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SARS-CoV-2 has infected more than 600 million people worldwide over the last 2.5 years. So far, there efficacy of many antiviral drugs against COVID-19 has been evaluated only in small studies conducted in different countries. Objective. To assess the efficacy of umifenovir in patients with COVID-19. Materials and methods. We performed systematic search of publications in the PubMed and Google Scholar databases. Sixteen studies with a total of 1,843 patients were included in the analysis. The following endpoints were evaluated: frequencies of negative PCR test on days 7 and 14;mortality in patients with mild, moderate, and severe disease;and frequency of fever resolution on day 7. Results. We found that patients receiving umifenovir demonstrated a significantly higher frequency of negative PCR test on day 7 than patients who received no causal therapy or other antiviral drugs (odds ratio (OR) 1.69, 95% confidence interval (CI): 1.09-2.62, p = 0.02, I2 = 13%). This difference was even more significant among patients with mild to moderate COVID-19 (OR: 2.03, 95% CI: 1.24-3.32, p = 0.005, I2 = 0%), as well as on day 14 (OR: 2.02, 95% CI: 1.35-3.94, p = 0.0007, I2 = 50%). We also observed a reduced risk of death in the studies that included only patients with mild and moderate disease (JR: 0.53, 95% CI: 0.33-0.83, p = 0.006, I2 = 0). Umifenovir therapy did not affect the frequency of fever resolution by day 7 (OR: 0.87, 95% CI: 0.49-1.56, p = 0.64, I2 = 0%). Conclusion. Umifenovir significantly accelerated virus elimination by days 7 and 14 among patients with mild to moderate COVID-19. Umifenovir also reduced the risk of death compared to other antiviral drugs.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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Objective To explore the sociodemographic and psychological factors influencing the continuity of treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019 (COVID-19). Methods A total of 277 patients with chronic kidney disease who were admitted to Department of Nephrology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. 2020 to Mar. 2021 were enrolled and divided into 3 groups: non-dialysis group (n=102), hemodialysis (HD) group (n=108), and peritoneal dialysis (PD) group (n=67). All patients were investigated by online and offline questionnaires, including self-designed basic situation questionnaire, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). The general sociodemographic data, anxiety and depression of the 3 groups were compared, and the influence of sociodemographic and psychological factors on the interruption or delay of treatment was analyzed by binary logistic regression model. Results There were significant differences in age distribution, marital status, occupation, medical insurance type, caregiver type, whether there was an urgent need for hospitalization and whether treatment was delayed or interrupted among the 3 groups (all P0.05). The average SAS score of 65 PD patients was 38.15+/-15.83, including 53 (81.5%) patients without anxiety, 7 (10.8%) patients with mild anxiety, and 5 (7.7%) patients with moderate to severe anxiety. The average SAS score of 104 patients in the HD group was 36.86+/-14.03, including 81 (77.9%) patients without anxiety, 18 (17.3%) patients with mild anxiety, and 5 (4.8%) patients with moderate to severe anxiety. There were no significant differences in the mean score of SAS or anxiety severity grading between the 2 groups (both P0.05). The mean SDS scores of 65 PD patients were 53.42+/-13.30, including 22 (33.8%) patients without depression, 21 (32.3%) patients with mild depression, and 22 (33.8%) patients with moderate to severe depression. The mean SDS scores of 104 patients in the HD group were 50.79+/-10.76, including 36 (34.6%) patients without depression, 56 (53.8%) patients with mild depression, and 12 (11.6%) patients with moderate to severe depression. There were no significant differences in mean SDS scores or depression severity grading between the 2 groups (both P0.05). The results of intra-group comparison showed that the incidence and severity of depression were higher than those of anxiety in both groups. Multivariate binary logistic regression analysis showed that high school education level (odds ratio OR=5.618, 95% confidence interval CI) 2.136-14.776, P0.01), and unmarried (OR=6.916, 95% CI 1.441-33.185, P=0.016), divorced (OR= 5.588, 95% CI 1.442-21.664, P=0.013), urgent need for hospitalization (OR=8.655, 95% CI 3.847-19.476, P0.01) could positively promote the continuity of treatment in maintenance dialysis patients under the regular epidemic prevention and control of COVID-19. In the non-dialysis group, no sociodemographic and psychological factors were found to be associated with the interruption or delay of treatment (P0.05). Conclusion Education, marital status, and urgent need for hospitalization are correlated with the continuity of treatment in patients with chronic kidney disease on maintenance dialysis.