, 10.15 mg/L, and 229.33 U/L, respectively. Finally, an increase in ferritin levels in the inflammatory response to COVID-19 is linked to an increase in inflammatory markers including CRP, WBC, and LDH, which may assist in the diagnosis of COVID-19 infection.

Selected Predictors of COVID-19 Mortality in the Hospitalised Patient Population in a Single-Centre Study in Poland.

Background: The correct analysis of COVID-19 predictors could substantially improve the clinical decision-making process and enable emergency department patients at higher mortality risk to be identified. Methods: We retrospectively explored the relationship between some demographic and clinical factors, such as age and sex, as well as the levels of ten selected factors, namely, CRP, D-dimer, ferritin, LDH, RDW-CV, RDW-SD, procalcitonin, blood oxygen saturation, lymphocytes, and leukocytes, and COVID-19 mortality risk in 150 adult patients diagnosed with COVID-19 at Provincial Specialist Hospital in Zgierz, Poland (this hospital was transformed, in March 2020, into a hospital admitting COVID-19 cases only). All blood samples for testing were collected in the emergency room before admission. The length of stay in the intensive care unit and length of hospitalisation were also analysed. Results: The only factor that was not significantly related to mortality was the length of stay in the intensive care unit. The odds of dying were significantly lower in males, patients with a longer hospital stay, patients with higher lymphocyte levels, and patients with higher blood oxygen saturation, while the chances of dying were significantly higher in older patients; patients with higher RDW-CV and RDW-SD levels; and patients with higher levels of leukocytes, CRP, ferritin, procalcitonin, LDH, and D-dimers. Conclusions: Six potential predictors of mortality were included in the final model: age, RDW-CV, procalcitonin, and D-dimers level; blood oxygen saturation; and length of hospitalisation. The results obtained from this study suggest that a final predictive model with high accuracy in mortality prediction (over 90%) was successfully built. The suggested model could be used for therapy prioritization.

Demographic Characteristics, Clinical Features, Laboratory, and Radiological Findings in Children Admitted to COVID19 Center in Amara City, Misan Province, Iraq

Background: Most pediatric patients with covid 19 had mild to moderate infection and some had severe challenging infection. Generally, they had variable signs and symptoms, laboratory, and radiological findings correlated with the patient age, the involved system, disease severity and probably any underlying disease. Aim: To identify the most common clinical features, the frequency of positive radiological findings, and laboratory results of the infected children hospitalized in Misan COVID-19 Center. Materials and method: A retrospective descriptive with some analytic study applied on 100 pediatric patients in the age range of (0-16) years, diagnosed with COVID-19 or were highly suspected cases, depending on clinical findings, laboratory tests, COVID-19 RT-PCR and/or chest (X-ray + CT), whom were admitted to the Pediatric Covid -19 Center in Amara City, Iraq during the time period of (February-June, 2021). Their medical records were reviewed for demographic information, (gender, age, and residence), medical history, clinical examination, laboratory and imaging studies, (X-ray + CT), O saturation, the duration of illness before admission of any underlying chronic diseases as well as the most common presenting signs and symptoms. Results: Children infected slightly more in the age range of (5-10 years), boys slightly more infected than girls as (54%) and (46%), respectively. The urban residents suffered more than the rural ones, 4% of all cases had low O2 saturation. Fever and malaise were the most common presenting symptoms as (93%) and (68%), respectively. The illness duration before hospitalization commonly was (<5days), (RT-PCR) was negative in 45% of patients, 54% had anemia with or without leukopenia and lymphopenia, CTs were positive in (62%) and CXR was positive in (53%), while the underlying chronic diseases were found in (23%) of the cases. Conclusion: Children of ages between (5-<10 years) were slightly more infected than others, fever, malaise, and cough were the most common manifestations, the urban predominance is high, and half of patients had anemia about one third and had lymphopenia. Likewise, one forth had thrombocytopenia, negative Covid-19 (RT-PCR), and/or CXR. The CT results did not exclude infection. Thus, we need further local studies to support our results. © 2023 by SPC (Sami Publishing Company)

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.

Association of Lactate Dehydrogenase and C-reactive Protein Levels as Predictors of Respiratory Failure in Covid-19

Background and Aim: Inflammatory markers reproduce amount of disease development or revival. They are used to assess improvement or worsening of the illness. Hence the aim of the study was to determine the correlation of laboratory markers (LDH and CRP) and oxygen requirement with clinical severity in Covid 19 subjects. Material(s) and Method(s): There were 216 subjects admitted to the emergency department of the hospital. The incorporated subjects were divided into two groups: group I subjects had covid19 pneumonia and in group 2 subjects did not have covid 19 pneumonia. Blood count and serum values of lactate dehydrogenase (LDH) and C-reactive protein (CRP) were quantified in all subjects enrolled in the research. An automated hematology analyzer was utilized to perform blood count according to the manufacturer's protocol. Serum samples were analyzed on a fully automated clinical chemistry Instrument. Result(s): LDH was amplified in 82% of subjects, CRP resulted elevated in 98% of subjects, only 21% of subjects presented pathological values of white blood cell (WBC), but 18% had a neutrophils count above the upper normal range value, while 89% of subjects had lymphocytes count below the lower normal range value, as formerly reported. Conclusion(s): LDH and CRP could be helpful for the premature identification of subjects who are at elevated risk for acute respiratory failure. They should be considered a helpful test for the early recognition of subjects who need closer respiratory monitoring and more aggressive supportive therapies to avoid poor prognosis. These subjects could be benefited from a quick hospitalization, a closer observation and correct treatments. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Cluster Analysis of Biochemical Markers as Predictor of COVID-19 Severity

