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1.
Cir Cir ; 90(5): 596-601, 2022.
Article in English | MEDLINE | ID: covidwho-2100848

ABSTRACT

OBJECTIVE: COVID-19 infection is characterized with elevation of inflammatory markers in bloodstream. A novel inflammatory marker, C-reactive protein (CRP)-to-lymphocyte ratio (CLR), is suggested to be associated with inflammation. We aimed to compare the CLR values of the deceased COVID-19 patients to the CLR of survived subjects. MATERIALS AND METHODS: The patients with COVID-19 whom presented to outpatient or inpatient clinics of AbantIzzet Baysal University Hospital were enrolled to the present retrospective study. Subjects were grouped as either deceased or survived. CLR values of the groups were compared. RESULTS: Study cohort was consisted of 568 subjects in deceased and 4753 patients in survived group. Median CLR of the deceased and survived groups were 90 (0.2-1679)% and 11 (0.2-1062)%, respectively (p < 0.001). The sensitivity (75%) and specificity (70%) of CLR (> 23.4% level) in detecting mortality were higher than those of CRP and ferritin (AUC 0.80, p < 0.001, 95% CI 0.78-0.82). CONCLUSION: We suggest that elevated CLR levels in COVID-19 patients on admission should alert physicians for poor outcome.


OBJETIVO: La infección por Covid-19 se caracteriza por elevación de marcadores inflamatorios en el torrente sanguíneo. Se sugiere que un nuevo marcador inflamatorio, la proporción de C-reactive protein (CRP) a linfocitos (CLR), está asociado con la inflamación. Nuestro objetivo fue comparar los valores de CLR de los pacientes fallecidos con Covid-19 con el CLR de los sujetos sobrevivientes. MATERIALES Y MÉTODOS: Los pacientes con Covid-19 que se presentaron en clínicas ambulatorias o de hospitalización del Hospital Universitario Abant Izzet Baysal se inscribieron en el presente estudio retrospectivo. Los sujetos se agruparon como fallecidos o sobrevivientes. Se compararon los valores de CLR de los grupos. RESULTADOS: La cohorte del estudio estuvo compuesta por 568 sujetos en el grupo fallecido y 4753 pacientes en el grupo sobreviviente. La mediana de CLR de los grupos fallecidos y sobrevivientes fue 90 (0.2-1679)% y 11 (0.2-1062)%, respectivamente (p < 0.001). La sensibilidad (75%) y la especificidad (70%) de CLR (nivel > 23.4%) en la detección de mortalidad fueron superiores a las de CRP y ferritina (AUC 0.80, p < 0.001, IC 95%: 0,78-0.82). CONCLUSIÓN: Sugerimos que los niveles elevados de CLR en pacientes con Covid-19 al ingreso deberían alertar a los médicos sobre un resultado deficiente.


Subject(s)
COVID-19 , Humans , C-Reactive Protein/analysis , Retrospective Studies , Lymphocytes/chemistry , Biomarkers
2.
World J Clin Cases ; 10(30): 11210-11213, 2022 Oct 26.
Article in English | MEDLINE | ID: covidwho-2100434

ABSTRACT

Numerous risk variables, including age, medical co-morbidities, and deranged inflammatory response, lead to higher mortality in a senior population with coronavirus disease 2019. C-reactive protein (CRP), an acute phase inflammatory protein secreted by the liver, was tested in the elderly, showing a diagnostic and prognostic role. However, recent research has shed light on new applications for CRP in geriatrics. It was used as a follow-up marker and as a therapeutic target. Early and accurate identification of patients' risks may mitigate the devastation of the invading virus in older cases and permit the implementation of a quick treatment plan for those most likely to deteriorate.

