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Villanueva-Cotrina F, Velarde J, Rodriguez R, Bonilla A, Laura M, Saavedra T, Portillo-Alvarez D, Bustamante Y, Fernandez C, Galvez-Nino M. Active cancer as the main predictor of mortality for COVID-19 in oncology patients in a specialized center. Pathol Oncol Res 2023; 29:1611236. [PMID: 37746553 PMCID: PMC10511753 DOI: 10.3389/pore.2023.1611236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/11/2023] [Indexed: 09/26/2023]
Abstract
Introduction: The role of the type, stage and status of cancer in the outcome of COVID-19 remains unclear. Moreover, the characteristic pathological changes of severe COVID-19 reveled by laboratory and radiological findings are similar to those due to the development of cancer itself and antineoplastic therapies. Objective: To identify potential predictors of mortality of COVID-19 in cancer patients. Materials and methods: A retrospective and cross-sectional study was carried out in patients with clinical suspicion of COVID-19 who were confirmed for COVID-19 diagnosis by RT-PCR testing at the National Institute of Neoplastic Diseases between April and December 2020. Demographic, clinical, laboratory and radiological data were analyzed. Statistical analyses included area under the curve and univariate and multivariate logistic regression analyses. Results: A total of 226 patients had clinical suspicion of COVID-19, the diagnosis was confirmed in 177 (78.3%), and 70/177 (39.5%) died. Age, active cancer, leukocyte count ≥12.8 × 109/L, urea ≥7.4 mmol/L, ferritin ≥1,640, lactate ≥2.0 mmol/L, and lung involvement ≥35% were found to be independent predictors of COVID-19 mortality. Conclusion: Active cancer represents the main prognosis factor of death, while the role of cancer stage and type is unclear. Chest CT is a useful tool in the prognosis of death from COVID-19 in cancer patients. It is a challenge to establish the prognostic utility of laboratory markers as their altered values it could have either oncological or pandemic origins.
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Affiliation(s)
- Freddy Villanueva-Cotrina
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Academic Department of Medical Microbiology, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Juan Velarde
- Department of Infectious Diseases, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Ricardo Rodriguez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Academic Department of Medical Technologist, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Alejandra Bonilla
- Department of Radiodiagnosis, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Marco Laura
- Department of Radiodiagnosis, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Tania Saavedra
- Department of Critical Care Medicine, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Professional School of Human Medicine, Universidad Privada San Juan Bautista, Lima, Peru
| | - Diana Portillo-Alvarez
- Department of Infectious Diseases, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Professional School of Human Medicine, Universidad de Piura, Lima, Peru
| | - Yovel Bustamante
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Academic Department of Medical Microbiology, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cesar Fernandez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Marco Galvez-Nino
- Professional School of Human Medicine, Universidad Privada San Juan Bautista, Lima, Peru
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Sarıoğlu E, Sarıaltın SY, Çoban T. Neurological complications and effects of COVID-19: Symptoms and conceivable mechanisms. BRAIN HEMORRHAGES 2023; 4:154-173. [PMID: 36789140 PMCID: PMC9911160 DOI: 10.1016/j.hest.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 in Wuhan, China. The new coronavirus disease (COVID-19) was declared a global pandemic by the World Health Organization (WHO) in March 2020. SARS-CoV-2 can invade the nervous system aside from infecting the respiratory system as its primary target. The most common nervous system symptoms of COVID-19 are stated as headache, myalgia, fatigue, nausea, vomiting, sudden and unexplained anosmia, and ageusia. More severe conditions such as encephalomyelitis, acute myelitis, thromboembolic events, ischemic stroke, intracerebral hemorrhage, Guillain-Barré-syndrome, Bell's palsy, rhabdomyolysis, and even coma have also been reported. Cohort studies revealed that neurological findings are associated with higher morbidity and mortality. The neurological symptoms and manifestations caused by SARS-CoV-2 and COVID-19 are examined and summarized in this article.
