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Hospitals were overburdened during peak periods of Coronavirus disease 2019 (COVID-19) pandemic, and bed occupancy was full. The ability to predict and plan patients' hospital length of stay allows predictability in terms of the free capacity of hospital facilities. The purpose of this article is to evaluate the factors that influence the hospital length of stay among discharged (recovered) from COVID-19 patients. This will allow the prediction of the likely number of bed days in the conditions of intensive workload of medical facilities for hospital care. A total of 441 discharged after hospital treatment for COVID-19 patients are followed up. Factors for prolonged hospital length of stay are searched among the indicators recorded at admission. Median hospital length of stay of the patients discharged from COVID-19 ward is 9 days (IQR 6-12) and in the COVID-19 intensive care unit 12 days (IQR 9.75-18.75). The median length of stay assessed by a survival analysis is 35 days in the COVID-19 unit and only 8 days in intensive care, due to the high mortality in the intensive care unit. The longer hospital length of stay of patients discharged from the COVID-19 wards is associated with the presence of hypertension (median 10 vs. 8 days for patients without the disease, p=0.006), ischemic heart disease (10 vs. 8 days, p<0.001), cerebrovascular disease (10 vs. 8 days, p=0.061 - did not reach significance), peripheral arterial disease (12 vs. 8 days, p=0.024), chronic renal failure or chroniodialysis (14 vs. 8 days, p<0.001), oncological illness (11 vs. 8 days, p=0.024), presence of at least one comorbidity (9 vs. 8 days, p=0.006), arrival at the hospital by ambulance vs. the patient's own transport (11 vs. 8 days, p=0.003), severe lung involvement shown on X-ray (10 vs. 8 days, p=0.030) or CT (18 vs. 10 days, p=0.045). Prolonged hospital length of stay is associated with older age (Spearman's rho=0.185, p<0.001), greater number of comorbidities (Spearman's rho=0.200, p<0.001), lower oxygen saturation on admission (Spearman's rho=- 0.294, p<0.001) and lower lymphocytes count (Spearman's rho=-0.209, p<0.001), as well as higher CRP (Spearman's rho=0.168, p<0.001), LDH (Spearman's rho=0.140, p=0.004), ferritin (Spearman's rho=0.143, p=0.004) and d-dimer (Spearman's rho=0.207, p<0.001). The multiple linear regression model found that the increase in the number of bed days of discharged from COVID-19 unit patients depends on the way the patient arrived at the Emergency Department (by ambulance instead of on their own transportation) and the presence of an accompanying oncological disease (R2=0.628, p<0.001). The hospital length of stay of patients discharged from COVID-19 intensive care unit is associated with the presence of hypertension (median 14 vs. 9 days for patients without the disease, p=0.067 - significance not reached) and at least one comorbidity (14 vs. 9 days, p=0.067 - significance not reached). The number of bed days is higher when recorded more comorbidities (Spearman's rho=0.818, p=0.004), lower oxygen saturation (Spearman's rho=-0.605, p=0.067 - significance not reached) and higher leukocytes count (Spearman's rho=0.546, p=0.102 - significance not reached). A multiple linear regression model demonstrated the hospital length of stay of patients in the COVID-19 intensive care unit as an outcome of the number of comorbidities only (R2=0.826, p=0.003). The ability to estimate and forecast quickly the number of bed-days based on a small number of variables would help reduce the burden on the healthcare system during a pandemic.
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Purpose: Today, coronavirus disease-19 (COVID-19) treatment is an evolving process, and synbiotic administration has been suggested as a new therapeutic strategy. This study aims to investigate the effect of synbiotic supplementation in COVID-19 patients. Design/methodology/approach: In this placebo-controlled trial, 80 patients were randomized to receive oral synbiotic capsule (containing fructooligosaccharide and seven bacterial strains;Lactobacillus (L) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium longum, L. bulgaricus, each one 109 colony-forming units) or placebo for two months. Inflammatory markers (Interleukin-6 [IL-6], C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) and white blood cell (WBC) count were evaluated at two timepoints (baseline, two months later). The measured variables were adjusted for confounders and analyzed by SPSS v21.0. Findings: All 80 enrolled patients completed the study. The study adherence was good (approximately 70%). The mean changes for IL-6 were not significant ( = -0.6 +or- 10.4 pg/mL vs = +11.2 +or- 50.3 pg/mL, p > 0.05). There were no significant improvements for CRP, ESR and WBC. Originality/value: Administration of synbiotics for two months did not improve inflammatory markers in COVID-19 patients.