3.
Niger J Clin Pract ; 25(10): 1745-1750, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2100047

ABSTRACT

Background: The C-reactive protein (CRP)/albumin ratio (CAR) is one of the new tools to assess the severity of inflammation. It is used to determine clinical severity and prognosis in many diseases. Aim: The present study aimed to investigate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and prognosis in pregnant patients with more severe COVID-19 infection. Retrospective study. Patients and Methods: The study was conducted in a retrospective manner by scanning the files of pregnant patients who had a positive polymerase chain reaction test result and were hospitalized in Adiyaman Training and Research Hospital. The patients were divided into two groups: patients who were admitted to the intensive care unit and patients who were not admitted. CRP/albumin ratio (CAR) levels were compared between these two groups. The cut-off value was determined in the prediction of intensive-care admission and poor prognosis. Results: 117 patient files were reviewed. 13 patients were followed up with intensive care, whereas 104 patients completed their treatment in the service. The CAR levels of the patients admitted to intensive care were significantly higher (P < 0.01). In the estimation of intensive-care admission, the CAR level was determined to be 0.970 in the area under the curve with 100% sensitivity and 86.5% specificity in the receiver operating characteristic (ROC) curve. The cut-off CAR level was calculated as 1.8. Conclusion: CAR is a valuable biomarker for predicting prognosis, as well as follow-ups of pregnant COVID-19 patients.


Subject(s)
C-Reactive Protein , COVID-19 , Humans , Pregnancy , Female , C-Reactive Protein/analysis , Retrospective Studies , Prognosis , Albumins
4.
Disaster and Emergency Medicine Journal ; 7(3):176-181, 2022.
Article in English | Scopus | ID: covidwho-2100255

ABSTRACT

INTRODUCTION: Diagnosis of COVID-19 is through polymerase chain reaction (PCR) or typical involvement of the lung by the virus in computed tomography (CT) scan. However, PCR is not always available, and also CT scan has a high dose of radiation. This study was performed to find the role of complete blood cell (CBC) indices and qualitative C-reactive protein (CRP) in screening of symptomatic patients. MATERIAL AND METHODS: A diagnostic accuracy study was performed on symptomatic cases in Abadan. Four stepwise logistic regression models were designed that the outcomes were PCR positivity, CT scan positivity, PCR and CT scan positivity, and COVID-19 positivity (i.e., PCR or CT scan positivity). Post-estimation receiver operating characteristics (ROC) curve analysis was performed to report the area under the curve (AUC). RESULTS: A total of 104 patients were studied. The most accurate model was for the prediction of CT scan positivity (AUC = 0.874) in which the predictors were age [odds ratio (OR) =1.063] and CRP (OR = 2.661 for each plus of positivity). The second accurate model was for the prediction of COVID-19 positivity (AUC = 0.828) in which the predictors were white blood cell count (OR = 0.735 for every 1000 counts per μL) and neutrophil per lymphocyte ratio (OR = 1.248). CONCLUSIONS: Higher levels of CRP are associated with and predictor of lung involvement in COVID-19 infection. CRP qualitative levels can be measured before a CT scan if there is no other indication for imaging. © 2022 Via Medica.

5.
J Pharm Health Care Sci ; 8(1): 27, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2098465

ABSTRACT

BACKGROUND: COVID-19 has become a significant health threat and a primary healthcare concern among the most vulnerable patients with cancer. Patients with COVID-19 who have lung cancer are at great risk and need careful monitoring if they are affected. This study aimed to investigate the clinical characteristics of COVID-19-positive patients with lung cancer and the risks associated with anticancer medication. METHODS: This study was a single-center, retrospective cohort study. Patients with lung cancer who presented with COVID-19 during hospitalization were divided into two groups: those who presented with respiratory failure and those who did not. The patient's background, clinical laboratory values, and anticancer drugs used for therapy were investigated to identify risk factors for respiratory failure. RESULTS: Thirty-one patients were included in the study; 18 (58.1%) were in the respiratory failure group and 13 (41.9%) were in the group without respiratory failure. In the respiratory failure group, there was a significant difference in using immune checkpoint inhibitor (ICI) use within 90 days (p = 0.025) and the level of C-reactive protein (CRP) level (p = 0.017). The analysis of the operating characteristic of the receiver revealed a cutoff value of 2.75 mg/dL for CRP (area under the curve = 0.744, sensitivity 0.611, specificity 0.923). CONCLUSIONS: A history of ICI within 90 days and elevated CRP (≥ 2.75 mg/dL) levels are potential factors leading to respiratory failure in COVID-19-affected patients undergoing chemotherapy for lung cancer.