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Affiliation(s)
- Elif Sarıoğlu
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
| | - Sezen Yılmaz Sarıaltın
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
| | - Tülay Çoban
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
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3
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Miguélez M, Velasco C, Camblor M, Cedeño J, Serrano C, Bretón I, Arhip L, Motilla M, Carrascal M, Olivares P, Morales A, Brox N, Cuerda C. Nutritional management and clinical outcome of critically ill patients with COVID-19: A retrospective study in a tertiary hospital. Clin Nutr 2022; 41:2940-2946. [PMID: 34782169 PMCID: PMC8559438 DOI: 10.1016/j.clnu.2021.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Severe COVID-19 infection is characterized by an inflammatory response and lung injury that can evolve into an acute respiratory distress syndrome that needs support treatment in intensive care unit. Nutritional treatment is an important component of the management of critically ill patients and should be started in the first 48 h of ICU admission to avoid malnutrition. This study describes the characteristics of the patients treated in a tertiary hospital in Madrid during the months of March-May 2020 (first wave), the medical nutrition treatment employed and its influence in the clinical outcome of these patients. METHODS This is a retrospective study including COVID-19 patients admitted in ICU that needed medical nutrition treatment (MNT). Collected variables included sex, age, BMI, underlying diseases, time from hospitalisation to ICU admission, type of respiratory support (invasive mechanical ventilation (IMV) or high flow nasal cannula (HFNC) or non-invasive ventilation (non-IMV)), caloric and protein requirements (25 kcal/kg adjusted body weight (ABW), 1.3 g/kg ABW/day), MNT type (enteral nutrition (EN), parenteral nutrition (PN), mixed EN + PN), total calories (including propofol) and proteins administered, percentage of caloric and protein goal in ICU day 4th and 7th, metabolic complications, acute kidney failure (AKF), length of stay (LOS) and mortality. Data are expressed as mean ± SD, median (IQR) or frequencies. Statistical analysis was performed with the IBM SPSS Statistics for Windows, Version 25.0. p < 0.05 were considered statistically significant. RESULTS A total of 176 patients were included (72.7% male), 60.1 ± 13.5 years, BMI 29.9 ± 5.4 kg/m2. Underlying diseases included 47.4% overweight, 39.8% obesity, 49.1% hypertension, 41.4% dyslipidaemia. 88.6% of patients needed IMV, 89.1% prone position, 2.9% ECMO. Time to ICU admission: 2 (4.75) days. Estimated caloric and protein requirements were 1775 ± 202 kcal and 92.4 ± 10.3 g. Calories and proteins administered at days 4th and 7th were 1425 ± 577 kcal and 66 ± 26 g and 1574 ± 555 and 74 ± 37, respectively. Most of the patients received PN (alone or complementary to EN) to cover nutritional requirements (82.4% at day 4th and 77.9% at day 7th). IVM patients received more calories and proteins during the first week of ICU admission. Complications included 77.8% hyperglycaemia, 13.2% hypoglycaemia, 83.8% hypertriglyceridemia, and 35.1% AKF. ICU LOS was 20.5 (26) days. The mortality rate was 36.4%. CONCLUSIONS In our series, the majority of patients reached energy and protein requirements in the first week of ICU admission due to the use of PN (total or complementary to EN). Patients with HFNC or non-IMV may be at risk of malnutrition if total or complementary PN to oral diet/ONS/tube feeding is not used to cover nutritional requirements. Therefore, if EN is not possible or insufficient, PN can be safely used in critically ill patients with COVID-19 with a close monitoring of metabolic complications.