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This special issue contains 8 articles that discuss and highlights the importance of nutrition in mitigating the mental and health-related issues associated with the pandemic, as well as its effects on diet quality and physical activity levels. Topics include: (1) a systematic literature review that emphasizes the role of nutrition in minimizing mental and health-related issues during COVID-19. The review concludes that a healthy diet rich in essential nutrients can play a crucial role in supporting mental health, immune function and overall well-being during the pandemic. In addition, it highlights the need for public health interventions that promote healthy eating habits and provide access to nutritious foods, (2) adherence to the Mediterranean diet in Greek adolescents during COVID-19, (3) a randomized, double-blind, placebo-controlled clinical trial investigated the effect of synbiotics on inflammatory markers and white blood cell count in COVID-19 patients, (4) COVID-19 pandemic anxiety was reflected in nutritional habits in adults, (5) investigation of the link between metabolic risks, dietary patterns and COVID-19 prognosis, (6) exploration of the factors related to sedentary lifestyle in a Brazilian sample during the COVID-19 initial quarantine.
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Coronavirus disease 2019 (COVID-19) can be life threating if untreated. Early diagnosis and effective nutritional management can save life. To assess the nutritional status and predict possible outcomes of critical patients Sequential Organ Failure Assessment (SOFA), nutrition risk in critically ill patients (NUTRIC), and acute physiology and chronic health evaluation (APACHE) score has been used. This retrospective observational study was conducted on confirmed COVID-19 cases in Intensive Care Unit (ICU) of Shifa hospital between November 24, 2020 to May 31, 2021. The demographic, clinical and laboratory information was obtained from hospital records. Risk factors for COVID-19 were identified and compared using multivariate logistic regression analysis. The nutritional risk for each patient was assessed. In this study 162 COVID-19 patients with median age of 64 years (IQR: 56-74) were included. Hypertension (59.2%) was found to be the most common comorbidity and the most prevalent symptoms upon admission were fever (54.9%). The patients in critical condition were supplied nutrients through nasogastric route (61.7%) while 37.7% and 0.6% were assisted through oral and total parenteral nutrition (TPN) route. The Glasgow comma score was found to be mild (72.2%) (GCS>12) with increased creatinine, white blood cell count, C-reactive protein (CRP C), and glycosylated haemoglobin HbA1c level were present. Interestingly based on SOFA, APACHE and NUTRIC score low insignificant malnutrition risk was observed. Our study found different demographic factors and comorbidities have a substantial impact on COVID-19 patients, as evidenced by demographic, laboratory, clinical, and nutritional risk factors.
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Feline Infectious Peritonitis (FIP) is highly mortality disease in cats. The reliable and fast diagnosis is crucial to the best prognosis. The aim of this study to evaluate the hemogram profile in cats infected with effusive FIP. Twenty cats had been diagnosed effusive FIP at Animal Clinic Department of Internal Medicine, Faculty Veterinary Medicine, Universitas Gadjah Mada were used in the study. The diagnosis were based on clinical examination, ultrasound, x-ray, rivalta test, and rapid test. The hemogram profile were analyzed include routine hematology and serum biochemistry. Hemogram profile in effusive FIP showed the decreased hematocrit, hyperproteinemia, and leukocytosis with an average 22.9+or-7.4%;9.0+or-2.2 g/dL;22425+or-4116 cells/mm3 respectively. Erythrocyte, hemoglobin and fibrinogen levels were still in the normal range. The results of differential leukocytes revealed that 90% cats had neutrophilia and 75% lymphopenia with an average 20066+or-3337 cells/mm3 and 1861+or-1818 cells/mm3 respectively. The blood chemistry profile showed 60% of cats experienced increase in SGPT and SGOT with an average 138.4+or-72.3 IU/L and 101+or-60.5 IU/L respectively. Hyperglobulinemia was found in 90% samples with an average 6.7+or-0.8 g/dL. All cats have a low albumin:globulin ratio with an average 0.3+or-0.1. The hemogram profile of effusive FIP were: leukocytosis, neutrophilia, lymphopenia, hyperglobulinemia, and decreased albumin-globulin ratio..
