COVID-19 disease severity to predict persistent symptoms: a systematic review and meta-analysis.

BACKGROUND: It is unclear, whether the initial disease severity may help to predict which COVID-19 patients at risk of developing persistent symptoms. AIM: The aim of this study was to examine whether the initial disease severity affects the risk of persistent symptoms in post-acute COVID-19 syndrome and long COVID. METHODS: A systematic search was conducted using PUBMED, Google Scholar, EMBASE, and ProQuest databases to identify eligible articles published after January 2020 up to and including 30 August 2021. Pooled odds ratio (OR) and confidence intervals (CIs) were calculated using random effects meta-analysis. FINDINGS: After searching a total of 7733 articles, 20 relevant observational studies with a total of 7840 patients were selected for meta-analysis. The pooled OR for persistent dyspnea in COVID-19 survivors with a severe versus nonsevere initial disease was 2.17 [95%CI 1.62 to 2.90], and it was 1.33 [95%CI 0.75 to 2.33] for persistent cough, 1.30 [95%CI 1.06 to 1.58] for persistent fatigue, 1.02 [95%CI 0.73 to 1.40] for persistent anosmia, 1.22 [95%CI 0.69 to 2.16] for persistent chest pain, and 1.30 [95%CI 0.93 to 1.81] for persistent palpitation. CONCLUSIONS: Contrary to expectations, we did not observe an association between the initial COVID-19 disease severity and common persistent symptoms except for dyspnea and fatigue. In addition, it was found that being in the acute or prolonged post-COVID phase did not affect the risk of symptoms. Primary care providers should be alert to potential most prevalent persistent symptoms in all COVID-19 survivors, which are not limited to patients with critical-severe initial disease.

Serum periostin levels in COVID-19: Is it useful as a new biomarker?

OBJECTIVES: Severe disease characterised by interstitial pneumonia may develop in some cases of coronavirus disease (COVID-19). Periostin has been associated with many respiratory diseases. In this study, we aimed to investigate whether periostin could be a useful new biomarker in the follow-up and severity assessment of the disease in patients with COVID-19 pneumonia. METHODS: In the study, 32 patients followed up during May to July 2020 because of COVID-19 and 24 healthy controls were included. The patients were divided into two groups, namely, mild/moderate and severe, according to the severity of the disease. Serum periostin and transforming growth factor beta (TGF-ß) levels were tested using an enzyme-linked immunosorbent assay (ELISA) method using commercially available ELISA kits. RESULTS: It was observed that the periostin level was significantly higher in both mild/moderate cases and severe cases compared with the control group at first presentation. However, TGF-ß levels at first presentation were similar between the groups. CONCLUSIONS: The current manuscript may be the first one performing periostin ELISA on COVID serum, and we believe that periostin can be used as a new biomarker.

Oxidative stress index can be a new marker related to disease severity in COVID-19

The aim of this study was to evaluate the relationship between systemic oxidative balance, and the severity of the disease in patients with COVID 19.Sixty-four patients were divided into three groups according to the severity of the disease: mild (n=28), moderate (n=11) and severe (n=25). Twenty-four healthy controls included to the study. Proinflammatory cytokines (IL-6 and TNF-α), D-dimer, fibrinogen, total oxidative status (TOS), total antioxidant status (TAS) were measured and oxidative stress index (OSI) was calculated.The mean age of severe group was significantly higher than the other groups (p=0.001). TAS levels were significantly decreased in all patient groups compared to controls, while serum TOS and OSI levels were significantly different in all three stages of the disease. Serum IL-6 and TNF- α levels were significantly elevated in severe group compared to other groups. TOS and OSI levels were also significantly correlated with IL-6, CRP, ferritin, fibrinogen, LDH and D-dimer.TOS and OSI levels are an indicator of systemic oxidative balance in COVID-19 and related to the disease severity. They can be an important marker for evaluating the disease severity and used in the management of patients with COVID-19. (English) [ABSTRACT FROM AUTHOR] Bu çalışmanın amacı COVID 19 hastalarında sistemik oksidatif denge ile hastalık şiddeti arasındaki ilişkiyi değerlendirmektir.Altmış dört hasta, hastalık şiddetine göre hafif (n=28), orta (n=11) ve şiddetli (n=25) olmak üzere üç gruba ayrıldı. Yirmi dört sağlıklı kontrol çalışmaya dahil edildi. Proinflamatuar sitokinler (IL-6 ve TNF-α), D-dimer, fibrinojen, total oksidan status (TOS) ile total antioksidan status (TAS) düzeyleri ölçüldü ve oksidatif stres indeksi (OSI) hesaplandı.Şiddetli grubun yaş ortalaması diğer gruplara göre anlamlı derecede yüksekti (p0,001). TAS seviyeleri kontrollere kıyasla tüm hasta gruplarında anlamlı olarak azalırken, serum TOS ve OSI seviyeleri hastalığın her üç evresinde de anlamlı olarak farklıydı. Şiddetli grupta serum IL-6 ve TNF-α seviyeleri diğer gruplara göre anlamlı derecede yüksekti. TOS ve OSI seviyeleri ayrıca IL-6, CRP, ferritin, fibrinojen, LDH ve D-dimer ile anlamlı korelasyon gösterdi.TOS ve OSI düzeyleri, COVID-19’da sistemik oksidatif dengenin bir göstergesidir ve hastalık şiddeti ile ilişkilidir. Hastalık şiddetini değerlendirmek için önemli bir belirteç olabilir ve COVID-19 hastalarının yönetiminde kullanılabilir. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Turkish Journal of Biochemistry / Turk Biyokimya Dergisi is the property of De Gruyter 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Beclin-1, an autophagy-related protein, is associated with the disease severity of COVID-19.

AIMS: Coronavirus disease 2019 (COVID-19), which is a highly contagious disease, is an ongoing outbreak worldwide with high morbidity and mortality. The approaches targeting the autophagy processes might have promising diagnostic and therapeutic values against Coronavirus infection. Here, we aimed to investigate the relationship of Beclin-1 (BECN1), an autophagy-related protein, with blood parameters and the clinical severity in patients with COVID-19. MATERIALS AND METHODS: We enrolled 108 patients with COVID-19 and 21 healthy controls in this study, from September 2020 to January 2021 and divided all patients into two groups according to the severity of the disease: The non-severe group and the severe group. BECN1 levels and blood parameters were measured with Enzyme-Linked Absorbent Assay and routine techniques, respectively. KEY FINDINGS: Serum BECN1 levels were increased in patients with COVID-19 compared to the healthy controls, and its concentrations were significantly higher in the severe group than in the non-severe group (p < 0.001). BECN1 levels showed a significantly positive correlation with coagulation markers such as D-dimer and Fibrinogen (FIB) and inflammation markers such as C-reactive protein (CRP), Procalcitonin (PCT), Ferritin and biochemical markers such as Blood urea nitrogen and Lactate dehydrogenase (p < 0.001). We detected that areas under the ROC curve for BECN1, D-dimer, FIB, PCT, CRP and Ferritin were 0.8662, 0.9110, 0.8278, 0.9996 and 0.9284, respectively (p < 0.0001). SIGNIFICANCE: BECN1 may serve as a predictive biomarker in evaluating the disease severity of COVID-19. Our data suggest that BECN1 mediated-autophagy modulation might have a promising value in improving the clinical outcomes of COVID-19.