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Affiliation(s)
- M. Miguélez
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C. Velasco
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain,Corresponding author. Nutrition Unit, Hospital General Universitario Gregorio Marañón, c/ Doctor Esquerdo 46, 28007, Madrid, Spain
| | - M. Camblor
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J. Cedeño
- Intensive Care Service. Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C. Serrano
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - I. Bretón
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L. Arhip
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M. Motilla
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M.L. Carrascal
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - P. Olivares
- Intensive Care Service. Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A. Morales
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - N. Brox
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C. Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Yu X, Wang L, Zheng X, Wen Y, Zhang Z, Fan L, Zhou Q, Yang X, Xue B, Lin Y. Moraxella occupied the largest proportion in the nasal microbiome in healthy children, which potential protect them from COVID-19. Microb Pathog 2022; 170:105685. [PMID: 35870694 PMCID: PMC9299982 DOI: 10.1016/j.micpath.2022.105685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND In the prevalence of COVID-19, infection symptoms are different in children and adults. In this study to investigate the differences in the upper respiratory tract microbiome profile between healthy children and adults and to explore which microbiome protect them from COVID-19. METHODS Thirty healthy children and 24 healthy adults were enrolled between October 2020 and January 2021. Nasal and throat swabs were obtained at enrollment, and DNA was extracted. We performed 16S rDNA sequencing to compare the alpha and beta diversity of the nasal and throat microbiomes between children and adults and assessed potential microbiome biomarkers. RESULTS In the nasal microbiome, there were significant differences between healthy children and adults, and Moraxella occupied the largest proportion in healthy children. Notably, there was no significant difference between healthy children and adults in the throat microbiome, and it was predominated by Firmicutes. In the function analysis, compared with adults, there was increased enrichment in pathways related to amino acid metabolism and lipid metabolism, in children. CONCLUSIONS In the upper respiratory tract microbiome profiles, Moraxella may be involved in protecting children from COVID-19 infections and may be involved the amino acid metabolism and lipid metabolism.
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Affiliation(s)
- Xia Yu
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Li Wang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - XueMei Zheng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yizhou Wen
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Zhirong Zhang
- Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, PR China
| | - Lingxia Fan
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Qin Zhou
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Xiao Yang
- Department of Obstetrics and Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Binqian Xue
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yonghong Lin
- Department of Obstetrics and Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, PR China.
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5
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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6
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Chait M, Yilmaz MM, Shakil S, Ku AW, Dogra P, Connors TJ, Szabo PA, Gray JI, Wells SB, Kubota M, Matsumoto R, Poon MM, Snyder ME, Baldwin MR, Sims PA, Saqi A, Farber DL, Weisberg SP. Immune and epithelial determinants of age-related risk and alveolar injury in fatal COVID-19. JCI Insight 2022; 7:157608. [PMID: 35446789 PMCID: PMC9228710 DOI: 10.1172/jci.insight.157608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/20/2022] [Indexed: 01/08/2023] Open
Abstract
Respiratory failure in COVID-19 is characterized by widespread disruption of the lung’s alveolar gas exchange interface. To elucidate determinants of alveolar lung damage, we performed epithelial and immune cell profiling in lungs from 24 COVID-19 autopsies and 43 uninfected organ donors ages 18–92 years. We found marked loss of type 2 alveolar epithelial (T2AE) cells and increased perialveolar lymphocyte cytotoxicity in all fatal COVID-19 cases, even at early stages before typical patterns of acute lung injury are histologically apparent. In lungs from uninfected organ donors, there was also progressive loss of T2AE cells with increasing age, which may increase susceptibility to COVID-19–mediated lung damage in older individuals. In the fatal COVID-19 cases, macrophage infiltration differed according to the histopathological pattern of lung injury. In cases with acute lung injury, we found accumulation of CD4+ macrophages that expressed distinctly high levels of T cell activation and costimulation genes and strongly correlated with increased extent of alveolar epithelial cell depletion and CD8+ T cell cytotoxicity. Together, our results show that T2AE cell deficiency may underlie age-related COVID-19 risk and initiate alveolar dysfunction shortly after infection, and we define immune cell mediators that may contribute to alveolar injury in distinct pathological stages of fatal COVID-19.