6.
JAAD Case Rep ; 30: 35-37, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2095601
7.
Journal of Knowledge and Health in Basic Medical Sciences ; 17(3):26-32, 2022.
Article in Arabic | Scopus | ID: covidwho-2091357

ABSTRACT

Introduction: Testing C-reactive protein with a decrease in blood lymphocytes can help in the rapid diagnosis of Covid-19 disease. Therefore, this study was performed to investigate the relationship between C-reactive protein levels and lymphopenia on mortality from Covid 19 disease. Methods: The present study is a cross-sectional analytical study that was performed on 179 patients with Covid-19 referred to Imam Hossein Hospital in Shahroud. Subjects with positive PCR test, presence of C-reactive protein and lymphocytes in the experiments, outpatient referral or hospitalization in normal wards, ICU, and CCU of the hospital were included in the study. Chi-square and independent t-tests were used for statistical analysis using SPSS software version 23. The significance level was considered 0.05. Results: 179 patients were included in the study, 51.4% of whom were male. The mortality rate in the lymphopenia group was 15.9%, which was higher than the group with normal lymphocytes, and the mean age of those who died of the disease was significantly higher than those who improved (P=0.01). The results also showed that the mean age in people with high CRP is higher (P=0.01). Conclusion: According to the present study and the higher mortality rate in patients with lymphopenia, lymphopenia can be suggested as an indicator of the prognosis of patients, and also CRP can be considered a factor for the risk of mortality in patients. © 2022, Shahroud University of Medical Sciences. All rights reserved.

8.
Infect Dis (Lond) ; : 1-7, 2022 Oct 25.
Article in English | MEDLINE | ID: covidwho-2087664

ABSTRACT

BACKGROUND: Post-acute COVID-19 syndrome (PCS) is a multisystem disorder degrading the quality of life. The study determined characteristics and predictors of PCS in unvaccinated healthcare workers (HCWs) suffering from PCS based on a comparison with their fully recovered counterparts. METHODS: 305 HCWs were examined at least 12 weeks post COVID-19 symptom onset to obtain data about their acute phase of COVID-19 and current health status and tested for complete blood count, C-reactive protein (CRP), electrophoresis of plasma proteins and SARS-CoV-2-specific immunoglobulin (Ig) G and M. RESULTS: 181 (59.3%) HCWs reported persisting symptoms attributable to PCS during the examination and 124 (40.7%) HCWs stated no symptoms. In the entire sample, the mean CRP level slightly exceeded the normal range (6.63 mg/L, 95% confidence interval [CI] 5.96-7.3) while all other laboratory results were within the normal range. No statistically significant differences in laboratory results were revealed between both subgroups except for the mean Ig levels, which were higher in HCWs with PCS. The average number of symptoms of PCS was 1.9 (median 2). The most frequent symptoms of PCS were fatigue that interfered with daily life (47.5%), shortness of breath (38.1%), muscle or joint aches (16%), loss of smell (14.9%), headache (14.9%) and sleep disorders (11%). The only statistically significant predictors of PCS were female sex (odds ratio [OR] 1.48, 95% CI 1.059-2.067, p = .022) and increasing age (OR 1.04, 95% CI 1.01-1.07, p = .008). CONCLUSIONS: PCS appears to be a prevalent condition determined by female sex and increasing age.