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Amantadine has begun to be used as a possible alternative in COVID-19 therapy to mitigate its effects. There is anecdotal evidence that patients with Parkinson's disease (PD) treated with amantadine and who test positive for COVID-19 often do not develop clinical manifestations of COVID-19. Objective(s): to compare the clinical course of COVID-19 in patients with PD who took or did not take amantadine sulfate. Patients and methods. A prospective continuous study included 142 patients with PD who were treated in Republican Clinical Diagnostic Center for Extrapyramidal Pathology and Botulinum Therapy in Kazan from October 2021 to January 2022. Patients filled out a proprietary internally developed questionnaire. Results and discussion. Out of 142 individuals with PD COVID-19 occurred in 77 (54.2%), of which 52.0% had a mild course, 39.0% had a moderate course, 2.6% had a severe course, and in 6.5% the severity of the disease has not been established. Deterioration after COVID-19 infection was noted by 36% of patients: the appearance or increase in motor fluctuations (41%), increased tremor, stiffness or slowness (31%), the appearance of "exhaustion" of the effect of a single dose of levodopa (13%), the appearance or increased dyskinesia (21%), hallucinations (3.5%). Patients taking amantadine sulfate had PD much longer (11.5+/-5.62 years versus 5.12+/-3.24 years) and had a more pronounced (III-IV) stage of the disease. These patients were more likely to experience mild COVID-19 (in 60.87% of cases), in contrast to patients not receiving amantadine sulfate (only in 48.15% of cases). There was no correlation between the severity of COVID-19 and levodopa intake. Conclusion. The results of the study showed that patients with PD taking amantadine sulfate are more likely to have a mild course of COVID-19.Copyright © 2022 Ima-Press Publishing House. All rights reserved.
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Aim: Although most patients with COVID-19 experience respiratory tract infections, severe reactions to the virus may cause coagulation abnormalities that mimic other systemic coagulopathies associated with severe infections, such as disseminated intravascular coagulation and thrombotic microangiopathy. Fluctuations in platelet markers, which are an indicator of the acute phase response for COVID-19, are of clinical importance. The aim of this study is to evaluate the relationship between disease severity and Platelet Mass Index (MPI) parameters in COVID-19 patients. Material(s) and Method(s): This retrospective observational study was conducted with patients who were diagnosed with COVID-19 in a tertiary hospital. The study was continued with the remaining 280 patients. All laboratory data were scanned retrospectively from patient files and hospital information system. Result(s): A very high positive correlation was found between PMI and PLT. The PMI value in women was significantly higher than in men. It was observed that PMI did not differ significantly in terms of mortality, intubation, CPAP and comorbidity. PMI vs. Pneumonia Ct Severity Score, biochemistry parameters (AST, CRP), hemogram parameters (WBC, HGB, HCT, MCV, LYM, MPV EO) and coagulation factors (aPTT and FIB) at various levels of positive/negative, weak and strong, and significant relationship was found. There was no significant relationship between hormone and D-dimer when compared with PMI. Discussion(s): Although platelet count alone does not provide information about the prognosis of the disease, PMI may guide the clinician as an indicator of lung damage in seriously ill patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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A new coronavirus infection caused by the SARS-CoV-2 virus is characterized by a systemic hyperinflammatory response with a pronounced increase in the content of pro-inflammatory cytokines. Materials and methods. The study was conducted on the basis of the Samara Regional Children's Infectious Diseases Hospital from 2021 to 2022. 