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1.
Professional Medical Journal ; 29(12):1755-1759, 2022.
Article in English | Academic Search Complete | ID: covidwho-2164610

ABSTRACT

Objective: To assess whether hematological and inflammatory parameters can be useful in assessing severity of disease and predict mortality in patients with COVID-19. Study Design: Cross Sectional Comparative Retrospective. Setting: COVID ward and ICU, Central Park Teaching Hospital Lahore. Period: 23rd April 2021 to 23rd June 2021. Material & Methods: The study population was selected by convenient sampling and all patients admitted to the COVID ward and ICU during this time span of two months with positive COVID PCR were included in the study. Results: Among the study population 29(58%) were males while 21(42%) were females with male to female ratio of 1.38:1 and the difference was not found to be statistically significant. The mean age of the patients was 65.2±08 years. The complete blood parameterswhite blood count, absolute neutrophil count, lymphocyte count and neutrophil lymphocyte ratio were compared between groups and it was found that white blood count, absolute neutrophil count and neutrophil lymphocyte ratio was significantly different between different groups. Inflammatory markers like IL-6, ferritin, C-reative protein and d-dimers were also assessed in different severity groups and all were found to be significantly high in severe/critical group. Conclusion: It is concluded that simple inexpensive parameters like white blood count, neutrophil lymphocyte ratio and neutrophil count can be used to evaluate the severity of disease and to predict those patients who are at increased risk of mortality. In the similar way inflammatory markers like C-reactive protein, D-dimers, IL-6 and ferritin can be used to group the disease severity and also to monitor the disease. [ FROM AUTHOR]

2.
Pakistan Journal of Medical Sciences ; 39(1), 2023.
Article in English | EMBASE | ID: covidwho-2145277

ABSTRACT

Objectives: To identify the factors that affect outcome in COVID-19 patients in the Pakistani population. Method(s): A total of 225 patients of COVID-19 RT-PCR proven were included during November, 2020 to June, 2021 in this cross-sectional study. They were stratified into different disease severity categories as per WHO guidelines. The characteristics of survivors and non survivors were recorded and then compared to draw conclusions. Result(s): Mean age was 59 years. Majority of the patients were male (68%) and the overall mortality rate was 30.1%. The non survivors were more likely to be female, had a greater number of comorbidities, had a higher respiratory rate and lower oxygen saturations at presentation and had a greater frequency of invasive mechanical ventilation. Non survivors had higher values of TLC, CRP, D-dimers and lower values of Hemoglobin and Platelets. The non survivors had higher incidence of ARDS, Septic shock and Multiorgan involvement. A higher CURB-65 score was observed in non survivors as compared to those who survived. Multivariate analysis showed that female gender, presence of and higher number of comorbid conditions and a higher CURB-65 score was linked with mortality. Conclusion(s): Results are compatible with international studies;increasing age, number of comorbid conditions and high inflammatory markers are associated with increased mortality. Our study had an exception that female gender had higher mortality as compared to men. Copyright © 2023, Professional Medical Publications. All rights reserved.

3.
J Clin Med ; 11(22)2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2116152

ABSTRACT

Growing research data suggests that the severity of COVID-19 is linked with higher levels of inflammatory mediators, such as cytokines, chemokines, tumor necrosis factor, C-reactive protein, ferritin, and D-dimers. In addition, it was evident from the existing research data that the severity of SARS-CoV-2 infection differs according to independent risk factors such as race and ethnicity. Some scarce evidence shows that the European Roma community is likely to be at an elevated risk of illness and death during the pandemic due to their lifestyle, social factors, and economics. Assuming that precautions must be taken to protect this population from coronavirus infections and from widening existing disparities in comparison with the Romanian ethnic population, the current study aimed to observe the clinical evolution of the Roma patients with severe SARS-CoV-2 infection in correlation with the laboratory findings and inflammatory markers involved. After calculating the sample size requirements, we included 83 Roma patients admitted to the hospital with severe COVID-19 and 236 patients of Romanian ethnicity with the same inclusion criteria. Patients were selected from the period stretching from March 2020 to December 2021, before COVID-19 vaccines were introduced. Compared with the general population, the Roma patients with severe SARS-CoV-2 infection had a higher unemployment rate (39.8%), and most of them were residing in rural regions (65.4%). There were significantly more overweight patients in the Roma group than in the control group (57.8% vs. 40.7%), and it was also observed that high blood pressure and diabetes mellitus were significantly more prevalent in the Roma patients. They had significantly longer mean duration of hospitalization was significantly longer in the group of Roma patients (18.1 days vs. 16.3 days). IL-6 and CRP levels were significantly more elevated during admission in the group of Roma patients (43.4% vs. 28.4%); however, IL-6 levels normalized at discharge, but ESR remained high. Although ICU admissions were significantly more frequent in this group, the mortality rate was not significantly higher than in the general population. It is necessary to plan different healthcare strategies aimed at special populations, such as the Roma ethnicity to prevent disparities in negative outcomes reflected in this study. The results imply that community-health collaborations between organizations of minority groups and healthcare professionals can mitigate the disproportionate consequences of the pandemic on Roma.