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Objective: In this study, it was aimed to reveal the relationship between the clinical features, presenting symptoms, and prognosis of COVID-19 patients who were hospitalized in our center. Materials and Methods: 499 patients with the diagno-sis of COVID-19 followed in the service and intensive care units of Sakarya University Training and Research Hospital between March 2020 and January 2021 were included in the study. The clinical and demographical data of the patients were obtained from the patient files and hospital automation system. The obtained data were ana-lyzed statistically. Results: Of 499 patients, 171 were followed up in the ward and 328 in the intensive care unit. Follow-up of 230 patients resulted in death, while 269 patients were dis-charged. Comorbid diseases were found to be more fre-quently seen in the mortal group (p< 0.05). Mean leuko-cyte, neutrophil, c-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, d-dimer, and troponin values were higher in the mortal group;whereas mean lymphocyte value was found to be lower (p< 0.05). While fever, cough, and other less common symptoms (diarrhea, nausea, muscle weakness, etc.) were more frequently seen in the non-mortal group (p=0.022, p=0.038, and p=0.000 respectively), shortness of breath was significantly more common in the mortal group (p=0.000). The frequency of symptoms such as sputum, fatigue, sore throat, and the headache were found to be similar in both groups (p >0.05). Conclusion: It was concluded that the clinical course of patients with dyspnea at admission may be more severe and these patients should be followed more closely.
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The most significant single nucleotide human leukocyte antigen genes polymorphisms and innate immunity genes associated with varying degrees of acute respiratory infection severity are considered-COVID-19 caused by the SARS-CoV-2 coronavirus. As data accumulated, it became clear that the SARS-CoV-2 virus exhibits significant regional, ethnic, and individual specificity. This is due to the population groups' genetic characteristics. This is necessary to reliably know the human genotype relationship with the COVID-19 course severity (asymptomatic, mild, moderate, severe, and extremely severe up to fatal outcomes) for more successful therapy and vaccination. At the same time, it was also known that the innate immunity system is on the first line of defense against the pathogenic penetration into the body, and the human leukocyte antigen system encodes molecules of the same name on the surface of cells that present various antigens, including viral infection pathogens, and determine the severity of the course of many diseases;therefore, these systems' genes. This approach makes it possible to assess the likelihood of a severe and extremely severe disease course in healthy and infected people, which in turn contributes to the correct therapy strategy, pharmacotherapy, and vaccination, as well as to create new antiviral therapeutic and preventive medicines. The genetically determined immune response heterogeneity to SARS-CoV-2 infection requires further study, since there is no unambiguous opinion about the leading mechanism that determines disease severity.
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Objective To observe the clinical efficacy and safety of Qingke Pingchuan Granules in treatment of light and common type of novel coronavirus infection(phlegm heat stagnating lung syndrome). Methods Sixty patients with novel coronavirus infection(phlegm heat stagnating lung syndrome) hospitalized in the Novel Coronavirus Unit of Shanghai Public Health Clinical Center from March 2022to June 2022 were selected and divided into control group and treatment group according to different therapeutic drugs, with 30 cases in each group. Patients in the control group were given conventional treatment. Patients in the treatment group were po administered with Qingke Pingchuan Granules on the basis of conventional treatment, 10 g/time, 3 times daily. The efficacy of TCM syndromes, inflammatory indexes and adverse reactions were observed before and after treatment. Results After treatment, the total effective rate in the treatment group(86.7%) was significantly higher than that in the control group(66.7%)(P < 0.05). After treatment, daytime and nighttime cough scores in 2 groups were lower than before treatment(P < 0.05), and daytime and nighttime cough scores in the treatment group were lower than those in the control group(P < 0.05). There was no significant difference in the levels of peripheral blood leukocytes and procalcitonin between the two groups before and after treatment. After treatment, the level of C-reactive protein(CRP) in the two groups was significantly lower than that before treatment(P < 0.05), and the CRP level in the treatment group was lower than that in the control group(P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Qingke Pingchuan Granules has good clinical efficacy in treatment of light and common type of novel coronavirus infection(phlegm heat stagnating lung syndrome), and can relieve the clinical symptoms of patients, which has good safety.