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Affiliation(s)
- Michael Chait
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Mine M Yilmaz
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Shanila Shakil
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Amy W Ku
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Pranay Dogra
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, United States of America
| | - Thomas J Connors
- Department of Pediatrics, Columbia University Irving Medical Center, New York, United States of America
| | - Peter A Szabo
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, United States of America
| | - Joshua I Gray
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, United States of America
| | - Steven B Wells
- Department of Systems Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Masaru Kubota
- Department of Surgery, Columbia University Irving Medical Center, New York, United States of America
| | - Rei Matsumoto
- Department of Surgery, Columbia University Irving Medical Center, New York, United States of America
| | - Maya Ml Poon
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, United States of America
| | - Mark E Snyder
- Department of Medicine, University of Pittsburgh, Pittsburgh, United States of America
| | - Matthew R Baldwin
- Department of Medicine, Columbia University Iring Medical Ceter, New York, United States of America
| | - Peter A Sims
- Department of Systems Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Anjali Saqi
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, United States of America
| | - Donna L Farber
- Department of Surgery, Columbia University Irving Medical Center, New York, United States of America
| | - Stuart P Weisberg
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, United States of America
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7
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Lu LY, Feng PH, Yu MS, Chen MC, Lin AJH, Chen JL, Yu LHL. Current utilization of interferon alpha for the treatment of coronavirus disease 2019: A comprehensive review. Cytokine Growth Factor Rev 2022; 63:34-43. [PMID: 35115233 PMCID: PMC8755267 DOI: 10.1016/j.cytogfr.2022.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 12/14/2022]
Abstract
Recent studies have identified an association between perturbed type I interferon (IFN) responses and the severity of coronavirus disease 2019 (COVID-19). IFNα intervention may normalize the dysregulated innate immunity of COVID-19. However, details regarding its utilization and therapeutic evidence have yet to be systematically evaluated. The aim of this comprehensive review was to summarize the current utilization of IFNα for COVID-19 treatment and to explore the evidence on safety and efficacy. A comprehensive review of clinical studies in the literature prior to December 1st, 2021, was performed to identify the current utilization of IFNα, which included details on the route of administration, the number of patients who received the treatment, the severity at the initiation of treatment, age range, the time from the onset of symptoms to treatment, dose, frequency, and duration as well as safety and efficacy. Encouragingly, no evidence was found against the safety of IFNα treatment for COVID-19. Early intervention, either within five days from the onset of symptoms or at hospital admission, confers better clinical outcomes, whereas late intervention may result in prolonged hospitalization.
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Affiliation(s)
- Ling-Ying Lu
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying District, Kaohsiung City, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd, Zhonghe District, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City, Taiwan
| | - Ming-Sun Yu
- Division of Hematology, Conde S. Januário Hospital, Estrada do Visconde de São Januário, Macau, China
| | - Min-Chi Chen
- Graduate Institute of Biomedical Sciences, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, Taiwan
| | - Alex Jia-Hong Lin
- Medical Affairs Department, Panco Healthcare Co., Ltd., a PharmaEssentia Company, 2F-5 No. 3 Park Street, Nangang District, Taipei, Taiwan
| | - Justin L. Chen
- Medical Affairs Department, Panco Healthcare Co., Ltd., a PharmaEssentia Company, 2F-5 No. 3 Park Street, Nangang District, Taipei, Taiwan
| | - Lennex Hsueh-Lin Yu
- Medical Affairs Department, Panco Healthcare Co., Ltd., a PharmaEssentia Company, 2F-5 No. 3 Park Street, Nangang District, Taipei, Taiwan,Corresponding author
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Aljohani FD, Khattab A, Elbadawy HM, Alhaddad A, Alahmadey Z, Alahmadi Y, Eltahir HM, Matar HMH, Wanas H. Prognostic factors for predicting severity and mortality in hospitalized COVID‐19 patients. J Clin Lab Anal 2022; 36:e24216. [PMID: 35076953 PMCID: PMC8906044 DOI: 10.1002/jcla.24216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 01/30/2023] Open
Abstract
Background Coronavirus disease 2019, COVID‐19, has reached all the corners of the world and was declared by the WHO as a global pandemic and public health emergency of international concern on the January 31, 2020. Allocating quick and specific biomarkers to predict the disease severity upon admission to hospital became a crucial need. This study, therefore, aimed at exploring the relationship between laboratory results in COVID‐19 patients admitted to hospital and the final outcome in these patients. Methods Retrospective analysis was performed on the medical records of 310 COVID‐19‐positive patients admitted to Uhod Hospital, the referral hospital in the area of Madinah, Kingdom of Saudi Arabia, between the April 13 and the July 29, 2020. The association of laboratory results with the survival/mortality outcomes was studied. Results It was demonstrated that lymphopenia, prolonged aPTT, high INR, high D. dimer and high CK are valuable prognostic predictors of the severity of the disease at early stages that can determine the outcome. Based on the results of the multiple logistic regression, the variables that are associated with death outcome are aPTT, HR, RR, ALT and CK level Conclusion It is proposed to perform these tests on admission to hospital for moderate to severe COVID‐19 patients to improve the management of those cases and reduce mortality.