40 patients with moderate (n = 20, group I) and severe forms (n = 20, group II) COVID-19 were studied, the comparison group consisted of patients with viral pneumonia of another etiology (n = 35, group III). Results. The infectious agent SARS-CoV-2 induces high levels of cytokines IL-6 (p < 0.005), IL-8 (p < 0.05) and a slight increase in TNF-alpha (p < 0.05). IL-8 was significantly associated with disease duration (p < 0.01). We assume that the value of this interleukin will increase in the post-COVID period. Conclusions. Changes in IL-6 and IL-8 levels in patients with COVID-19, along with clinical features, are important biomarkers for predicting the severity and duration of the disease.Copyright © Children Infections.All rights reserved
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Objective. To assess the relationship between the severity of COVID-19 in patients without significant baseline cardiovascular pathology and various echocardiographic parameters of myocardial dysfunction. Material and methods. 46 patients with COVID-19 were included in our study: 33 patients of moderate severity and 13 - with severe disease. On days 1 and 9 upon admission, all patients underwent an echocardiographic study with standard assessment of the both ventricles function, as well as an assessment of their global longitudinal strain (GLS). Comparison of the studied parameters was carried out both between groups of patients and within each group in dynamics. Results. On day 1patients in the severe group had higher values of the systolic gradient on the tricuspid valve (22.0 [21.0;26.0] vs 30.0 [24.0;34.5] mm Hg, p = 0.02), systolic excursion of the plane of the tricuspid ring (2.3 [2.1;2.4] vs 2.0 [1.9;2.2] mm, p = 0.016), E/e' ratio (9.5 [7.7;8.9] vs 7.5 [6.8;9.3], p = 0.03). At day 9 among patients in the severe group, there was a decrease in end-diastolic (111.0 [100.0;120.0] vs 100.0 [89.0;105.0] ml, p = 0.03) and of end-systolic (35.5 [32.0;41, 2] vs 28.0 [25.0;31.8] ml, p < 0.01) volumes of the left ventricle. There was a decrease in GLS of the both ventricles compared to general accepted values. In dynamics, there was an increase in the GLS of the right ventricle in both groups, but it was more pronounced among severe group of patients (day 1 -18.5 [-15.2;-21.1] vs -20.2 [-15.8.1;-21.1] %, p = 0.03). The troponin levels were in the normal range. Conclusion. In COVID-19 patients without significant baseline cardiovascular pathology, there is a transient decrease in longitudinal strain of both ventricles, even in the absence of clinical and laboratory signs of acute myocardial injury.Copyright © Creative Cardiology 2021.
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Background: This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium. Method(s): Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021. Result(s): Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores. Conclusion(s): The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.Copyright © 2022, The Author(s).
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Severe pneumonia is a condition with a high risk of death and mandatory hospitalization in the intensive care unit. The incidence of severe pneumonia has increased dramatically during the pandemic of new coronavirus infection. Timely diagnosis and early initiation of adequate treatment of severe pneumonia are crucial for improving survival of critically ill patients. The aim of this review was to analyze published scientific research on molecular markers that allow to objectively assess the severity of pneumonia and to determine treatment tactics based on the predicted outcome upon admission to the hospital. A systematic search was conducted in the electronic databases PubMed, Medline, Web of Science for the period 2019 - 2022. Conclusion. The review focuses on the prognostic role of a number of markers of immune response, vascular transformation, as well as angiotensin II and angiotensin converting enzyme-2. Further prospective studies of potential predictors of severe pneumonia will enable using marker molecules in a comprehensive clinical and laboratory diagnosis for early prediction of the hospitalized patient's condition and expected outcome.Copyright © Volchkova E.V. et al., 2023.
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Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.