4.
Cancer Med ; 2022 Nov 13.
Article in English | MEDLINE | ID: covidwho-2112984

ABSTRACT

Neutrophil-to-lymphocyte ratio (NLR) has been studied as a prognostic factor for mortality in COVID-19 patients. Our study aimed to evaluate the association between NLR at COVID-19 diagnosis and survival during the following 90 days in hospitalized patients with solid cancer. Between May 2020 and June 2021, 120 patients were included in a retrospective cohort study. Univariable analysis showed patients with an NLR > 8.3 were associated with an increased risk of death (HR: 4.34; 95% CI: 1.74-10.84) compared to patients with NLR < 3.82 and with NLR ≥3.82 and ≤8.30 (HR: 2.89; 95% CI: 1.32-6.36). Furthermore, on multivariable analysis, NLR > 8.30 independently correlated with increased mortality. In patients with solid malignancies with COVID-19, an NLR > 8.3 is associated with an increased risk of death.

5.
Cureus ; 14(8): e28255, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2121595

ABSTRACT

Introduction Zonulin is a protein that plays a role in the reversible regulation of epithelial permeability. As zonulin is released in large amounts into the intestinal lumen, it disrupts the integrity of the tight junctions and causes continuous migration of antigens to the submucosa. Consequently, it can trigger inflammatory processes and severe immune reactions. In severe cases, SARS-CoV-2 may have a major impact on the clinical manifestations of the disease by directly or indirectly affecting intestinal cells and triggering systemic inflammation. Therefore, our study aimed to investigate the role of one of the possible mediators, zonulin, in the severity of the COVID-19 infection. Methods  Thirty COVID-19 patients and 35 healthy controls were included in the study. Blood samples were taken from the patients on the 1st, 4th, and 8th days of hospitalization. Serum zonulin levels were determined by enzyme-linked immunosorbent assay (ELISA). Complete blood count (white blood cell [WBC], neutrophil, lymphocyte, and platelet), biochemical parameters (serum lactic acid dehydrogenase [LDH], erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], D-dimer, ferritin, fibrinogen levels) were determined and chronic systemic disease states of the patients were assessed. Results  Serum zonulin levels were notably higher in the healthy control group compared to the patient group (p=0.003). Although there was an increase in the zonulin values by time in hospitalization, this rising was not significant. Conversely, ESR and CRP levels were significantly higher in the patient group (p<0.001). There was no significant difference between the two groups regarding gender, age, and WBC counts. Conclusion  The serum zonulin levels of COVID-19 patients with the mild clinical course were lower than the healthy control group. Moreover, serum zonulin levels were not correlated with ESR, CRP, and other inflammation markers. Our results suggest that low serum zonulin levels in COVID-19 patients might represent a mild disease course.

6.
Dubai Medical Journal ; : 1-6, 2022.
Article in English | Web of Science | ID: covidwho-2108424

ABSTRACT

Background: It is well known that COVID-19 infection affects multiple systems in the body. Reports have documented many changes in the hematopoietic system in the pathophysiology of the disease, and many haematological markers like lymphopenia and high d dimer have been linked to worse outcomes after COVID-19 infection in adult patients. Aim: The aim of the study was to find out the prevalence and any significant difference in routine haematological parameters on presentation in paediatric and adult patients with COVID-19 infection. Methodology: We conducted a multicentre retrospective descriptive observational study and investigated the prevalence of haematological abnormalities at the presentation of 1,000 PCR swab-confirmed COVID-19-infected randomly selected adult and paediatric patients admitted to 3 tertiary hospitals in Dubai from 15 March-30 May 2020. Data were gathered through their electronic medical records, and all analysis was done using the Statistical Package for the Social Sciences software (SPSS). Results: The prevalence of at least one abnormal haematological parameter was 95.1% (794/835) on the first presentation to the hospital. After adjusting of age and gender, the prevalence of any white cell abnormality was 34.7% (290/835) (5.7% leukopenia, 9.6% leucocytosis, 25.4% lymphopenia, 5.5% neutropenia, 16.4% neutrophilia, 7.3% monocytosis, and 1.2% eosinopenia). A prevalence of 15.3% (128/835) anaemia, 9.5% (79/835) thrombocytopenia, and 4.3% (36/835) thrombocytosis was also observed. The prevalence of other abnormal blood parameters was C-reactive protein 69.5% (573/835), D dimer 57.5% (280/835), high lactate dehydrogenase 52% (383/835), high ferritin 72.1% (452/835), high international normalized ratio 5.1% (38/835), prolonged prothrombin time 32.2% (240/835), and prolonged activated partial thromboplastin time 35.6% (264/835). A significant difference in the prevalence of these abnormalities was evident between adult and paediatric populations, and these abnormalities were much more prevalent in adults but interestingly paediatric population tended to have a higher incidence of neutropenia, eosinophilia, and monocytosis (p < 0.001). Conclusion: COVID-19 infection tends to be milder and has better outcomes in the paediatric population. The immune system responds differently to the infection in these populations. The response is exaggerated in adults reflected by the increased prevalence of haematological abnormalities like raised inflammatory markers and other white cell abnormalities and has been linked with increased severity of infection and mortality.