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The purpose of this experiment was to increase poultry meat production by increasing the number of chickens reared in the same area and managing it by using medicinal herbs Salvia officinalis L and Lavandula angustifolia L. in the broiler chicken diet. 705 one-day-old chicks were randomly distributed into to7 treatments with three replicates for an area of two m2 floor system in each replicate for each treatment, during 35 days of the study. T0 negative control 75 chicks, 25 chicks for each replicate 12-13 chicks per m2 fed standard diet. T1 positive control (stocking density without supplementation)105 chicks, 35 each replicate chicks 17-18 per m2 fed standard diet. The same stocking density for T2, T3, T4, T5, and T6 have been given standard feed with supplemented herbals, salvia 0.7%, 0.9%, lavender0.7%, 0.9%, and mixed 0.7% respectively. Depending on the results, chickens reared in stress stocking density with supplementations led to higher improvement of body weight, meat production, body weight gain (BWG), feed conversion ratio(FCR g feed/g weight), production index PI, carcass weight (g) and dressing percentage, RBCs 106cells/mm3, lymphocyte%, of increasing activity of thyroid hormones T3, T4 (nmol/L) boost antibody titers of ND and IBV when compared with positive control. However, heterophil%, stress indicator H/L ratio, glucose mg/ dL and cholesterol mg/ dL significantly reduced. The results showed that adding sage and lavender plants to broiler feed is effective in improving productivity, immunity, and resistance characteristics in reducing the adverse effects of stress caused by increasing the intensity of broiler rearing in the same area.
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Objective: To explore the application value of blood cell subtype ratio [neutrophil/lymphocyte ratio (NLR) platelet/lymphocyte ratio (PLR)], platelet/neutrophil ratio (PNR) and inflammatory indicators in clinical treatment and prognosis of coronavirus disease 2019 (COVID - 19) patients. Methods The blood routine and inflammatory data were collected from 47 hospitalized COVID- 19 patients and 30 healthy subjects and analyzed retrospectively, and the ratios of NLR, PLR and PNR were calculated. The differences of each index were compared between the two groups, and the variation trend of NLR, PLR and PNR were dynamically monitored during the course of disease. ROC curve was used to evaluate the diagnostic value of blood cell subtype ratio and inflammatory indicators. Results Compared with the control group, white blood cell (WBC) and lymphocyte (LYMPH) were decreased (Z =-3.578, -5.558, all P <0.05), and NLR, PLR, C-reactive protein(CRP), serum amyloid A(SAA) and SAA/CRP were increased in COVID-19 patients group (Z =-4.210, -5.087, -2.434, -5.263, -3.091, all /1/40.05). Trend analysis of NLR, PLR and PNR showed that NLR and PLR increased first and reached the peak, and gradually decreased with the improvement of patients' condition (x2=27.441, 38.699, all PC 0.05). ROC curve analysis results showed that the area under curve (AUC) of SAA, PLR, NLR and CRP were 0.855, 0.845, 0.786 and 0.662, respectively. Conclusions The combination of NLR, PLR, SAA and CRP could reflect systemic inflammatory status of patients, and had good clinical diagnostic value for disease monitoring and prognosis.