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Background: COVID-19 has appeared as a pandemic and public health issue at a universal level. First documented as a respiratory disease, COVID-19 has been found to interrelate with and disturb the cardiovascular system causing myocardial injury and also cardiac dysfunction. Initial documentation of cardiac pathology can play a substantial role in dropping the death rate. This study emphasizes on the relationship between the serum levels of cardiac Trop I and prognosis in patients with and without pre-existing CAD in COVID-19 patients. Aims and Objectives: The first objective was to explore the association among the serum levels of cardiac Trop I and bad prognosis in patients with antiquity of CAD and without CAD. The secondary objective was to explore and understand whether increased Trop I is an appreciated prognostic indicator for COVID-19 patient antagonistic prognosis. Material(s) and Method(s): This was conducted as a retrospective observational study in which a whole of 45 patients admitted in COVID Hospital of Malabar Medical College and Research Center category C were studied. The medical record of the patients whose COVID-19 confirmation done by combined conclusions of reverse transcription PCR, symptoms, and chest X-ray was studies by the team. Result(s): Mean age of the study participants was 59.3 +/- 13.7. Every study participants had elevated Trop I levels with a median Trop I in study subjects being 397.9. There was a statistically significant elevation in Trop I levels in patients with CAD linked with non-CAD patients with a median IQR of 641.6 and P = 0.003 and there was a significant increase in Trop I levels in patients who expired related to patients who got discharged with a median IQR of 587.3 and P = 0.003. Conclusion(s): From this study, we accomplish that rise in cardiac troponin-I level is connected with elevated mortality in patients with COVID-19. Hence, it can be used as significant biomarker of disease evolution, hospitalization, and worse prognosis in COVID-19 patients.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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COVID-19 due to severe acute respiratory syndrome coronavirus 2, which has become a global pandemic, produces elevated liver enzymes, especially in severe cases. The mechanism suggests involvement of an administrated drug, cytokine storm, or hypoxia, etc., as opposed to virus-induced direct damage. If liver enzymes are elevated in COVID-19, we should evaluate for the presence of other liver diseases, and strictly follow-up liver enzyme values. In patients with COVID-19 complicated by chronic liver disease, we will use telemedicine/visits by phone, so as not to interrupt the treatment of the underlying disease, avoid unnecessary outpatient visits, and strive to halt the spread of the infection. Metabolism-associated fatty liver disease, which is often related to obesity, diabetes, and hypertension, may be a risk factor for COVID-19 severity. International academic societies have recommended guidance outlining the evidence to date regarding the management of patients with COVID-19 and liver disorders, and chronic liver disease under the COVID-19 pandemic.Copyright 2020 The Japan Society of Hepatology.
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Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Material(s) and Method(s): Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Result(s): A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion(s): The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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The aim of the study was to study the clinical and epidemiological features of the new COVID-19 coronavirus infection in children hospitalized in the infectious department. Material and methods. 249 case histories of patients from 0 to 18 years of age who are on inpatient treatment at <<Clinical Hospital N1>> in Smolensk for the period from April 2020 to July 2022 were studied by the continuous sampling method. Verification of a new coronavirus infection was carried out by examining smears from the nasopharynx and oropharynx for the presence of SARS-CoV-2 by real-time PCR. Results. The prevalence of patients from 1 to 3 (19.3%, 49.1%) and from 6-15 (15.8%, 50.5%) years was revealed both in 2020 and in 2021 and the first half of 2022. No significant differences in gender were found. The largest number of cases in 2020 was registered in April (16%) and November (14%), in 2021 - in December (18%) and November (16%). The prevailing severity in both 2020 and 2021, 2022 was the average severity (63%, 72%, 93%, respectively). The main syndromes of COVID-19 have been identified: intoxication syndrome, respiratory catarrhal syndrome, bronchopulmonary, intestinal. Bilateral pneumonia was most often detected (47% in 2020, 44% in 2021, 62% in 2022), right-sided pneumonia (33% in 2020, 30% in 2021, 31% in 2022), and left-sided pneumonia (20%, 26% and 7%, respectively). The main co-morbid pathologies are noted, and cases of somatic diseases first registered against the background of COVID-19 are described.Copyright © Children Infections.All rights reserved