10.
Int J Cardiol Heart Vasc ; 43: 101144, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2086280

ABSTRACT

Background: Coronavirus-2019 (COVID-19) is known to affect the heart and is associated with a pro-inflammatory state. Most studies to date have focused on clinically sick subjects. Here, we report cardiac and proinflammatory biomarkers levels in ambulatory young adults with asymptomatic or mild COVID-19 infection compared to those without infection 4-8 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) testing. Methods: 131 asymptomatic or mildly symptomatic subjects were enrolled following testing for SARS-COV-2. Fifty subjects tested negative, and 81 subjects tested positive. Serum samples were collected for measurement of C-reactive protein, ferritin, interleukin-6, NT-pro-B-type natriuretic peptide, and cardiac troponin 28-55 days after SARS-COV-2 RT-PCR testing. Results: Biomarker levels trended higher in SARS-COV-2-positive vs negative subjects, but differences in biomarker levels or proportion of subjects with elevated biomarkers were not statistically significant with respect to SARS-COV-2 status. Among individuals with ≥ 1 comorbidity, odds of elevated CRP were greater compared to individuals without any comorbidities (odds ratio [OR] = 2.90); this effect size was increased 1.4-fold among SARS-COV-2-positive subjects (OR = 4.03). Similarly, NT-pro-BNP was associated with CVD, with the strongest association in COVID-positive individuals (OR = 16.9). Conclusions: In a relatively young, healthy adult population, mild COVID-19 infection was associated with mild elevations in cardiac and proinflammatory biomarkers within 4-8 weeks of mild or asymptomatic COVID-19 infection in individuals with preexisting comorbidities, but not among individuals without comorbidities. For the general population of young adults, we did not find evidence of elevation of cardiac or proinflammatory biomarkers 4-8 weeks after COVID-19 infection.Clinical Perspective: This is a characterization of cardiac and proinflammatory biomarkers in ambulatory subjects following asymptomatic or mild COVID-19 infection. Young, ambulatory individuals did not have cardiac and proinflammatory biomarker elevation 4-8 weeks after mild COVID-19 infection. However, COVID-19 infection was associated with biomarker elevations in select individuals with comorbidities.Clinical study number: H-47423.

11.
Open Life Sciences ; 17(1):1360-1370, 2022.
Article in English | Web of Science | ID: covidwho-2082700

ABSTRACT

Prognostic markers are the biomarkers used to measure the disease progression and patient outcome regardless of treatment in coronavirus disease 2019 (COVID-19). This study aimed to analyze laboratory parameters as prognostic markers for the early identification of disease severity. In this study, 165 patients attending Sukraraj Tropical and Infectious Disease Hospital with COVID-19 were enrolled and divided into severe and non-severe groups. The demographic data, underlying co-morbidities, and laboratory findings were analyzed and compared between severe and non-severe cases. The correlation between the disease criticality and laboratory parameters was analyzed. Cut-off values of parameters for severe patients were speculated through the receiver operating characteristics (ROC) curve, and regression analysis was performed to determine the risk factors. Patients with severe COVID-19 infection had significantly higher absolute neutrophil count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), ferritin, positive carbohydrate reactive protein (CRP), glucose, urea, creatinine, and aspartate aminotransferase, while lower absolute lymphocyte count, absolute eosinophil count (AEC), and red blood cell count in comparison to non-severe infection. ROC analysis gave a cut-off value (sensitivity, specificity) of age, AEC, NLR, PLR, and ferritin as 47.5 years (70.2, 64.7%), 335 cells/mm(3) (74, 67%) 3.3 (68.4, 63.7%), 129 (77.2, 51%), and 241 ng/mL (74.0%, 65.0%) respectively. Risk factor analysis showed higher age, low AEC, high ferritin, and positive CRP as independent risk factors associated with severe COVID-19 infection. Hematological and inflammatory markers, including novel NLR and PLR, should be assessed to aid clinicians in the early identification of severe cases, prioritization of cases, and effective management to decrease the mortality of COVID-19 patients.