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Objective: To analyze the laboratory indexes of patients infected with malaria patients and COVID-19, so as to provide reliable evidence for the diagnosis of mixed infection of both. Methods The routine clinical laboratory items such as routine blood, biochemistry and lymphocyte subsets were tested in three cases of COVID-19 complicated with falciparum malaria who admitted to Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University from July to December 2020 were tested. Laboratory data were stage-wise analyzed in conjunction with changes in the course of disease. Results Three patients confirmed COVID-19 infection recruited all had malaria infection history. Fever, headache, and other symptoms emerged on the 4rd to 11th day after admission. Malaria parasite was detected by malaria parasite antigen testing and blood smear testing, and all three patients had re-ignition of malaria after being confirmed COVID-19 infection. In the early stage of malaria relapse, lymphocytes decreased, CRP and SAA increased, and gradually returned to normal level after antimalarial treatment. Interestingly, we only found one patient at the initial stage of malaria detection showed PLT decreased, no other unnormal changes in other routine blood results (WBC, ESO) and liver function results (ALT, AST, GGT, TBIL, DBIL, CG) were found from the beginning to end course of the disease. Conclusion COVID-19 infection may promote the resurgence of malaria, so the relapse of malaria should be monitored especially for the patient with malaria infection history who begin to develop fever and other symptoms a few days after the diagnosis of COVID-19. The inflammatory indicators would be worth able as an auxiliary judgment basis for the effective treatment of the two combined infection.
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Domestic and wild dogs of all ages and breeds are susceptible to Canine Coronavirus(CCoV) infections and be seen in T..rkiyeand amongst world. CCoV has recently been declared a zoonotic disease agent and the eighth pathogenic human coronavirus. This study was conducted on 143 naturally infected dogs with gastroenteritis which were not vaccinated against CCoV in T..rkiye in 2015-2020. The data of dogs were analyzed seroepidemiologically, clinicopathologically and statistically. CCOV antibodies in serum and CCOV antigens in stool were detected by ELISA and lateral immunochromatography. The rising CCoV IgG antibody titers were detected at all dogs and were as follows;<10 ng/L in 3 (2%), 10-20 ng/L in 18 (13%), 20-30 ng/L in 16 (11%), 30-40 ng/L in 14 (%10), 40-64 ng/L in 11 (8%) and >64 ng/L in 81 (81%) dogs. CCOV and Canine Parvovirus (CPV) antigen were detected together in the stool of the 41 (28.7%) dogs. As a result, it was concluded that the CCOV agent is in circulation among dogs living in T..rkiye. CCOV and CPV can cause co-infections and increased mortality. Although infection can be seen in dogs of all ages, it can be seen more frequently in dogs younger than 1 year of age, and especially in dogs younger than 6 months, and can cause enteritis, low hemoglobin, erythropenia, lymphopenia, leukopenia, thrombocytopenia, and hypoproteinemia.
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Intracranial infection with the JHM strain of the mouse hepatitis virus (JHMV), a member of the Betacoronavirus family, causes acute encephalomyelitis resulting in immune-mediated demyelination. JHMV infection is an excellent model to study both viral-induced neurologic disease and the immunologic mechanisms contributing to demyelination and is a well-accepted model for the human demyelinating disease multiple sclerosis (MS). Following JHVM infection of the CNS, the innate immune system is rabidly mobilized and secretion of the ELR+ family of chemokines, including CXCL1, which contribute to multiple cell processes including migration, differentiation, and maturation. Using a transgenic mouse in which the neutrophil chemoattractant CXCL1 can be induced to be overexpressed from astrocytes, we previously showed that sustained neutrophil infiltration exacerbates demyelination and clinical severity in the JHMV model. Subsequently, we wanted to replicate these findings in the prototypic experimental autoimmune encephalomyelitis (EAE) model and also to elucidate the mechanisms by which neutrophils are augmenting white matter damage in the JHMV mouse model of demyelination. In the EAE model we found that sustained infiltration of neutrophils into the CNS increased severity of demyelination and worsened clinical score without affecting the infiltration of other immune cell populations. Additionally, blocking neutrophil over accumulation with anti-CXCR2 antibody ameliorated these negative effects. We also found in the JHMV model that