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The COVID-19 pandemic has altered people's lifestyles around the world. Prevention of recurrent episodes of the disease and mitigation of its consequences are especially associated with effective post-COVID-19 rehabilitation in patients. The aim of the study was to evaluate the effects of the drug Likopid (glucosaminylmuramyl dipeptide, GMDP) for post-COVID-19 rehabilitation in patients. Material and methods. Patients who recovered from mild to moderate COVID-19 (n=60, mean age 54+/- 11.7 years) were randomized into the observation group (n=30, 15 men and 15 women) who received 2 courses of Licopid (1 mg twice a day) and the comparison group (n=30, 15 men and 15 women). Analysis of the phenotypic and functional characteristics of the innate immune cellular factors was carried out before the start of immunomodulatory therapy, immediately after the end of the course, and also after 6 months observations. In order to assess the quality of life of all patients, we used the SF-36 Health Status Survey and the Hospital Anxiety and Depression Scale questionnaires. Results. During assessing the effect of immunomodulatory therapy on the parameters of innate immunity of patients at the stage of rehabilitation after COVID-19, an increase in the protective cytolytic activity of CD16+ and CD8+Gr+ cells, as well as a persistent increase in TLR2, TLR4 and TLR9 expression was found, which indicates the antigen recognition recovery and presentation at the level of the monocytic link of the immune system. The use of GMDP as an immunomodulatory agent resulted in an 8-fold reduction in the frequency and severity of respiratory infections due to an increase in the total monocyte count. As a result of assessing patients' quality of life against the background of the therapy, a positive dynamic in role functioning was revealed in patients. In the general assessment of their health status, an increase in physical and mental well-being was noted during 6 months of observation. The comparison group showed no improvement in the psychoemotional state. Discussion. The study demonstrated the effectiveness of GMDP immunomodulatory therapy in correcting immunological parameters for post-COVID-19 rehabilitation in patients. The data obtained are consistent with the previously discovered ability of GMDP to restore impaired functions of phagocytic cells and induce the expression of their surface activation markers, which in turn contributes to an adequate response to pathogens. Conclusion. The study revealed that the correction of immunological parameters with the use of GMDP in COVID-19 convalescents contributed not only to a decrease in the frequency and severity of respiratory infections, but also to an improvement in the psycho-emotional state of patients, and a decrease in anxiety and depression.Copyright © Eco-Vector, 2023. All rights reserved.
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Introduction: The coronavirus disease (COVID-19) was extended to the entire population in China and around the world, and its mortality rate was about 3.4%. The impact of laser therapy on chronic respiratory diseases has been shown in previous studies. This study was aimed at examining the effects of laser acupuncture (LA) on patients with severe COVID-19. Methods: In the present study, 60 patients with a positive reverse transcription-polymerase chain reaction (RT-PCR) test were assigned to the intervention and control groups (30 patients in each group). The intervention group was treated with LA, that is, laser light with low energy on acupuncture points, once a day for five consecutive days. Results: The participants' mean age in the intervention and control groups was 48.96 ± 12.65 and 53.16 ± 12.28 respectively;70% of the patients were male and 30% of them were female. IL6 had a significant reduction in the intervention group (P value = 0.038) in comparison with the control group (P value = 0.535). Furthermore, the mean admission time in the control group was significantly higher than that in the intervention group (P value = 0.047). However, the mortality rate in the intervention group was zero, but three patients in the control group died. Conclusion: Our study showed that LA can be used as supportive therapy for routine treatment in patients with severe COVID-19. Moreover, due to LA safety and it's low cost, it could be recommended as an adjuvant to conventional therapy in patients interested in treating their disease with such a method © 2023, Journal of Lasers in Medical Sciences.All Rights Reserved.
