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Background and Objectives Several studies have shown that SARS-CoV-2 can induce a cytokine release storm which is a major cause of disease severity and death. Therefore, cytokine levels in the serum may predict disease severity and survival in patients with COVID-19. Methods We included 88 COVID-19 patients who were hospitalised at the Division of Pulmonology of the Vienna General Hospital between January and May 2021 in this observational trial. Blood samples for serum peptide measurements were drawn at the time closest to hospitalisation, at day 5, 9 and 13( +/- 1). We correlated the type of ventilation (nasal oxygen therapy, high flow nasal canula, non-invasive ventilation or mechanical ventilation), occurrence of consolidations on chest X-ray or if available HRCT and the level of care (general ward, IMCU or ICU) with serum peptide values. We assessed the concentration of cytokines (IL-1a, IL-1b, IL-1RA, IL-6, L-7, L-10, IFN- gamma and TNF-alpha), chemokines (CCL-3, CCL-4 and CCL-7) and growth factors (G-CSF, GM-CSF and VEGF). Results Patients were 68 years of age (median) and stayed in hospital between 5-171 days. The peak inspiratory pressure in patients receiving non-invasive ventilation or mechanical ventilation was significantly associated with IL-1RA, G-CSF and IFN-gamma and the fraction of inspired oxygen in patients receiving highflow nasal canula oxygen therapy was significantly associated with IL-6, IL-7, IFN-gamma, and CCL-7. Results are shown in Table 1. No investigated cytokine correlated with the type of ventilation, occurrence of consolidations on imaging and in-hospital mortality. Conclusions In conclusion, concentrations of IL-1RA, G-CSF, IL-6, IL-7, IFN-gamma, and CCL-7 were associated with more severe disease progression in hospitalised COVID-19 patients.
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Aim/Introduction: Inoperable HCC patients with multifocal lesions and malignant portal vein thrombosis (PVT) have poorer prognosis with limited treatment options. 188Re-N-DEDC lipiodol is an emerging agent for such cases due to its simple and on-site labelling procedure, cost-effectiveness and least radiation induced side effects. We aimed to explore the response assessment, safety and efficacy of 188Re-N-DEDC-lipiodol in multifocal HCC with/without PVT. Material(s) and Method(s): Radiologically and biochemically confirmed HCC patients with/without PVT having ECOG performance status <=2 and Child Pugh score A /B were recruited. Baseline serum alpha-fetoprotein (AFP) was obtained for biochemical correlation and follow-up. After lipiodol labelling & QC checks, therapeutic activity of 188Re-N-DEDC/lipiodol were injected under fluoroscopic guidance through femoral branch in super-selective artery of tumor. Post-therapy planar and SPECT/CT imaging were performed at 2, 6, 12, 24, 48 and 72hrs to see tumoral retension. Response was assessed at 2 months post-therapy by mRECIST criteria and S. AFP level. Clinical & biochemical toxicities were graded by CTCAE v5.0. Result(s): Thirty-One (31) patients (27 male;4 female) with mean age 55.9 +/- 9.78 years have been recruited for therapy. Overall mean injected activity of 188Re-N-DEDC lipiodol was 2.9+/-0.9GBq (78.4+/-24.2mCi). The median follow-up period was of 6 months. One patient was lost to follow-up due to prevailing COVID situations and 3 patient died before follow-up due to internal variceal bleeding, so radiological and biochemical response were assessed only in 27/31 patients by mRECIST criteria and serum AFP tumor marker level respectively. Radiologically, objective response rate was seen in 12/27 patients (~45%) and disease control rate was seen in 20/27 patients (~74%). 6/27 patients had non-AFP producing tumor i.e. serum AFP were normal at baseline and follow-ups while in remaining 21 patients, biochemical objective response rate was seen in 11/21 patients (~52%) and disease control rate was 14/21 patients (~67%). Post-therapy clinical toxicities (Nausea, Vomiting, Fever, abdominal pain) were observed in most of the patients for 2-3 days and were treated symptomatically. One patient showed grade 3 liver toxicity & progressive worsening of LFT, 20 patients showed grade 1 derangements in liver enzymes & 6 patients showed grade 2 derangements in liver enzymes. Hematological toxicities were seen in 4 patients (<=Grade 2 in 2 patients & grade 3 in two patients). Conclusion(s): In patients of HCC with/without PVT, trans-arterial Re188-N-DEDC/lipiodol therapy proved to be safe and effective with good disease control.