sustained neutrophil infiltration exacerbated demyelination through both direct and indirect effects. Neutrophils in the spinal cord were found to have a more mature phenotype associated with increased granularity and proinflammatory protein production and also polarized other infiltrating immune cells to a more inflammatory phenotype.The CXCR2/CXCL1 signaling pathway is also important for proper myelination of the CNS, specifically in the positional migration and proliferation of oligodendrocyte precursor cells (OPCs) in the developing mouse brain. In addition, CXCR2 signaling has been implicated in regulating remyelination in several pre-clinical models of demyelination. In order to determine the role of CXCR2 signaling on OPCs we developed a mouse model in which Cxcr2 was conditionally ablated following tamoxifen treatment in adult mice. We found using the JHMV model that Cxcr2 silencing on OPCs did not affect clinical disease, infiltrating immune cells, or demyelination. It also had no effect on the structural myelin composition of noninfected transgenic mice. However, we did find that Cxr2 ablation resulted in more mature oligodendroglia and more remyelination at later time points following JHMV infection. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic pathogen which causes high mortality rate in humans. Dromedary camels may play a central role in virus transmission to humans. Dipeptidyl peptidase-4 (DPP4), a transmembrane protein located on the cell surface of many epithelial and endothelial tissues was identified as the receptor for MERS-CoV. The current study investigated the possibility that bacterial stimulation of camel blood could affect the expression level of DPP4 on camel leukocyte subpopulation, which in turn may contribute to the higher susceptibility of camels with bacterial infection to MERS-CoV infection. DPP4 expression was evaluated by membrane immunofluorescence and flow cytometry. Stimulation of camel blood with the bacterial species S. aureus or E. coil resulted in the upregulation of DPPV on both monocytes and granulocytes, while S. agalactiae did not significantly modulate DPPV expression on either of the immune cells (p > 0.05). None of the bacterial species could induce a change in DPPV expression on lymphocytes from stimulated blood. Collectively, the present study showed an enhancing effect of bacterial stimulation on DPPV expression on camel monocytes and granulocytes.
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Objective: Sungkai extract contains flavonoids. It has an analgesic, anti-inflammatory, and antipyretic function. The research objective was to determine the effect of stewed sungkai leaves on the decrease in inflammatory symptoms of COVID-19 patients. Method(s): The research design used a quasi-experimental one-group pre-post-test. The computerized Wilcoxon test processed the data obtained, and the Cronbach alfa test was used to ensure reliability. Sampling was done by using an accidental sampling technique with the following criteria: confirmed positive for COVID-19;agreed with informed consent;did not use other traditional medicines;and a total of samples from 14 people that were carried out at the Reksodiwiryo Padang Hospital. The patients were given stewed sungkai leaves by taking five pieces of young sungkai leaves boiled in 3 cups of water to make 1 cup of drink to be consumed twice a day 5, 12 patients had no inflammatory reaction. Result(s): The results showed that giving stewed/ boiled sungkai leaves decreased inflammatory symptoms of COVID-19 patients with a p-value (<0.05). The result of the normality test is 0.00. Conclusion(s): Thus, it can be concluded that boiled sungkai leaves have the potential as an anti-infection that can increase leukocytes. Copyright © RJPT All right reserved.
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The mitochondrial membrane potential (ΔΨm ) is a parameter often used to determine mitochondrial function; therefore, it can be used to determine the integrity and functionality of cells. A decrement of ΔΨm is implicated in several inflammatory-related pathologies, such phenomena can be related to COVID-19 infection. The present work aimed to compare the ΔΨm in leucocytes (human PBMCs; HPBMC) isolated from healthy control (HC) subjects, patients with COVID-19 (C-19), recovered subjects at 40 ± 13 (R1) and 335 ± 20 (R2) days after infection (dai). Obtained data showed that ΔΨm decreased in HPBMC of subjects with C-19, R1, and R2 compared with HC. When analyzing the ΔΨm data by sex, in females, a significant decrease was observed in R1 and R2 groups versus HC. Regarding men, a significant decrease of ΔΨm was observed in R1, with respect to HC, contrary to R2 group, who reestablished this parameter. Obtained results suggest that the loss of ΔΨm could be related to the long-COVID.