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Purpose: The aim of this study was to investigate the relationship between the functionality of disabled children and its effects on parents during the Covid-19 pandemic. Method(s): A total of 168 people, including 84 disabled children and 84 mothers, were included in the study. The Pediatric Disability Assessment Inventory (PEDI) and Gross Motor Function Classification System (GMFCS) were used for children with disabilities. The Zarit Burden Scale (ZBS), Fatigue Severity Scale (FSS) and The Nordic Musculoskeletal Questionnaire (NMQ) were applied to the mothers to question musculoskeletal disorders. Result(s): There was no correlation between care burden score and PEDI, total score, self-care and mobility scores (p>0.05). A moderately negative (r=-0.306;p<0.01) significant linear relationship was found between care burden score and social function score. There was no significant linear relationship between the fatigue severity score and PEDI total score, self-care, mobility and social function scores (p>0.05). No correlation was found between care burden score and fatigue severity score (p>0.05). For the last 12 months, only the pain in the lumbar region of the parents prevented them from doing their usual work. It was determined that the most aching body parts of the parents who complained of musculoskeletal pain during the last 12 months were in the waist, neck, shoulder, back, and knee regions. Conclusion(s): As a result, no relationship was found between the functionality of disabled children and their parents' influences during the Covid-19 pandemic.Copyright © 2022 Turkish Physiotherapy Association. All rights reserved.
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The novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).Mortality attributable to COVID-19 remains considerably high, with case fatality rates as high as 8-11%. Early medical intervention in patients who are seriously and critically ill with COVID-19 reduces fatal outcomes. Thus, there is an urgent need to identify biomarkers that could help clinicians determine which patients with SARS-CoV-2 infection are at a higher risk of developing the most adverse outcomes, which include intensive care unit (ICU) admission, invasive ventilation, and death. In COVID-19 patients experiencing the most severe form of the disease, tests of liver function are frequently abnormal and liver enzymes are found to be elevated. For this reason, we examine the most promising liver biomarkers for COVID-19 prognosis in an effort to help clinicians predict the risk of ARDS, ICU admission, and death at hospital admission. In patients meeting hospitalization criteria for COVID-19, serum albumin < 36 g/L is an independent risk factor for ICU admission, with an AUC of 0.989, whereas lactate dehydrogenase (LDH) values > 365 U/L accurately predict death with an AUC of 0.943.The clinical scores COVID-GRAM and SOFA that include measures of liver function such as albumin, LDH, and total bilirubin are also good predictors of pneumonia development, ICU admission, and death, with AUC values ranging from 0.88 to 0.978.Thus, serum albumin and LDH, together with clinical risk scores such as COVID-GRAM and SOFA, are the most accurate biomarkers in the prognosis of COVID-19.Copyright © 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.
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Background: The coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities are a great global concern. Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with COVID-19. Objective(s): This study examined the frequency of BM, newly diagnosed hyperglycemia, and their impacts on hospitalized patients with COVID-19. Method(s): This retrospective study examined 810 medical records of PCR-confirmed COVID-19 patients admitted to Razi Hospital, Ahvaz, Iran. The clinical presentations, severity, and impacts of COVID-19 were compared between patients with and without DM. Disease severity was determined based on the NEWS2 scoring system. Result(s): This study included 810 medical records of COVID-19 patients, of whom 326 had pre-existing DM, and 484 were non-DM. The rates of diabetes and newly diagnosed hyperglycemia were 40.2% and 11.2%, respectively. The most common underlying diseases were hypertension (35.3%), ischemic heart disease (17.9%), and chronic kidney disease (11.9%), which were higher in people with diabetes than non-diabetics. The rate of acute kidney injury was higher in patients with diabetes than in non-diabetics (30.7% vs. 19.2%;P < 0.001) and in patients with severe COVID-19 than in those whose disease was not severe (27.8% vs. 21.5%;P = 0.04). The rates of severe COVID-19 (46.3% vs. 34.7%;P = 0.093), ICU admission (40.7% vs. 27.4%;P = 0.012), and mortality (18.5% vs. 10.5%;P = 0.079) were higher in patients with newly diagnosed hyperglycemia than in euglycemic patients. Conclusion(s): This study showed that COVID-19 infection is linked with newly diagnosed hyperglycemia and pre-existing DM, both associated with severe COVID-19, more need for ICU admission, and mortality.Copyright © 2023, Author(s).