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Affiliation(s)
| | | | - Hossein M. Elbadawy
- Department of Pharmacology and Toxicology College of Pharmacy Taibah University Madinah Saudi Arabia
| | - Aisha Alhaddad
- Department of Pharmacology and Toxicology College of Pharmacy Taibah University Madinah Saudi Arabia
| | | | - Yaser Alahmadi
- Department of Hospital and Clinical Pharmacy College of Pharmacy Taibah University Madinah Saudi Arabia
| | - Heba M. Eltahir
- Department of Pharmacology and Toxicology College of Pharmacy Taibah University Madinah Saudi Arabia
| | - Heba M. H. Matar
- Department of Anesthesia and Surgical Intensive Care Faculty of Medicine Zagazig University Zagazig Egypt
| | - Hanaa Wanas
- Department of Pharmacology and Toxicology College of Pharmacy Taibah University Madinah Saudi Arabia
- Department of Medical Pharmacology Faculty of Medicine Cairo University Cairo Egypt
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9
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Fang XM, Wang J, Liu Y, Zhang X, Wang T, Zhang HP, Liang ZA, Luo FM, Li WM, Liu D, Wang G. Combined and interactive effects of alcohol drinking and cigarette smoking on the risk of severe illness and poor clinical outcomes in patients with COVID-19: A multicentre retrospective cohort study. Public Health 2022; 205:6-13. [PMID: 35219128 PMCID: PMC8784431 DOI: 10.1016/j.puhe.2022.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/30/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
Abstract
Objectives Cigarette smoking is an established risk factor for illness severity and adverse outcomes in patients with COVID-19. Alcohol drinking may also be a potential risk factor for disease severity. However, the combined and interactive effects of drinking and smoking on COVID-19 have not yet been reported. This study aimed to examine the combined and interactive effects of alcohol drinking and cigarette smoking on the risk of severe illness and poor outcomes in patients with COVID-19. Study design This was a multicentre retrospective cohort study. Methods This study retrospectively reviewed the data of 1399 consecutive hospitalised COVID-19 patients from 43 designated hospitals. Patients were grouped according to different combinations of drinking and smoking status. Multivariate mixed-effects logistic regression models were used to estimate the combined and interactive effects of drinking and smoking on the risk of severe COVID-19 and poor clinical outcomes. Results In the study population, 7.3% were drinkers/smokers, 4.3% were drinkers/non-smokers and 4.9% were non-drinkers/smokers. After controlling for potential confounders, smokers or drinkers alone did not show a significant increase in the risk of severe COVID-19 or poor clinical outcomes compared with non-drinkers/non-smokers. Moreover, this study did not observe any interactive effects of drinking and smoking on COVID-19. Drinkers/smokers had a 62% increased risk (odds ratio = 1.62, 95% confidence interval: 1.01-2.60) of severe COVID-19 but did not have a significant increase in the risk for poor clinical outcomes compared with non-drinkers/non-smokers. Conclusions Combined exposure to drinking and smoking increases the risk of severe COVID-19, but no direct effects of drinking or smoking, or interaction effects of drinking and smoking, were detected.
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Affiliation(s)
- X M Fang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China
| | - Y Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - X Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - T Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - H P Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Z A Liang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - F M Luo
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China
| | - W M Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - D Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
| | - G Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan 610041, China.