7.
Viruses ; 14(11)2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2081920

ABSTRACT

Patients with Coronavirus disease 2019 (COVID-19) are at increased risk of venous thromboembolism (VTE); however, data on arterial thromboembolism (ATE) is still limited. We report a case series of thromboembolic events (TE) in 290 COVID-19 patients admitted between October and December 2020 to a Portuguese hospital. Admission levels of various laboratory parameters were evaluated and compared between COVID-19 patients with (TE) and without thrombotic events (non-TE). The overall incidence of isolated ATE was 5.52%, isolated VTE was 2.41% and multiple mixed events was 0.7%. A total of 68% events were detected upon admission to the hospital with 76% corresponding to ATE. Admissions to the Intensive Care Unit were higher in patients with TE, when comparing with the non-TE group (44% vs. 27.2%; p = 0.003). Patients with ATE presented significantly lower levels of CRP (p = 0.007), ferritin (p = 0.045), LDH (p = 0.037), fibrinogen (p = 0.010) and higher monocyte counts (p = 0.033) comparatively to the non-TE patients. These results point to an early occurrence of TE and an increased incidence of ATE over VTE. The less prominent inflammation markers in patients with TE and the early presence of TE in patients with otherwise no reason for hospitalization, may suggest a direct role of SARS-CoV-2 in the thrombotic process.


Subject(s)
COVID-19 , Hemostatics , Thrombosis , Venous Thromboembolism , Humans , COVID-19/diagnosis , Venous Thromboembolism/epidemiology , Venous Thromboembolism/etiology , SARS-CoV-2 , Retrospective Studies , Thrombosis/epidemiology , Hospitalization , Biomarkers , Hospitals
8.
Front Immunol ; 13: 1016181, 2022.
Article in English | MEDLINE | ID: covidwho-2080157

ABSTRACT

Introduction: Sore throat is a common reason for overuse of antibiotics. The value of inflammatory or biomarkers in throat swab or saliva samples in predicting benefit from antibiotics is unknown. Methods: We used the 'person-based approach' to develop an online tool to support self-swabbing and recruited adults and children with sore throats through participating general practices and social media. Participants took bacterial and viral swabs and a saliva sponge swab and passive drool sample. Bacterial swabs were cultured for streptococcus (Group A, B, C, F and G). The viral swab and saliva samples were tested using a routine respiratory panel PCR and Covid-19 PCR testing. We used remaining viral swab and saliva sample volume for biomarker analysis using a panel of 13 biomarkers. Results: We recruited 11 asymptomatic participants and 45 symptomatic participants. From 45 symptomatic participants, bacterial throat swab, viral throat swab, saliva sponge and saliva drool samples were returned by 41/45 (91.1%), 43/45 (95.6%), 43/45 (95.6%) and 43/45 (95.6%) participants respectively. Three saliva sponge and 6 saliva drool samples were of insufficient quantity. Two adult participants had positive bacterial swabs. Six participants had a virus detected from at least one sample (swab or saliva). All of the biomarkers assessed were detectable from all samples where there was sufficient volume for testing. For most biomarkers we found higher concentrations in the saliva samples. Due to low numbers, we were not able to compare biomarker concentrations in those who did and did not have a bacterial pathogen detected. We found no evidence of a difference between biomarker concentrations between the symptomatic and asymptomatic participants but the distributions were wide. Conclusions: We have demonstrated that it is feasible for patients with sore throat to self-swab and provide saliva samples for pathogen and biomarker analysis. Typical bacterial and viral pathogens were detected but at low prevalence rates. Further work is needed to determine if measuring biomarkers using oropharyngeal samples can help to differentiate between viral and bacterial pathogens in patients classified as medium or high risk using clinical scores, in order to better guide antibiotic prescribing and reduce inappropriate prescriptions.