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COVID-19 , COVID-19/complications , Female , Humans , Leukocytes , Male , Membrane Potential, Mitochondrial , Mitochondria/metabolism , Post-Acute COVID-19 SyndromeABSTRACT
INTRODUCTION: The main aim of this study was to assess the utility of differential white cell count and cell population data (CPD) for the detection of COVID-19 in patients admitted for community-acquired pneumonia (CAP) of different etiologies. METHODS: This was a multicenter, observational, prospective study of adults aged ≥18 years admitted to three teaching hospitals in Spain from November 2019 to November 2021 with a diagnosis of CAP. At baseline, a Sysmex XN-20 analyzer was used to obtain detailed information related to the activation status and functional activity of white cells. RESULTS: The sample was split into derivation and validation cohorts of 1065 and 717 patients, respectively. In the derivation cohort, COVID-19 was confirmed in 791 patients and ruled out in 274 patients, with mean ages of 62.13 (14.37) and 65.42 (16.62) years, respectively (p<0.001). There were significant differences in all CPD parameters except MO-Y. The multivariate prediction model showed that lower NE-X, NE-WY, LY-Z, LY-WY, MO-WX, MO-WY, and MO-Z values and neutrophil-to-lymphocyte ratio were related to COVID-19 etiology with an AUC of 0.819 (0.790, 0.846). No significant differences were found comparing this model to another including biomarkers (p=0.18). CONCLUSIONS: Abnormalities in white blood cell morphology based on a few cell population data values as well as NLR were able to accurately identify COVID-19 etiology. Moreover, systemic inflammation biomarkers currently used were unable to improve the predictive ability. We conclude that new peripheral blood biomarkers can help determine the etiology of CAP fast and inexpensively.
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COVID-19 , Community-Acquired Infections , Pneumonia , Adult , Humans , Adolescent , COVID-19/diagnosis , Prospective Studies , Leukocyte Count , Community-Acquired Infections/diagnosis , Pneumonia/diagnosis , BiomarkersABSTRACT
Features of variation of peripheral blood leukocyte formula parameters in 86 patients with coronavirus pneumonia with leukocytosis with a background of glucocorticoid treatment were investigated. All patients were divided into 2 groups. Group 1 was 22 individuals who showed clinical signs of the bacterial infection (purulent sputum cough in combination with neutrophilic leukocytosis at hospital the admission). The 2nd group was made up of 64 patients with the glucocorticoids developed against the background of treatment with glucocorticoids (dexamethasone 20 mg/day or prednisolone 150 mg/day, intravenously for 3 days) leukocytosis >10 x109/l without signs of a bacterial infection. It was found that in patients of the 1st group compared to the 2nd group, levels of the white blood cells and neutrophils were significantly (p < 0.001) exceeded the reference values in the absence of a significant change in the number of monocytes. In patients of the 2nd group after a three-day intravenous application of the glucocorticoids on the 4th day of hospitalization, a statistically significant (p < 0.001) increase in the number of neutrophils and monocytes was established. When comparing the quantitative parameters of the leukocyte formula between the 2nd group on the 4th day of the hospitalization and the 1st group at admission, there were no differences in the level of leukocytes and neutrophils. Number of monocytes in group 2 (1.11 (0.90;1.34) x 109/l), on the contrary, statistically significantly (p < 0.001) exceeded their level in the 1st group (0.59 (0.50;0.77) x 109/l). Thus, an indicator of the number of monocytes in the peripheral blood could be a promising differential diagnostic criterion for the genesis of the leukocytosis in patients with the COVID-19. This parameter may be one of the factors influencing the decision to prescribe the antibacterial therapy.
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Objective: Retrospectively analyze the clinical data in patients with suspected COVID-19 for reference to differential diagnosis of this infection.
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Objective: To investigate a reasonable threshold d total bilirubin for the diagnosis of hepatitis B virus - related acute - on -chronic liver failure (HBV - ACLF), and to realize accurate early diagnosis.