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10
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Salerno S, Sun Y, Morris EL, He X, Li Y, Pan Z, Han P, Kang J, Sjoding MW, Li Y. Comprehensive evaluation of COVID-19 patient short- and long-term outcomes: Disparities in healthcare utilization and post-hospitalization outcomes. PLoS One 2021; 16:e0258278. [PMID: 34614008 PMCID: PMC8494298 DOI: 10.1371/journal.pone.0258278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/22/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Understanding risk factors for short- and long-term COVID-19 outcomes have implications for current guidelines and practice. We study whether early identified risk factors for COVID-19 persist one year later and through varying disease progression trajectories. METHODS This was a retrospective study of 6,731 COVID-19 patients presenting to Michigan Medicine between March 10, 2020 and March 10, 2021. We describe disease progression trajectories from diagnosis to potential hospital admission, discharge, readmission, or death. Outcomes pertained to all patients: rate of medical encounters, hospitalization-free survival, and overall survival, and hospitalized patients: discharge versus in-hospital death and readmission. Risk factors included patient age, sex, race, body mass index, and 29 comorbidity conditions. RESULTS Younger, non-Black patients utilized healthcare resources at higher rates, while older, male, and Black patients had higher rates of hospitalization and mortality. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss anemia were risk factors for these outcomes. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss were associated with lower discharge and higher inpatient mortality rates. CONCLUSIONS This study found differences in healthcare utilization and adverse COVID-19 outcomes, as well as differing risk factors for short- and long-term outcomes throughout disease progression. These findings may inform providers in emergency departments or critical care settings of treatment priorities, empower healthcare stakeholders with effective disease management strategies, and aid health policy makers in optimizing allocations of medical resources.
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Affiliation(s)
- Stephen Salerno
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Yuming Sun
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Emily L. Morris
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Xinwei He
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Yajing Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Ziyang Pan
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Peisong Han
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
| | - Michael W. Sjoding
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Yi Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States of America
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11
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Mira-Iglesias A, Mengual-Chuliá B, Cano L, García-Rubio J, Tortajada-Girbés M, Carballido-Fernández M, Mollar-Maseres J, Schwarz-Chavarri G, García-Esteban S, Puig-Barberà J, Díez-Domingo J, López-Labrador FX. Retrospective screening for SARS-CoV-2 among influenza-like illness hospitalizations: 2018-2019 and 2019-2020 seasons, Valencia region, Spain. Influenza Other Respir Viruses 2021; 16:166-171. [PMID: 34528756 PMCID: PMC8652788 DOI: 10.1111/irv.12899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 01/08/2023] Open
Abstract
On 9 March 2020, the World Health Organization (WHO) Global Influenza Programme (GIP) asked participant sites on the Global Influenza Hospital Surveillance Network (GIHSN) to contribute to data collection concerning severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). We re‐analysed 5833 viral RNA archived samples collected prospectively from hospital admissions for influenza‐like illness (ILI) in the Valencia Region of Spain by the Valencia Hospital Surveillance Network for the Study of Influenza and Other Respiratory Viruses (VAHNSI) network (four hospitals, catchment area population 1 118 732) during the pre‐pandemic 2018/2019 (n = 4010) and pandemic 2019/2020 (n = 1823) influenza seasons for the presence of SARS‐CoV‐2. We did not find evidence for community‐acquired SARS‐CoV‐2 infection in hospital admissions for ILI in our region before early March 2020.
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Affiliation(s)
- Ainara Mira-Iglesias
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - Beatriz Mengual-Chuliá
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain.,Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Cano
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - Javier García-Rubio
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | | | - Mario Carballido-Fernández
- Hospital General Universitario de Castellón, Castellón, Spain.,Universidad CEU Cardenal Herrera, Castellón, Spain
| | | | | | - Sandra García-Esteban
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - Joan Puig-Barberà
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - Javier Díez-Domingo
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - F Xavier López-Labrador
- Virology Laboratory, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain.,Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology and Ecology, University of Valencia, Spain
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12
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Gkoufa A, Maneta E, Ntoumas GN, Georgakopoulou VE, Mantelou A, Kokkoris S, Routsi C. Elderly adults with COVID-19 admitted to intensive care unit: A narrative review. World J Crit Care Med 2021; 10:278-289. [PMID: 34616662 PMCID: PMC8462023 DOI: 10.5492/wjccm.v10.i5.278] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/19/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the context of the Coronavirus disease 2019 (COVID-19) pandemic, it has been reported that elderly patients are particularly at risk of developing severe illness and exhibiting increased mortality. While many studies on hospitalized elderly patients with COVID-19 have been published, limited information is available on the characteristics and clinical outcomes of those elderly patients admitted to intensive care unit (ICU).