12.
Embase; 26.
Preprint in English | EMBASE | ID: ppcovidwho-346543

ABSTRACT

While significant attention has been paid to the immunologic determinants of disease states associated with COVID-191,2, their contributions to post-acute sequelae of COVID-19 (PASC) remain less clear3-5. Due to the wide array of PASC presentations6, it is critical to understand if specific features of the disease are associated with discrete immune processes, and whether those processes may be therapeutically targeted. To this end, we performed wide immunologic and serological characterization of patients in the early recovery phase of COVID-19 across a breadth of symptomatic presentations. Using high-parameter proteomics screening and applied machine learning (ML), we identify clear signatures of immunologic activity between PASC patients and uncomplicated recovery, dominated by inflammatory cytokine signaling, neutrophil activity, and markers of cell death. Consistent with disease complexity, heterogeneity in plasma profiling reveals distinct PASC subsets with striking divergence in these ongoing inflammatory processes, here termed plasma quiescent (plaq) and inflammatory (infl) PASC. In addition to elevated inflammatory blood proteomics, inflPASC patients display positive clinical tests of acute inflammation including C-reactive protein and fibrinogen, increased B cell activity with extrafollicular involvement coupled with elevated targeting of viral nucleocapsid protein and clinical autoreactivity. Further, the unique plasma signatures of PASC patients allowed for the creation of refined models with high sensitivity and specificity for the positive identification of inflPASC with a streamlined assessment of 12 blood markers. Additionally, refined ML modeling highlights the unexpected significance of several markers of potential diagnostic or therapeutic use for PASC in general, including the peptide hormone, epiregulin. In all, this work identifies clear biological signatures of PASC with potential diagnostic and therapeutic potential and establishes clear disease subtypes that are both easily identifiable and highly relevant to ongoing efforts in both therapeutic targeting and epidemiological investigation of this highly complex disease. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.

13.
Cureus ; 14(10): e30304, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2080880

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has been associated with significant morbidity and mortality. Following the introduction of vaccines, various side effects have been reported. Whilst those reported may be attributed to the vaccine itself, at times, it may simply incite an immunological phenomenon. We present a case series of two patients who presented with symptoms of yellowing of the eyes and the skin along with fatigue, and tiredness, following vaccination for COVID-19. The diagnosis of post COVID-19-vaccination related hepatitis is one of the fewer, less understood, yet reported side effects associated with significant morbidity. The diagnosis of COVID-19 vaccination-related cholangitis is an outcome reported here for the first time to the best of our knowledge. It was alarming that both patients did not have any significant past history of medical ailments. A prompt assessment followed by investigations including liver biopsy assisted in a timely understanding of the phenomenon with complete resolution of the symptoms.

14.
HIV Nursing ; 22(2):631-633, 2022.
Article in English | Scopus | ID: covidwho-2081494

ABSTRACT

Background: The coronavirus associated with severe acute respiratory syndrome type 2 causes Coronavirus disease 2019 (COVID-19) (SARS-CoV-2). Xanthine is a purine nucleotide that is found in the majority of human tissues and fluids, as well as other biota. Hypoxanthine is a purine derivative that occurs naturally. C-reactive protein (CRP) is an annular (ring-shaped) pentameric protein that is detected in blood plasma and whose circulating levels increase in response to inflammation. The aim of the current study is evaluation of serum (Xanthine, Hypoxanthine, and C-RP) patients of COVID-19 (vaccinated and unvaccinated) with P-fizer vaccine.Methods: The study was done in Babylon University/College of Science. Study continued five months from 3-1 to 3-5 - 2022.. 150 samples of blood were obtained from three groups.50 blood samples were obtained from healthy people (group I), 50 blood samples were drawn from COVID-19 patients unvaccinated (group II), and 50 samples were obtained from COVID-19 patients vaccinated with P-fizer (group III). The target parameters were (Xanthine, Hypoxanthine, and C-RP). (Xanthine and Hypoxanthine) were measured by HPLC instruments. C-RP was measured by the ichroma instrument.Results: The result showed age was shown to be not significant between groups. Xanthine showed a significant increase in the non-vaccinated group of patients compared to the rest of the groups, where it was 2.16 ± 0.02, While in the vaccinated group, it was 0.68 ± 0.01. Hypoxanthine also showed a significant increase in unvaccinated patients. CRP showed a significant increase in unvaccinated patients.Conclusion: The current study concluded that the Pfizer vaccine had an effect on (Xanthine, Hypoxanthine,C-reactive protein (CRP)) concentrations for the better in the vaccinated group of patients. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.

