ABSTRACT
Aim: This study aimed to investigate the diagnostic and prognostic value of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike IgG/IgM antibodies in patients infected with coronavirus Delta variant. Methods: This analytical observational study included 270 unvaccinated patients (aged ≥18 years) diagnosed with coronavirus disease 2019 (COVID-19) Delta variant who referred to Emergency Department of our hospital. The serum levels of anti-SARS-CoV-2 Spike IgG and IgM were measured by indirect ELISA. Main measured outcomes included anti-SARS-CoV-2 Spike IgG and IgM, chest computed tomography (CT) severity score, clinical and laboratory findings which were prospectively evaluated throughout the study period. Results: The IgM levels in critical patients were significantly higher than non-critical patients (p<0.05). But the mean level of IgG in critical patients was not significantly different from its level in non-critical patients (p>0.05). However, a significant positive correlation was observed between the levels of both antibodies and chest CT severity score (p<0.0001); this implies that their levels may reflect the degree of lung involvement. The IgM level on 15th-16th days after symptoms onset was significantly associated with the hazard of death even after adjusting for all other factors (adjusted HR (95%CI):1.28(1.014_1.63), p=0.03), whereas IgG was not (p>0.05). The survival probability among patients with IgM level ≥8.67 RU/ml (34.2%) was significantly lower than those with IgM level <8.67 RU/ml (99.5%, p=0.0001). Conclusions: Anti-SARS-CoV-2 Spike IgM antibody was significantly associated with the disease severity and risk of death in unvaccinated patients infected with coronavirus Delta variant. However, further large-scale investigations on diverse infected populations are required to precisely determine the diagnostic/prognostic value of these antibodies.
ABSTRACT
Objective: To verify D-dimer values to predict disease severity, degree of lung involvement and mortality in patients with COVID-19. Method: The D-dimer levels of 200 confirmed COVID-19 patients were prospectively measured in the Emergency Department of Razi Hospital of Ahvaz on the admission day, and its relations with the illness severity, computed tomography (CT) score, and mortality were assessed. Results: D-dimer level > 1.04 µg/mL and ≤ 1.12 µg/mL could indicate severe illness and high grade of pulmonary involvement but low risk of death. The mortality rate in the patients with D-dimer level > 1.12 µg/mL (was significantly higher than its rate in those with D-dimer level ≤ 1.12 µg/mL (17.2% x 1.5%; P:0.02). An independent positive correlation was found between D-dimer and Chest CT score as well as the disease severity (OR: 1.84; 95%CI:1.38 - 2.45; P:0.0001). Conclusion: D-dimer level > 1.12 µg/mL on the early stage of COVID-19 infection may independently predict the severe illness, high grade of pulmonary involvement, and high risk of death, indicating its beneficial role in timely management of critical patients.
Objetivo: Verificar os valores do D-dímero para predizer a gravidade da doença, o grau de envolvimento pulmonar e a mortalidade em pacientes com COVID-19. Método: Os níveis de dímero D de 200 pacientes confirmados com COVID-19 foram medidos, prospectivamente, no Departamento de Emergência do Hospital Razi de Ahvaz, no dia da admissão, e suas relações com a gravidade da doença, escore de tomografia computadorizada (CT) e mortalidade foram avaliadas. Resultados: Os níveis do D-dímero > 1,04 µg/mL e ≤ 1,12 µg/mL podem indicar doença grave e alto grau de envolvimento pulmonar, mas baixo risco de morte. A taxa de mortalidade nos pacientes com valor de D-dímero > 1,12 µg/mL foi significativamente maior do naqueles com nível de D-dímero ≤ 1,12 µg/mL (17,2% x 1,5%; P:0,02). Foi encontrada uma correlação positiva independente entre o D-dímero e o escore de CT de tórax e a gravidade da doença (OR: 1,84; IC 95%:1,38 - 2,45; P:0,0001). Conclusão: O nível do D-dímero > 1,12 µg/mL no estágio inicial da infecção por COVID-19 pode prever independentemente a doença grave, alto grau de envolvimento pulmonar e alto risco de morte, indicando seu papel benéfico no manejo oportuno de pacientes críticos.
Subject(s)
Humans , Male , Female , Middle Aged , Severity of Illness Index , Mortality , COVID-19 , LungABSTRACT
AIM: The aim of this study is the predictive validation of red cell distribution width (RDW) in COVID-19 patients. METHOD: In total, 331 COVID-19 patients were classified as 'severe' and 'nonsevere' groups based on the WHO standard criteria. The levels of RDW standard deviation (SD) were evaluated as both continuous and categorical variables. Multivariate statistical analyses were used. RESULTS: RDW-SD ≤43 and ≤47 fl thresholds showed high specificity (90.1-91.4%) for diagnosing nonsevere illness and no risk of death. RDW-SD >47 indicated severe illness and a high mortality risk while 43