AIM To review the available evidence of the clinical data of elderly patients admitted to the ICU due to COVID-19.
METHODS We searched for published articles available in English literature to identify those studies conducted in critically ill patients admitted to the ICU due to COVID-19, either exclusively designed for the elderly or for the whole ICU population with COVID-19, provided that analyses according to the patients’ age had been conducted.
RESULTS Only one study exclusively focusing on critically ill elderly patients admitted to the ICU due to COVID-19 was found. Eighteen additional studies involving 17011 ICU patients and providing information for elderly patients as a subset of the whole study population have also been included in the present review article. Among the whole patient population, included in these studies, 8310 patients were older than 65 years of age and 2630 patients were older than 70 years. Clinical manifestations were similar for all patients; however, compared to younger ones, they suffered from more comorbidities and showed a varied, albeit high mortality.
CONCLUSION In summary, at present, although elderly patients constitute a considerable proportion of critically ill patients admitted to the ICU due to severe COVID-19, studies providing specific information are limited. The evidence so far suggests that advanced age and comorbidities are associated with worse clinical outcome. Future studies exclusively designed for this vulnerable group are needed.
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Affiliation(s)
- Aikaterini Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Eleni Maneta
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Georgios N Ntoumas
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Vasiliki E Georgakopoulou
- First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Athina Mantelou
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Stelios Kokkoris
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Christina Routsi
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
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13
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D V, Sharma A, Kumar A, Flora SJS. Neurological Manifestations in COVID-19 Patients: A Meta-Analysis. ACS Chem Neurosci 2021; 12:2776-2797. [PMID: 34260855 PMCID: PMC8291134 DOI: 10.1021/acschemneuro.1c00353] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
Common symptoms such as dizziness, headache, olfactory dysfunction, nausea, vomiting, etc. in COVID-19 patients have indicated the involvement of the nervous system. However, the exact association of the nervous system with COVID-19 infection is still unclear. Thus, we have conducted a meta-analysis of clinical studies associated with neurological problems in COVID-19 patients. We have searched for electronic databases with MeSH terms, and the studies for analysis were selected based on inclusion and exclusion criteria and quality assessment. The Stats Direct (version 3) was used for the analysis. The pooled prevalence with 95% confidence interval of various neurological manifestations reported in the COVID-19 patients was found to be headache 14.6% (12.2-17.2), fatigue 33.6% (29.5-37.8), olfactory dysfunction 26.4% (21.8-31.3), gustatory dysfunction 27.2% (22.3-32.3), vomiting 6.7% (5.5-8.0), nausea 9.8% (8.1-11.7), dizziness 6.7% (4.7-9.1), myalgia 21.4% (18.8-24.1), seizure 4.05% (2.5-5.8), cerebrovascular diseases 9.9% (6.8-13.4), sleep disorders 14.9% (1.9-36.8), altered mental status 17.1% (12.3-22.5), neuralgia 2.4% (0.8-4.7), arthralgia 19.9% (15.3-25.0), encephalopathy 23.5% (14.3-34.1), encephalitis 0.6% (0.2-1.3), malaise 38.3% (24.7-52.9), confusion 14.2% (6.9-23.5), movement disorders 5.2% (1.7-10.4), and Guillain-Barre syndrome 6.9% (2.3-13.7). However, the heterogeneity among studies was found to be high. Various neurological manifestations related to the central nervous system (CNS) and peripheral nervous system (PNS) are associated with COVID-19 patients.