Subject(s)
COVID-19 , Pharyngitis , Child , Adult , Humans , Feasibility Studies , Pharyngitis/diagnosis , Streptococcus pyogenes , Anti-Bacterial Agents/therapeutic use , Biomarkers
10.
Multisistemik &Iacute ; nflmatuar Sendrom (MIS-C) Nedeniyle Takip Edilen Çocuk Hastaların Hematolojik ve &Iacute;nflamatuar Parametrelerin Değerlendirilmesi.; 32(4):415-424, 2022.
Article in English | Academic Search Complete | ID: covidwho-2057228

ABSTRACT

Objective: Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised lifethreatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment. Material and Methods: In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups;mild, moderate, and severe. Results: Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), d-dimer, ferritin, interleukin 6 (IL- 6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatm ent period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the posttreatment group. Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group. Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predicting the prognosis and early initiation of the appropriate treatment. (English) [ FROM AUTHOR] Amaç: Çocuklarda multisistem inflamatuar sendrom (MIS-C), coronavirus disease 2019 (COVID-19)'un yeni tanımlanan yaşamı tehdit eden bir komplikasyonudur. Hastalığın klinik şiddetinin erken tespiti, tedavi rejimlerine erken karar verilmesinde önemlidir. Bu çalışmanın amacı, MIS-C'li hastalarda hematolojik parametrelerin, inflamatuar belirteçlerin ve biyokimyasal testlerin hastalığın cidiyetine göre, akut dönemde ve anti-inflamatuar tedavi sonrasındaki değerlerini araştırmaktır. Gereç ve Yöntem: Retrospektif vaka kontrollü çalışmaya MIS-C tanısı alan 64 çocuk ve yaş ve cinsiyet uyumlu 95 sağlıklı çocuk dahil edildi. Hastalar klinik bulgulara göre;hafif, orta ve şiddetli olarak üç gruba ayrıldı. Bulgular: Ciddi MIS-C kliniğinde olan hastalarda hastaneye başvuruda ortalama trombosit hacmi (MPV), MPV/lenfosit oranı (MPVLR), d-dimer, ferritin, interlökin 6 (IL-6) seviyeleri anlamlı olarak daha yüksekken, albumin düzeyleri daha düşüktü. Klinik şiddeti orta olan hastalarda hafif olan hastalara göre;nötrofil-lenfosit oranı (NLR) ve derived NLR (d-NLR) seviyeleri anlamlı olarak daha yüksek saptandı. MIS-C hastalarında tedavi öncesinde tedavi sonrasına göre MPV, trombosit dağılım genişliği (PDW) değerleri daha yüksekken;beyaz küre sayısı, lenfosit, monosit, hemoglobin, ortalama korpüsküler hacim (MCV), kırmızı hücre dağılım genişliği (RDW), plateletcrit ve trombosit değerleri daha düşüktü. Kontrol grubunda, tedavi öncesi gruba göre lenfosit, trombosit ve hemoglobin düzeyleri anlamlı derecede yüksekti. Akut faz reaktanları, NLR, nötrofil monosit oranı, platelet lenfosit oranı, d-NLR, MPVLR ve sistemik inflamatuar indeks, kontrol grubuna kıyasla tüm MIS-C hastalarında başvuru sırasında anlamlı derecede yüksekti. Sonuç: Spesifik rutin laboratuvar test sonuçları, MIS-C'nin hastalık şiddetini belirlemede, prognozu öngörmede ve uygun tedavinin erken başlatılmasında yararlı olabilir. (Turkish) [ FROM AUTHOR] Copyright of Genel Tip Dergisi is the property of Genel Tip Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

11.
Journal of Research in Medical and Dental Science ; 10(7):107-110, 2022.
Article in English | Web of Science | ID: covidwho-2040837

