Prognostic factors for the severity of SARS-CoV-2 infection.

Objectives: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a novel coronavirus that causes COVID-19. This disease is associated with leukocytosis with lymphopenia, neutrophilia, and elevated levels of d-dimer, and C-reactive protein, ferritin, procalcitonin, and lactate dehydrogenase. The aim of this study was to describe the clinical and analytical characteristics of hospitalized patients with SARS-CoV-2 infection and to identify prognostic factors of disease progression. Methods: Patients were categorized into two groups based on COVID-19 severity. Study variables included demographic data, medical history, length of hospital stay, course of pneumonia, drug therapy, and analytical parameters. A descriptive and multivariate analysis was performed to identify prognostic factors for disease severity. Results: The study population included 197 patients, of whom 127 had mild disease and 70 had severe COVID-19. Statistically significant differences were observed in most analytical parameters. The parameters included in the multivariate analysis were advanced age and elevated levels of leukocytes, CRP, GGT, and PCT at admission as prognostic factors for disease severity. Conclusions: The prognostic factors for the severity of SARS-CoV-2 infection identified in this study (age, leukocytes, CRP, GGT, and PCT) will help predict the course of the disease at an early stage.

Utilidad del estudio de la actividad antibiótica por bioensayo en el manejo de los derrames pleurales / Usefulness of the measurement of antibiotic activity by bioassay in the management of pleural effusions

Objetivo. El objetivo de este estudio fue determinar la presencia de actividad antibiótica en las muestras de líquido pleural remitidas para estudio y valorar su posible influencia en el manejo clínico de los pacientes. Material y métodos. Estudio observacional y prospectivo que incluyó 81 muestras de líquidos pleurales remitidas al Servicio de Bioquímica del Hospital Universitario de Valme. El estudio de la actividad antibiótica se realizó por bioensayo con base en las recomendaciones del proyecto Pneumonia Etiology Research for Child Health. A todas las muestras se les realizó estudio bioquímico, citológico y bacteriológico con base en técnicas convencionales. Adicionalmente, el uso previo de antibióticos fue evaluado a partir de lo registrado en la historia clínica. Resultados. De los 81 líquidos estudiados, en 26 (32,1%) se constató uso previo de antibióticos a la toma de la muestra según lo registrado en la historia clínica y en 23 (28,4%) existía actividad antibiótica por bioensayo. La actividad antibiótica fue detectada en 15 (62,5%) de los exudados y en 8 (19%) de los trasudados, con una mediana de halos de inhibición de 17mm (rango: 11-22mm). Los 23 líquidos en los que se detectó actividad antibiótica dieron todos cultivo negativo. Conclusiones. Los resultados de este estudio demuestran un alto porcentaje de uso de antibióticos previo al cultivo (32,1%). La evaluación de la actividad antibacteriana del líquido pleural mediante bioensayo paralelamente al cultivo podría ayudar a enfocar el tratamiento y, con base en los parámetros bioquímicos y citológicos, su adecuación (AU)

Objective. The aim of this study was to determine the presence of antibiotic activity in the pleural fluid samples submitted to the laboratory for study, and to assess its possible influence on the clinical management of patients. Material and methods. An observational and prognostic study that included 81 samples of pleural fluid sent to the Biochemistry Department of Valme University Hospital, Seville, Spain. The study of antibiotic activity was performed by bioassay based on the recommendations of the Pneumonia Aetiology Research for Child Health project. All samples were subjected to a biochemical, cytological, and bacteriological study based on conventional techniques. In addition, previous use of antibiotics was evaluated based on what was recorded in the medical records. Results. Based on the medical records, it was observed that 26 (32.1%) of the 81 fluids studied had previous use of antibiotics, with 23 (28.4%) showing antibiotic activity by bioassay. Antibiotic activity was detected in 15 (62.5%) of the exudates and in 8 (19%) of the transudates, with a median inhibition zone of 17mm (range: 11-22mm). In the 23 fluids in which antibiotic activity was detected, all had negative cultures. Conclusions. The results of this study demonstrate a high percentage of previous use of antibiotics prior to culture (32.1%). The evaluation of the antibacterial activity by bioassay in the pleural fluid parallel to bacteriological culture could help in the treatment approach, using the biochemical and cytological parameters to assess its suitability (AU)

The influence of the age in the risk of the prothrombin G20210A mutation for spontaneous venous thrombosis.

