RESUMO
The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcomes of SARS-CoV2 disease has not been described. We studied 400 RT-PCR confirmed SARS-CoV2 patients to determine independent factors associated with poor outcomes, including MICU admission, prolonged MICU stay and hospital admissions, and in-hospital mortality. We also measured serum IgG against the N protein and correlated its concentrations with clinical outcomes. We found that several factors, including Charlson comorbidity Index (CCI), high levels of IL6, and presentation with dyspnea were associated with poor clinical outcomes. It was shown that higher CCI and higher IL6 levels were independently associated with in-hospital mortality. Anti-N protein IgG was detected in the serum of 55 (55%) patients at the time of admission. A high concentration of antibodies, defined as signal to cut off ratio (S/Co)> 1.5 (75 percentile of all measurements), was found in 25 (25%) patients. The multivariable logistic regression models showed that between being an African American, higher CCI, lymphocyte counts, and S/Co ratio> 1.5, only S/Co ratio were independently associated with MICU admission and longer length of stay in hospital. This study recommends that titers of IgG targeting N-protein of SARS-CoV2 at admission is a prognostic factor for the clinical course of disease and should be measured in all patients with SARS-CoV2 infection.
RESUMO
PURPOSE: To compare the macular retinal thickness of moderately to severely amblyopic eyes with non-amblyopic eyes as controls. METHODS: This case control study was conducted on 56 children aged 4 to 10 years old (64.3% female subjects). Twenty-eight children had unilateral amblyopia (28 amblyopic eyes as cases and 28 normal fellow eyes as internal controls) and 28 children had normal visual acuity in both eyes and were considered as external controls (n = 56 eyes). Among our cases, 14 had strabismic amblyopia and 14 had anisometropic amblyopia. Macular retinal thickness was measured using optical coherence tomography at the center and in 1-, 3-, and 6-mm rings. RESULTS: Best-corrected visual acuity of the amblyopic eyes was less than that of the internal and external controls, and the best-corrected visual acuity of their fellow eyes was also less than that of the external controls. Thickness of the central macula and a 1-mm ring area in the amblyopic eyes was higher than that of both internal and external controls. Difference of central macular thickness ≥20 µm between two eyes of the amblyopic children was significantly more than non-amblyopic subjects. CONCLUSIONS: Based on the results of this study, the macular retinal thickness was significantly higher in moderate to severe amblyopic eyes compared to their fellow eyes and external controls. This might be due to macular developmental disorders in amblyopic eyes. Therefore, optical coherence tomography imaging is recommended if subtle macular abnormalities are suspected in moderate to severe amblyopic eyes.