16.
Health Sci Rep ; 5(6): e868, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2068568

ABSTRACT

Introduction: C-reactive protein (CRP) and cytokines levels could alter in patients with coronavirus disease (COVID-19) due to the inflammatory response caused by the virus. This analysis aimed to assess the relationship between the CRP levels and the levels of various cytokines in COVID-19 patients. Materials and Methods: We searched the databases of PubMed, Cochrane, and Web of Science for relevant articles on May 29th, 2021. Applying the inclusion/exclusion criteria, the retrieved records underwent two-phase screenings; first, a title/abstract screening process, and then, a full-text screening to find the eligible studies. Data for study variables were extracted, including the CRP levels and the levels of all reported cytokines. A strong and significant relationship between Interleukins and CRP was defined as: p ≤ 0.05, 0.7 ≤ r ≤ 1. Results: In this study, 103 studies were included for systematic review and correlation analysis. The aggregate mean and SD of study variables were calculated and reported. The correlation between Interleukins and CRP was measured using correlation coefficient (r). It appeared that interleukin (IL)-10 has a moderate and significant relationship with CRP (p ≤ 0.05, r = 0.472). IL-10 predicted almost 10% of CRP changes. Conclusion: This correlation analysis suggests IL-10 is moderately correlated with CRP levels in patients with COVID-19 infection. A better understanding of the pro-inflammatory markers could contribute to the implementation of therapeutic and preventive approaches. More prospective studies are suggested to explore the relationship between CRP and cytokines as potential markers for the early identification of COVID-19 progression and severity.

17.
Pakistan Journal of Medical and Health Sciences ; 16(7):668-671, 2022.
Article in English | EMBASE | ID: covidwho-2067744

ABSTRACT

The review is devoted to investigate cardiovascular biomarkers in patients with SARS-CoV-2 associated with a high risk of complications and death. The article provides information on the main cardiovascular biomarkers and pro-inflammatory cytokines in relations to the processes of decompensation in patients with chronic heart failure complicated by ARVI, including the SARS-CoV-2.

18.
Pulmonologiya ; 32(2):151-161, 2022.
Article in Russian | EMBASE | ID: covidwho-2067423

ABSTRACT

Bronchial asthma occurs in 0.9 - 17% of patients hospitalized with COVID-19. However, it is not clear whether asthma is a risk factor for the development and severity of COVID-19. Studies have shown that patients with asthma appear to be more susceptible to COVID-19 infection, but severe disease progression is not related to medication use, including asthma biologics, but rather to older age and comorbidities. Aim. To evaluate the clinical course of SARS-CoV-2 infection in elderly patients with asthma, to examine the effect of asthma and comorbidities on COVID-19-related outcomes, and to determine predictors of mortality. Methods. Elderly patients [WHO, 2020] (> 60 years, n = 131, median age 74 (67;80) years;59 men, 72 women) with asthma hospitalized for COVID-19 were included in the study. COVID-19 was confirmed by laboratory tests (PCR smear) and/or clinical and radiological examinations. All patients had a history of a documented diagnosis of asthma (GINA, 2020). Results. Out of 131 patients, 30 (22.9%) died in the hospital, and 15 (14.9%) died after discharge from the hospital (within 90 days). The group of patients with lethal outcome showed the following differences from those who recovered: values of Charlson index, respiration rate, degree of lung damage on CT scan, absolute number of leukocytes, neutrophils and neutrophils-to-lymphocytes ratio, C-reactive protein on the 5th day of hospitalization, and LDH were statistically significantly higher, while absolute number of eosinophils, total protein content, SpO2 and SpO2/FiO2 levels were lower;steroid intake during the year and non-atopic asthma were more common. Multivariate and ROC analysis revealed the most significant predictors of hospital mortality and their thresholds: Charlson comorbidity index ≥ 6 points, neutrophil/lymphocyte ratio ≥ 4.5, total protein ≤ 60 g/l, eosinophil level ≤ 100 cells/μL. Conclusion. The most significant predictors of hospital mortality in elderly patients with severe COVID-19 against asthma are Charlson comorbidity, neutrophil/lymphocyte ratio;lower eosinophil and total protein levels. Survival time of patients has an inverse correlation with the number of mortality risk factors present.