Numerous blood biomarkers are altered in COVID-19 patients;however, no early biochemical markers are currently being used in clinical practice to predict COVID-19 severity. COVID-19, the most recent pandemic, is caused by the SRS-CoV-2 coronavirus. The study was aimed to identify patient groups with a high and low risk of developing COVID-19 using a cluster analysis of several biomarkers. 137 women with confirmed SARS CoV-2 RNA testing were collected and analyzed for biochemical profiles. Two-dimensional automated hierarchy clustering of all biomarkers was applied, and patients were sorted into classes. Biochemistry marker variations (Ferritin, lactate dehydrogenase LDH, D-dimer, and C- reactive protein CRP) have split COVID-19 patients into two groups(severe cases and non-severe cases groups). Ferritin, lactate dehydrogenase LDH, D-dimer and CRP were markedly increased in COVID-19 patients in the first group (severe cases). Our findings imply that early measured levels of (Ferritin, lactate dehydrogenase LDH, D-dimer, and C- reactive protein CRP) are linked to a decreased probability of COVID-19 severity. Elevated levels of this biomarker may predict COVID severity development. © 2022 University of Baghdad. All rights reserved.

Assessment of the Risk Factor to Mortality in Hospitalized Covid-19 Patients, Pune

Background: There have been scientific papers in the Indian setting that describe demographics, clinical characteristics, hospital course, morbidity, and death in patients with coronavirus disease 2019 (COVID-19);however, they are based on limited numbers of cases. The current study of patients with known outcomes enabled us to acquire a better understanding of the disease process and progression in COVID-19 individuals, as well as correlate the factors affecting the outcome. Method(s): This study was carried out at a COVID-19 tertiary care facility at Dr. D. Y.Patil Medical College, Hospital and Research Centre, Pune. The demographic and clinical information, laboratory parameters of admitted COVID19 patients were collected were subsequently analysed. Categorical variables were analysed using either the chi-square test or Fisher's exact test. The level of significance was set at p<0.05. Result(s): Out of 603, 515 (85.4%) patients were discharged while 88 (15.8%) patients were died. The mean age of dead COVID-19 patients was significantly higher as compared to discharged COVID-19 patients. Serum urea, Serum Creatinine, serum AST, Serum total bilirubin, Serum Conjugated Bilirubin, serum LDH, Serum CRP and Serum Ferritin, Hb, PCV, TLC, neutrophils, eosinophils, basophils, lymphocytes, monocytes, neutrophils to lymphocyte ratio, platelets to lymphocyte ratio, ESR and D-dimer were differ significantly between discharged and dead COVID-19 cases whereas the levels of Serum ALT, Serum ALP, Serum Unconjugated bilirubin, MCV,MCH platelet count, PT and aPTT were remained comparable between discharged and dead COVID-19 cases. Multivariate analysis showed that Serum urea, D-dimer, ESR, NLR, PLR neutrophil and TLC were the significant predictors of COVID-19 death in our study. Conclusion(s): This study revealed that in hospitalised COVID-19 patients, older age, male sex, hypertension, diabetes, serum LDH, and urea levels were strongly linked to an increased risk of mortality. To enhance patient care and results, healthcare professionals should identify these aspects at the time of diagnosis. Copyright © 2022 Authors. All rights reserved.

Risk Factors Associated With Six-Month Mortality in Hospitalized COVID-19 Patients: A Single-Institution Study.

Background Coronavirus disease 2019 (COVID-19) infection can vary from asymptomatic infection to multi-organ dysfunction. The most serious complication of infection with COVID-19 is death. Various comorbid conditions and inflammatory markers have been associated with an increased risk of mortality, specifically within the immediate post-infection period; however, less is known about long-term mortality outcomes. Objectives Our objective is to determine risk factors associated with six-month mortality in hospitalized COVID-19 patients. Methods This is a single-institution, retrospective study. We included patients hospitalized with COVID-19 from the University of Toledo Medical Center in Toledo, Ohio, who were admitted from March 20, 2020, to June 30, 2021. This study was approved by a biomedical institutional review board at the University of Toledo. Patients with available pre-stored blood samples for laboratory testing were included, and hospital charts were assessed up to six months from the date of a positive COVID-19 test result. Two groups were created based on the mortality outcome at six months from COVID-19 positive test results: survivors and non-survivors. The clinical variables or outcomes and laboratory values were compared between the two groups using non-parametric methods due to the small sample size and non-normality of the data. Either the Mann-Whitney U-test for continuous variables or Fisher's exact test for categorical variables was used for statistical analysis. Results Lactate dehydrogenase (LDH) and D-dimer levels on admission were found to be significantly higher in non-survivors than in survivors. The median high D-dimer level in non-survivors was 5.96 micrograms/milliliter (µg/mL) (interquartile range (IQR): 3.95-11.29 µg/mL) vs 1.82 µg/mL (IQR 1.13-5.55 µg/mL) in survivors (p = 0.019). Median LDH levels were also higher in non-survivors vs survivors, i.e., 621.00 international units per liter (IU/L) (IQR 440.00-849.00 IU/L) vs 328.00 IU/L (IQR 274.00-529.00 IU/L), respectively (p = 0.032). The demographic profile, comorbidity profile, and laboratory data (typically associated with short-term mortality, inflammation, and organ dysfunction) were similar between survivors and non-survivors, except for LDH and D-dimer. Conclusion Higher LDH and D-dimer levels on admission were found to be associated with an increased six-month mortality rate in hospitalized COVID-19 patients. These hematologic data can serve as risk stratification tools to prevent long-term mortality outcomes and provide proactive clinical care in hospitalized COVID-19 patients.