ABSTRACT

Background: It is well known that COVID 19 infection affects multiple systems in the body. Reports have documented many changes in the hematopoietic system in the pathophysiology of the disease. Aim: The aim of the study was to find out the prevalence and any significant difference in routine haematological parameters on presentation in Paediatric and adult patients with COVID 19 infection. Methodology: We conducted a multicenter retrospective descriptive observational study and investigated the prevalence of haematological abnormalities at presentation of 1000 PCR swab confirmed COVID 19 infected randomly selected adult and Paediatric patients admitted to 3 tertiary hospital in Dubai. Data was gathered through their electronic medical records and all analysis was done using the Statistical Package for the Social Sciences software (SPSS). Results: The prevalence of at least one abnormal haematological parameter was 95.1% (794/835) on first presentation to the hospital. After adjusting of age and gender the prevalence of any white cell abnormality was 34.7% (290/835) (5.7% leukopenia, 9.6% leucocytosis, 25.4% lymphopenia, 5.5% neutropenia, 16.4% had neutrophilia, 7.3% monocytosis, and 1.2% eosinopenia). A prevalence of 15.3% (128/835) anaemia, 9.5% (79/835) thrombocytopenia and 4.3% (36/ 835) thrombocytosis was also observed. The prevalence of other abnormal blood parameters: C reactive protein 69.5%(573/835), D dimer 57.5% (280/835), high LDH 52%(383/835), high ferritin 72.1%(452/835), high INR 5.1%(38/835), prolonged PT 32.2% (240/835), and prolonged APTT 35.6%(264/835). A significant difference in prevalence of these abnormalities was evident between adult and Paediatric population, these abnormalities were much more prevalent in adults but interestingly paediatric population tended to have higher incidence of neutropenia, eosinophilia and monocytosis (p<0.001). Conclusion: The effects of COVID 19 infection are different in adult and paediatric patients. Many mechanisms have been hypothesized for this observation. This study revealed another less studied and interesting variation in the manifestation among the two populations.

12.
Clin Immunol ; 242: 109091, 2022 09.
Article in English | MEDLINE | ID: covidwho-2035866

ABSTRACT

BACKGROUND: The soluble urokinase Plasminogen Activator Receptor (suPAR) has been identified as a reliable marker of COVID-19 severity, helping in personalizing COVID-19 therapy. This study aims to evaluate the correlation between suPAR levels and COVID-19 severity, in relation to the traditional inflammatory markers. METHODS: Sera from 71 COVID-19 patients were tested for suPAR levels using Chorus suPAR assay (Diesse Diagnostica Senese SpA, Italy). suPAR levels were compared with other inflammatory markers: IL-1ß, IL-6, TNF-α, circulating calprotectin, neutrophil and lymphocyte counts, and Neutrophil/Lymphocytes Ratio (NLR). Respiratory failure, expressed as P/F ratio, and mortality rate were used as indicators of disease severity. RESULTS: A positive correlation of suPAR levels with IL-6 (r = 0.479, p = 0.000), TNF-α (r = 0.348, p = 0.003), circulating calprotectin (r = 0.369, p = 0.002), neutrophil counts (r = 0.447, p = 0.001), NLR (r = 0.492, p = 0.001) has been shown. Stratifying COVID-19 population by suPAR concentration above and below 6 ng/mL, we observed higher levels of circulating calprotectin (10.1 µg/mL, SD 7.9 versus 6.4 µg/mL, SD 7.5, p < 0.001), higher levels of P/F ratio (207.5 IQR 188.3 vs 312.0 IQR 127.8, p = 0.013) and higher mortality rate. Median levels of suPAR were increased in all COVID-19 patients requiring additional respiratory support (Nasal Cannula, Venturi Mask, BPAP and CPAP) (6.5 IQR = 4.9) compared to the group at room air (4.6 IQR = 4.2). CONCLUSION: suPAR levels correlate with disease severity and survival rate of COVID-19 patients, representing a promising prognostic biomarker for the risk assessment of the disease.


Subject(s)
COVID-19 , Receptors, Urokinase Plasminogen Activator , Biomarkers , Humans , Interleukin-6 , Leukocyte L1 Antigen Complex , Prognosis , Receptors, Urokinase Plasminogen Activator/metabolism , Tumor Necrosis Factor-alpha
13.
Journal of Research in Clinical Medicine ; 10, 2022.
Article in English | Scopus | ID: covidwho-2026627

ABSTRACT

Introduction: Different laboratory parameters get altered in coronavirus disease 2019 (COVID-19);therefore, the changes of these parameters could help recognize the patients with severe disease. This study was conducted to achieve a comprehensive biochemical and inflammatory profile of COVID-19 among the Indian population. Methods: The study consisted of 730 patients admitted to Jaya Arogya Hospital, Gwalior, with COVID-19 from August 2020 to December 2020. The patients were divided into mild disease group (MDG) (n=533) and severe disease group (SDG) (n=197) depending on certain criteria, and their biochemical and inflammatory markers were collected. Data were analyzed using SPSS version 25. Results: Statistically significant rise in blood urea (P=0.011), serum creatinine (P=0.008), serum bilirubin (P=0.012), interleukin 6 (IL-6) (P<0.001), and troponin I (P<0.001) was observed in SDG as compared to MDG. Serum electrolytes (sodium and potassium) and serum protein (total protein and albumin) showed a significant fall in SDG as compared to MDG (P<0.001 for electrolytes and P=0.023 for proteins). The area under the receiver operating characteristic curve (AUROC) showed a high diagnostic value of IL-6. Conclusion: Patients with severe COVID-19 showed a high prevalence of hyperbilirubinemia, hypoproteinemia, electrolyte imbalance, and raised inflammatory markers (IL-6, troponin I, and procalcitonin). Results showed their effectiveness in assessing disease severity and predicting outcomes in patients with COVID-19. © 2022 The Author(s).