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Aim/Introduction: Although 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography/Computed Tomography (PET/ CT) is not routinely used for diagnosis of COVID- 19 infections, we incidentally detected lung lesions in few patients, who were referred for some other indications. The study aimed to explore a cut off value of standardized uptake values (SUV) of 18F-FDG PET/ CT in predicting active COVID-19 infection in both symptomatic and asymptomatic patients referred to our department for various oncologic indications. Material(s) and Method(s): We retrospectively analysed PET/CT studies performed from March 2020 to August 2021 done at our department, who underwent 18F-FDG PET/CT for various oncological indications. PET/CT scans were reviewed by 2 experienced nuclear medicine physicians. At first, only HRCT chest was reviewed to ascertain inclusion of the patient. CT severity score and COVID-19 Reporting and Data System (CORADS) criteria were calculated from HRCT chest. PET/CT images were reviewed and SUVmax were recorded in lung parenchyma and mediastinal blood pool and SUV ratios (SUVR) between them were calculated. Result(s): A total of 85 patients were identified and divided into 3 groups based on clinical symptoms and reverse transcription-polymerase chain reaction (RT-PCR) results * Group A- patients with symptoms of COVID- 19 and positive RT-PCR- (n=51) * Group B- patients with symptoms of COVID-19 and a negative RT-PCR- (n=13) * Group Cpatients with no symptoms of COVID-19 - (n=21). SUVR of these 3 groups (2.67+/-1.21 vs 1.86+/-0.8 vs 1.42+/-0.53 respectively) showed significant statistical difference (p<0.05). Moderate correlation was obtained between SUVR and CT severity score (r= 0.43, p<0.05), thereby correlating towards prognosis. The area under the curve (AUC) obtained for different cut-off values of SUVR was 0.74 (95% CI- 0.55-0.97, p<0.05). A SUVR cut-off value of 1.87 yielded a specificity of at least 74.3% and a sensitivity of at least 68%. Conclusion(s): An SUVR cut off value of 1.87 can yield a specificity of at least 74.3% and a sensitivity of at least 68%. HRCT chest and 18F-FDG PET/CT plays a complementary role in determining active COVID-19 infection. SUVR of pulmonary lesions can be considered as an important prognostic indicator for active COVID-19 infections.
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Background and Aim: Combined use of surgical mask with filtering facepiece (FFP) 2 masks has been popular among the health-care workers. However, the effect of this preference on the vital values of individuals stays as a challenge among the professionals. The present study aimed to assess the effect of FFP2 mask versus combined use of it with surgical mask on the SpO2 values and pulse rates of individuals. Patients and Methods: This study was conducted on 20 health-care workers. The pulse rates and SpO2 values were evaluated by pulse oximeter placed in the index fingers of the participants. The participants were divided into two groups: those using the FFP2 mask and those using FFP2-surgical mask combination. Individuals wearing FFP2 mask were examined for a period of 60 min and the same examination was repeated for another period of 60 min in those using combination of FFP2 with surgical mask. The values were measured at the beginning and at 15, 30, 45, and 60 min intervals, respectively. The examinations were conducted in the rest position to obtain standardization. Results: The observed data showed no statistical difference at all periods in either SpO2 values or pulse rates between FFP2 and FFP2-surgical mask combined groups. The SpO2 values reduced from the initial time to 15 min in the FFP2-surgical mask group. Also, in the FFP2-SM group, statistically significant increase in values was observed between 15 and 45 min and 15 and 60 min. Another increase in SpO2 value was found in the observations made between made 30 and 45 min in the same group (P < 0.05). The pulse rates of the individuals showed no statistical difference in both the groups and at all experimental periods (P > 0.05). Conclusion: According to the present study, wearing only the FFP2 mask or FFP2-surgical mask combination seems not to cause any effect on the SpO2 values and pulse rates of the participants.
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COVID-19 , SARS-CoV-2 , Humanos , Máscaras , Frequência Cardíaca , Pessoal de SaúdeRESUMO
About Coronavirus and Coronavirus Disease 2019 Coronavirus belongs to a large family of single-stranded RNA viruses. Elderly people, and those with medical conditions such as hypertension, cardiac problems or diabetes, chronic obstructive airway disease, are more likely to develop serious illness.[[2]] Thyroid Disorders in India Thyroid diseases are common worldwide. The prevalence of hypothyroidism in T2DM and hypertension in India was found to be about 33%.[[6]] Hypothyroidism and Coronavirus Disease 2019 There is no information on how it affects individuals with hypothyroidism. [Extracted from the article] Copyright of Thyroid Research & Practice is the property of Wolters Kluwer India Pvt Ltd 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.)