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The aim of the research. To study the features of cardiovascular system disorders in post-covid syndrome (PCS) in children and adolescents after a mild form of coronavirus infection (COVID-19). Material and methods. From 260 children and adolescents after a mild form of COVID-19, a total of 30 patients aged 7-17 years with cardiac manifestations of PCS were selected. Therewith, 32 patients with an uncomplicated form of the disease were selected to form a comparison group. In 3 and 6 months after disease onset, a comprehensive examination of patients was performed with a questionnaire on the subjective scale for MFI-20 assessment asthenia (Multidimensional Fatigue Inventory-20), electrocardiography (ECG), echocardiography;daily monitoring of ECG and blood pressure. The biochemical blood test included assay of creatine phosphokinase-MB (CPK-MB), troponin I and lactate dehydrogenase (LDH). Results. The incidence of PCS with cardiac manifestations amounted to 11.5 %. After 3 months from the disease onset, complaints of pain and discomfort in the chest, palpitations, fatigue, and poor exercise tolerance persisted. Asthenic syndrome was diagnosed in 70 % of patients. The "general asthenia" indicator totalled14 [12;16] points (p<0.001) and was associated with the age of patients (r=+0.5;p<0.05). Arrhythmic syndrome and conduction disorders were detected in 67% of children. Labile arterial hypertension and hypotension occurred in 23 % of the adolescents. The increase in CPK-MB remained in 17% of the children, LDH - in 10%. In the sixth month after the onset of the disease, there were no significant differences in the results of the examination in the observation groups. However, a decrease in the level of resistance within 6 months was recorded in 43.3% of the schoolchildren with PCS (p<0.001). Conclusion. The data obtained indicate the need for early verification of cardiopathies in children with COVID-19, determination of a set of therapeutic and rehabilitation measures as well as ECG monitoring.Copyright © 2022, Krasnoyarsk State Medical University. All rights reserved.
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Timely, effective, and safe antiviral therapy in COVID-19 patients reduces complications, disability and mortality rates. The greatest concern with remdesivir is the risk of drug-induced liver injury, including in patients whose liver function is compromised by COVID-19. The aim of the study was to investigate the efficacy and safety of remdesivir in patients with confirmed SARSCoV-2 infection who had been admitted to an infectious diseases hospital in the Volgograd region in March 2022. Material(s) and Method(s): the authors carried out an open, non-randomised, single-arm study using medical records of 234 patients who had been diagnosed with "U07.1 COVID-19, virus identified" and prescribed remdesivir upon admission. The effectiveness of therapy was evaluated using two criteria: the need for oxygen supplementation or ventilatory support, or mortality. The authors conducted the evaluation on days 7, 14, and 28 using the six-point ordinal severity scale by Y. Wang et al. The safety of therapy was assessed on the basis of complaints and changes in laboratory findings. Result(s): for the patients prescribed remdesivir at admission, the 7-day mortality rate was 3.0%, the 14-day mortality rate was 5.6%, and the 28-day mortality rate was 7.3%. With the exception of a patient with myocardial infarction, all the patients who had been hospitalised with mild COVID-19 and prescribed remdesivir did not require oxygen therapy and/or transfer to intensive care and were discharged following recovery. The patients with moderate to severe COVID-19 had the 14-day mortality rate of 6.4% and the 28-day mortality rate of 8.6%. 17 patients (7.2%) discontinued remdesivir prematurely for various reasons, including adverse drug reactions. Remdesivir therapy of 5-10 days was associated with an increase in ALT activity by 2.7 +/- 0.8 times in 15.9% of patients with mild COVID-19, by 3.8 +/- 1.8 times in 20.4% of patients with moderately severe COVID-19, and by 4.8 +/- 2.7 times in 24% (12/50) of patients with severe COVID-19. In two patients (0.9%), the increase exceeded 10-fold the upper limit of normal. Conclusion(s): the obtained results support recommending remdesivir to patients with mild, moderate and severe COVID-19, including those with moderately elevated baseline activity of hepatic transaminases.Copyright © NEICON ISP LLC. All rights reserved.