14.
J Clin Med ; 11(17)2022 Aug 31.
Article in English | MEDLINE | ID: covidwho-2006093

ABSTRACT

Several investigations have revealed that COVID-19 causes a significant death rate due to acute respiratory distress syndrome, alterations in the quantity of ACE2 receptor expression, or the intensity of cytokine storm. Similarly, patients with hepatic impairment that are co-infected with SARS-CoV-2 are more likely to display upregulations of ACE2 receptors and cytokine storm overload, which exacerbates hepatic impairment, potentially increasing the death rate. Moreover, it is expected that the aging population develops a higher degree of hepatic fibrosis in association with other comorbid conditions that are likely to influence the course of COVID-19. Therefore, this research was developed to describe the differences in liver test parameters in elderly individuals with COVID-19 in relation to other inflammatory markers and outcomes. This current observational single-center research followed a case-control design of elderly patients hospitalized for SARS-CoV-2 infection. The research was conducted at a tertiary emergency hospital in western Romania during a two-year period. There were 632 patients included in the analysis that were split into two equal groups matched 1:1 based on gender and body mass index. Three hundred sixteen patients made the group of cases with COVID-19 patients older than 65 years, while the other half were the 316 patient controls with COVID-19 that were younger than 65 years old. Disease outcomes showed a higher prevalence of ICU admissions (22.8% vs. 12.7%, p-value < 0.001) and in-hospital mortality (17.1% vs. 8.9%, p-value = 0.002) in the group of cases. Specific and non-specific liver biomarkers were identified as risk factors for mortality in the elderly, such as ALP (OR = 1.26), LDH (OR = 1.68), AST (OR = 1.98), and ALT (OR = 2.34). Similarly, patients with APRI and NFS scores higher than 1.5 were, respectively, 2.69 times and, 3.05 times more likely to die from COVID-19, and patients with FIB-4 scores higher than 3.25 were 3.13 times more likely to die during hospitalization for SARS-CoV-2 infection. Our research indicates that abnormally increased liver biomarkers and high liver fibrosis scores are related to a worse prognosis in SARS-CoV-2 infected individuals.

15.
J Crit Care Med (Targu Mures) ; 8(3): 156-164, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2005827

ABSTRACT

Aim: The aim of this study was to evaluate whether systemic immune-inflammation index (SII) could predict mortality in patients with novel coronavirus 2019 (COVID-19) disease. Methods: This two-center, retrospective study included a total of 191 patients with confirmed diagnosis of COVID-19 via nucleic acid test (NAT). The SII was calculated based on the complete blood parameters (neutrophil × platelet/lymphocyte) during hospitalization. The relationship between the SII and other inflammatory markers and mortality was investigated. Results: The mortality rate was 18.3%. The mean age was 54.32±17.95 years. The most common symptoms were fever (70.7%) and dry cough (61.3%), while 8 patients (4.2%) were asymptomatic. The most common comorbidities were hypertension (37.7%), diabetes (23.0%), chronic renal failure (14.7%), and heart failure (7.9%) which all significantly increased the mortality rate (p<0.001). There was a highly positive correlation between the SII and polymorphonuclear leukocyte (PNL), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) (r=0.754, p<0.001; r=0.812, p<0.001; r=0.841, p<0.001, respectively), while a moderate, positive correlation was found between the SII and C-reactive protein (CRP) (r=0.439, p<0.001). There was a significant correlation between the SII and mortality (U=1,357, p<0.001). The cut-off value of SII was 618.8 (area under the curve=0.751, p<0.001) with 80.0% sensitivity and 61.5% specificity. A cut-off value of >618.8 was associated with a 4.68-fold higher mortality. Conclusion: Similar to NLR and PLR, the SII is a proinflammatory marker of systemic inflammation and can be effectively used in independent predicting COVID-19 mortality.