BACKGROUND AND OBJECTIVE: Factor V Leiden mutation (FVL), and the prothrombin G20210A mutation (PT G20210A) are polymorphisms with a weak risk factor for venous thromboembolic disease. The probability of spontaneous venous thrombosis in carriers of thrombophilic mutations (FVL and PT G20210A) was analyzed. PATIENTS AND METHOD: We studied 735 individuals (407 were healthy controls and 328 patients with venous thrombosis) with respect to FVL and PT G20210A, determined by polimerase chain reaction in liquid phase, real time. chi2 test and logistic regression analysis were used to evaluate the results. The dates were analyzed with the statistical program SPSS v. 14.0. RESULTS: The carrier patients of PT G20210A mutation whose age was over 40 years had a risk factor for spontaneous venous thrombosis which was 9.28 (odds ratio [OR]) (95% confidence interval [CI], 3.01-28.60; p < 0.0005) times greater than carriers of the PT G20210A mutation who were 40 year-old or younger. In our patients, being male meant a weak risk factor for venous spontaneous thrombosis (p = 0.021; OR = 1.64; 95% CI, 1.08-2.51) . CONCLUSIONS: Our results demonstrate a potentiation of the thrombotic risk by an increase of age in the carriers of the PT G20210A mutation.

Edad y mutación de la protrombina G20210A en los pacientes con trombosis venosa espontánea / The influence of the age in the risk of the prothrombin G20210A mutation for spontaneous venous thrombosis

Fundamento y objetivo: El factor V Leiden (FVL) y la mutación de la protrombina G20210A (PT G20210A) son unos polimorfismos que suponen un débil factor de riesgo para presentar enfermedad tromboembólica venosa. Hemos analizado la probabilidad de tener una trombosis venosa espontánea en los portadores de las mutaciones trombofílicas (FVL y PT G20210A). Pacientes y método: Hemos estudiado a 735 personas (407 controles sanos y 328 pacientes con trombosis venosa) con relación al FVL y a la PT G20210A, determinados por reacción en cadena de la polimerasa en fase líquida, en tiempo real. Para evaluar los resultados utilizamos el test de la x2 y el análisis de regresión logística. Los datos se analizaron con el programa estadístico SPSS versión 14.0. Resultados: Los pacientes con la mutación PT G20210A que eran mayores de 40 años tuvieron un factor de riesgo para trombosis venosa espontánea con una odds ratio (OR) 9,28 (intervalo de confianza (IC) del 95%, 3,01-28,60; p < 0,0005) veces mayor que los portadores de la mutación PT G20210A que tenían 40 años o menos. En nuestra serie el sexo masculino representó un factor de riesgo débil para trombosis venosa espontánea (p = 0,021; OR = 1,64; IC del 95%, 1,08-2,51). Conclusiones: Nuestros resultados demuestran una potenciación del riesgo trombótico por el incremento de la edad en los individuos portadores de la mutación PT G20210A

Background and objective: Factor V Leiden mutation (FVL), and the prothrombin G20210A mutation (PT G20210A) are polymorphisms with a weak risk factor for venous thromboembolic disease. The probability of spontaneous venous thrombosis in carriers of thrombophilic mutations (FVL and PT G20210A) was analyzed. Patients and method: We studied 735 individuals (407 were healthy controls and 328 patients with venous thrombosis) with respect to FVL and PT G20210A, determined by polimerase chain reaction in liquid phase, real time. x2 test and logistic regression analysis were used to evaluate the results. The dates were analyzed with the statistical program SPSS v. 14.0. Results: The carrier patients of PT G20210A mutation whose age was over 40 years had a risk factor for spontaneous venous thrombosis which was 9.28 (odds ratio [OR]) (95% confidence interval [CI], 3.01-28.60; p < 0.0005) times greater than carriers of the PT G20210A mutation who were 40 year-old or younger. In our patients, being male meant a weak risk factor for venous spontaneous thrombosis (p = 0.021; OR = 1.64; 95% CI, 1.08-2.51) . Conclusions: Our results demonstrate a potentiation of the thrombotic risk by an increase of age in the carriers of the PT G20210A mutation

Multicentre physiological reference values for some urinary component-to-creatinine (creatininium) concentration ratios.

Nine clinical laboratories in different regions of Spain have shared the search for reference individuals and the production of reference values for urinary component-to-creatininium concentration ratios measured in first morning urine samples using RD/Hitachi analysers. These urinary quantities include albumin, calcium(II), chloride, magnesium(II), phosphate, potassium ion, protein, sodium ion, urate and urea. All the logistic work was done in co-operation with the reagents' and analysers' supplier (Roche Diagnostics España, S.L., Sant Cugat del Vallès, Catalonia, Spain). From the blend of reference values obtained by each laboratory, the multicentre reference limits were estimated parametrically after mathematical transformation of original data.