19.
Journal of Clinical and Diagnostic Research ; 16(9):FC15-FC19, 2022.
Article in English | EMBASE | ID: covidwho-2067197

ABSTRACT

Introduction: Long-term repercussions of Coronavirus Disease-2019 (COVID-19) on antimicrobial resistance have been raised as a grave concern due to the rampant use of antibiotics in the management of COVID-19. As per meta-analysis, the prevalence of antibiotic prescribing was 74.6% which was significantly higher than the estimated prevalence of bacterial co-infection. World Health Organisation (WHO) recommended that antibiotic therapy should not be used in patients with mild/moderate COVID-19 unless there is any bacterial suspicion. Also, the guidelines laid down by the Ministry of Health and Family Welfare, Government of India, does not recommend systematic empiric antibiotic therapy in patients hospitalised with COVID-19. Despite not being recommended, antimicrobials are still given in clinical practice. Aim(s): To analyse prescriptions for antimicrobials and to identify potential predictors for antibiotic prescription. Material(s) and Method(s): A retrospective observational study was conducted at a tertiary care teaching institute. Data (demographic profile, co-morbidities, disease category, prescribed antimicrobials, laboratory investigations, and duration of hospital stay) were collected from case files of patients with laboratory-confirmed Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection. These patients were admitted in the institute from January 2021 to May 2021. Logistic regression was used to analyse factors associated with the empirical use of antimicrobial agents. Result(s): A total of 184 case files were analysed. The mean age of patients was 55.84+/-15.72 years, with a male preponderance (70.10%). Among antimicrobials, antivirals were prescribed in 159 (86.41%) patients, and antibiotics in 152 patients (82.6%). Antivirals prescribed include Remdesivir [109(68.55%)] and Favipiravir [70(44.02%)]. Ceftriaxone was found to be the highest prescribed antibiotic, with a median duration of administration of six days. An association was found between disease severity and CRP level with antibiotic prescription. On multivariable analysis, the odds of receiving antibiotics were 6.7 times higher in patients with severe disease. Conclusion(s): More than 80% of COVID-19 patients received antibiotics. Duration of hospital stay was similar among patients whether they received antibiotics or not. Disease severity and raised CRP level were strong predictors for prescribing antibiotics for COVID-19. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

20.
Haseki Tip Bulteni ; 60(4):345-350, 2022.
Article in English | EMBASE | ID: covidwho-2066933

ABSTRACT

Aim: Coronavirus disease-2019 (COVID-19) is more severe in hemodialysis patients than in the average population and causes much higher mortality. This study investigated the effect of inflammation parameters obtained from complete blood count on the prognosis of COVID-19 in hemodialysis patients with COVID-19. Method(s): Hemodialysis patients admitted to our hospital between 11.03.2020 and 01.12.2020 with the diagnosis of COVID-19 were included in this study. The relationship between the oxygen requirement, intensive care requirements, and mortality development of the patients and the parameters obtained from the complete blood count, C-reactive protein (CRP), secondary infection, and demographic characteristics of the patients were investigated. Result(s): A total of 94 hemodialysis patients were included in the study. There was a correlation between secondary infections and the need for oxygen and intensive care (p=0.001 and p<0.001, respectively). CRP levels were associated with mortality, need for intensive care and oxygen demand (p=0.031, p=0.019 and p=0.014, respectively). Systemic inflammation index, derived neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio were associated with oxygen demand (p=0.002, p=0.009 and p=0.044, respectively). The systemic inflammation index, platelet-lymphocyte ratio, and derived neutrophil-lymphocyte ratio exhibited the highest specificity (19.4% vs 26.9% vs 16.4%) and sensitivity (96.7% vs 92.6% vs 96.7%) and the largest areas under the curve of 0.672 vs 0.652 vs 0.666, respectively. Conclusion(s): Systemic inflammation index, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio obtained from complete blood count parameters in hemodialysis patients are functional parameters that can be used to predict the course of COVID-19. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.

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