16.
Infect Dis (Lond) ; 54(12): 897-908, 2022 12.
Article in English | MEDLINE | ID: covidwho-2004938

ABSTRACT

BACKGROUND: ABO blood group system modulates the inflammatory response and has been implicated in COVID-19. Group O protects against SARS-CoV-2 infection, but there are no data regarding post-COVID-19 syndrome (PCS). Our aim was to assess this possible association. METHODS: Case-control study in a community setting, with subjects who had experienced mild COVID-19. Cases were PCS+, controls were PCS-, and the exposure variable, group O. We collected age, sex, BMI, smoking, comorbidities, inflammatory markers, anti-SARS-CoV-2 IgG antibodies, blood type and clinical data. Five composite inflammatory indices were developed. Multivariate analyses were performed. RESULTS: We analysed 121 subjects (56.2% women), mean age 45.7 ± 16 years. Blood group frequencies were 41.5%, 7.9%, 5.9%, and 44.5% for A, B, AB and O, respectively. Thirty-six patients were PCS+, without significant differences between cases and controls. Compared to non-O, a higher prevalence of PCS (p = .036), and number of symptoms of PCS (p = .017) were noted in group O. Concerning biomarkers, PCS + and PCS- showed no differences in A, B, and AB groups. In contrast, group O PCS + patients had significantly lower albumin-to-globulin ratio and higher lymphocyte count, fibrinogen, CRP levels, and higher percentages of 3 composite indices, than PCS- subjects. Group O showed a 6-fold increased risk of PCS, compared to non-O (adjusted OR = 6.25 [95%CI, 1.6-23]; p = .007). CONCLUSIONS: Group O has shown a consistent relationship with PCS, characterised by a more intense inflammatory burden than the other blood groups. Blood group O could be part of the immunological link between acute COVID-19 and PCS.


Subject(s)
COVID-19 , Humans , Female , Adult , Middle Aged , Male , COVID-19/epidemiology , ABO Blood-Group System , Case-Control Studies , Outpatients , Retrospective Studies , SARS-CoV-2 , Antibodies, Viral , Comorbidity , Immunoglobulin G , Biomarkers , Fibrinogen , Albumins
17.
Med J Armed Forces India ; 2022 Aug 22.
Article in English | MEDLINE | ID: covidwho-1996433

ABSTRACT

Background: India is the epicenter of diabetes mellitus (DM). The relationship between COVID and DM in age/gender-matched non-diabetics has not been studied yet. The role of DM in predicting the disease severity and outcome in COVID patients might provide new insight for effective management. Methods: We conducted a prospective comparative study at a COVID care center from 25th April-31st May 2021. Among 357 severe-COVID patients screened, all consecutive diabetes (n-113) and age/gender-matched non-diabetes (n-113) patients were recruited. All diabetics and non-diabetics at admission were subjected to high resolution computed tomography (HRCT) chest and inflammatory markers (C-reactive protein (CRP), D-dimer, ferritin, interleukin-6 (IL-6), lactate dehydrogenase (LDH), Neutrophil-Lymphocyte Ratio (NLR)) before starting anti- COVID therapy. Statistical analysis was done using JMP 15·0 ver·3·0·0. Results: The prevalence of DM among the screened population (n-357) was 38·37%. The mean age of the study population was 61y with male preponderance (57%). There was no statistical difference in the HRCT-score or inflammatory markers in the two groups except for higher NLR (p-0·0283) in diabetics. Diabetics had significantly inferior overall survival (OS) (p-0·0251) with a 15d-OS of diabetics vs. non-diabetics being 58·87%, 72·67%, and 30d-OS of diabetics vs. non-diabetics being 46·76%, 64·61%, respectively. The duration of the hospital stay was not statistically different in the two groups (p-0·2). Conclusion: The mortality is significantly higher in severe-COVID patients with DM when compared to age/gender-matched non-diabetics. There was no significant difference in most inflammatory markers/CT at admission between the two groups.

18.
Journal of Health Sciences and Surveillance System ; 10(3):276-283, 2022.
Article in English | Scopus | ID: covidwho-1988944

ABSTRACT

Background: Patients with COVID-19 (coronavirus disease 2019) present varying disease severity;with such heterogeneity in clinical presentations, it can be challenging to assess the severity and progression of the disease. In addition, no specific markers have been identified that would indicate the diagnosis or prognosis of the disease. Therefore, this study was aimed to determine whether a panel of hematological and inflammatory biomarkers were indicative of disease severity in the assessment and the prognosis of COVID-19. Methods: The retrospective cross-sectional study was carried out in a university hospital in South India between May 2020 and September 2020. The participants were 997 patients with COVID-19, confirmed by real-time reverse transcriptasepolymerase chain reaction (RT-PCR). Information regarding demographics and laboratory tests was obtained from medical records. Association analysis was conducted using SPSS, version 16, and a P-value <0.05 was considered statistically significant. Results: Inflammatory markers such as C-reactive protein (CRP) and D-dimer, calculated inflammatory ratios, and hemoglobin were significantly increased in cases of severe COVID-19. Leucocytosis with increased absolute neutrophil count and decreased absolute lymphocyte count were observed. Conclusion: Haematological and inflammatory markers may indicate the severity of the disease. The severity of COVID-19 was indicated by elevated total white cells, increased neutrophillymphocyte, and platelet-lymphocyte ratios. Increasing levels of CRP indicated a severe prognosis of the disease. D-dimer elevations may indicate the incidence of thromboembolic episodes. Therefore, hematological indices were considered applicable in assessing the progression of the disease and for the risk stratification of the disease. © 2022 Shriaz University of Medical Sciences

19.
Cureus ; 14(7): e26580, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1988450

ABSTRACT

INTRODUCTION: Throughout the coronavirus disease 2019 (COVID-19) pandemic, studies have repeatedly shown that COVID-19 outcomes are more severe in the elderly and those with comorbidities, with diabetes being a significant risk factor associated with more severe infection. Here, we present the clinical characteristics of 25 patients with pre-existing type 2 diabetes mellitus who presented with diabetic ketoacidosis (DKA) and COVID-19 in a community hospital in Brooklyn, New York, and identify possible predictors of mortality. METHODS: This retrospective case series recruited patients from March 1st to April 9th, 2020, with lab-confirmed COVID-19 and met DKA criteria on admission (based on American Diabetes Association diagnostic criteria for DKA). RESULTS: Of the 25 patients who met the inclusion criteria, 22 were African American and three were Hispanic. Common comorbidities in addition to diabetes were hypertension, obesity, coronary artery disease, and dyslipidemia. Fever, cough, myalgias, and shortness of breath were common presenting symptoms. Most patients had elevated inflammatory markers erythrocyte sedimentation rate, C-reactive protein, D-dimer, and ferritin, but higher values increased the odds of mortality. The overall survival was 64%, with those recovering having more extended hospital stays but requiring less time in the intensive care unit. At the same time, those who died were more likely to require mechanical ventilation, have an acute cardiac injury, and/or be obese. Despite numerous studies on COVID and diabetes, only a few studies described DKA. CONCLUSION: This observational retrospective study illustrated that patients with diabetes are at risk of developing DKA with COVID-19 and identified some predictors of mortality. However, further studies with larger sample sizes and a control group are necessary to understand better the effects of COVID-19 on DKA and their clinical outcomes.

20.
Indian Journal of Biochemistry and Biophysics ; 59(6):667-674, 2022.
Article in English | Scopus | ID: covidwho-1981127

ABSTRACT

It has been two years since the global outbreak of the highly contagious and deadly corona virus disease (COVID-19) caused by SARS-CoV-2 first emerged in China. Since then, various diagnostic, prognostic and treatment strategies undertaken to address the pandemic have been dynamically evolving. Predictive and prognostic role of various biomarkers in COVID-19 has been a subject of intense exploration. We aimed to determine the association of Carcinoembryonic antigen (CEA) and various surrogate inflammatory biomarkers with the severity of COVID-19 disease. This retrospective cohort study was carried out on 98 patients admitted in Jaypee Hospital, Noida with COVID-19 disease. Information regarding demographics, laboratory parameters and clinical history was collected from Hospital Information System. Serum levels of CEA and other biomarkers such as Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), Interleukin-6 (IL-6), Ferritin, and Procalcitonin (PCT) were assessed. Correlation analyses were performed between the parameters and acute respiratory distress syndrome (ARDS) stages. Logistic regression and ROC curve analysis were performed to assess the various parameters for distinguishing COVID-19 patients requiring ICU admission. Mean hospital stay, NLR, CEA, IL-6, CRP, Ferritin (P <0.0001) and PCT (P = 0.01) were significantly higher in ICU patients when compared to general ward patients. NLR, median serum CEA, IL-6, and CRP levels were significantly higher in non-survivor compared to the survivors (P <0.0001, 0.0341 and 0.0092). CEA correlated well with disease severity based upon ARDS classification and was a better marker to differentiate patient according to ARDS stages (ARDS 0 vs 2 P = 0.0006;0 vs 3 P <0.0001;ARDS 1 vs 2 P = 0.0183;1 vs 3 P = 0.0006). The area under the Receiver operating characteristic (ROC) curve for CEA was 0.7467 (95% CI-0.64885-0.84459) which revealed the potential of CEA as a biomarker to distinguish COVID-19 patients requiring ICU admission. CEA can be used to predict the severity of COVID-19 associated ARDS as well as patients requiring ICU admission. Along with routine inflammatory biomarkers (NLR, CRP, IL-6, PCT, and ferritin), CEA should be used for early identification of critical COVID-19 positive patients and for assessing prognosis. © 2022, National Institute of Science Communication and Information Resources. All rights reserved.

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