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Affiliation(s)
- Vitalakumar D
- Department of Pharmacology and Toxicology,
National Institute of Pharmaceutical Education and Research
(NIPER)-Raeberali, Lucknow 226002, India
| | - Ankita Sharma
- Department of Biotechnology, National
Institute of Pharmaceutical Education and Research (NIPER)-Raeberali,
Lucknow 226002, India
| | - Anoop Kumar
- Department of Pharmacology and Clinical Research, Delhi
Institute of Pharmaceutical Sciences and Research (DIPSAR), Delhi
Pharmaceutical Sciences & Research University (DPSRU), New Delhi
110017, India
| | - S. J. S. Flora
- Department of Pharmacology and Toxicology,
National Institute of Pharmaceutical Education and Research
(NIPER)-Raeberali, Lucknow 226002, India
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14
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Martin PJ, Billet S, Landkocz Y, Fougère B. Inflammation at the Crossroads: the Combined Effects of COVID-19, Ageing, and Air Pollution. J Frailty Aging 2021; 10:281-285. [PMID: 34105713 PMCID: PMC7948651 DOI: 10.14283/jfa.2021.8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The global COVID-19 pandemic has highlighted different vulnerability profiles among individuals. With the highest mortality rate, the elderly are a very sensitive group. With regard to the main symptoms, a failure of the respiratory system, associated with deregulation of the immune system, has been observed. These symptoms may also be encountered in chronic exposure of susceptible populations to air pollution, including exacerbation of the inflammatory response. Is there a relationship between age, pollution exposure and the severity of COVID-19? Although it is unclear how these parameters are related, the same pathways can be activated and appear to find a common mechanism of action in inflammation.
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Affiliation(s)
- P J Martin
- Dr. Sylvain Billet, Univ. Littoral Côte d'Opale, UR 4492, UCEIV, Maison de la Recherche en Environnement Industriel 2, 189A, Avenue Maurice Schumann, 59140 Dunkerque, France. Phone: +33-3 28 23 76 41, E-mail:
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15
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Wang X, Chen L, Huang J, Pan J, Huang M, Chen L. Comparison of the clinical characteristics of patients with novel coronavirus pneumonia between China and overseas. J Clin Lab Anal 2021; 35:e23811. [PMID: 34080711 PMCID: PMC8209900 DOI: 10.1002/jcla.23811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND To explore the clinical manifestation, imaging examination, and serology of patients with novel coronavirus pneumonia (COVID-19) between China and overseas. METHODS Ninety patients with COVID-19 who admitted to Fuzhou Pulmonary Hospital from January 23, 2020, to May 1, 2020, were included in this retrospective study. They were divided into domestic group and overseas group according to the origin regions. The clinical manifestations, imaging examination, serology, treatment, and prognosis between the two groups were compared and analyzed. RESULTS The clinical manifestations of patients in the two groups mainly included fever (83.1% and 47.4%), cough (62% and 31.6%), expectoration (47.9% and 31.6%), anorexia (28.2% and 47.4%), fatigue (21.1% and 10.5%), and dyspnea (22.5% and 0%). The main laboratory characteristics in the two groups were decreased lymphocyte count, increased lactate dehydrogenase, decreased oxygenation index, decreased white blood cell count, increased erythrocyte sedimentation rate (ESR), and increased C-reactive protein. The computed tomography (CT) examinations of chest showed bilateral and peripheral involvement, with multiple patch shadows and ground glass shadows. However, pleural effusions were rare. CONCLUSION Fever, cough, and dyspnea are more common in domestic cases than overseas cases. However, patients with COVID-19 from overseas may have the symptoms of loss of taste and smell that domestic cases do not have.
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Affiliation(s)
- Xinhang Wang
- Department of Respiratory and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou, China
| | - Lulu Chen
- Department of Respiratory and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou, China
| | - Jinbao Huang
- Department of Respiratory and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou, China
| | - Jianguang Pan
- Department of Respiratory and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou, China
| | - Mingxiang Huang
- Department of Clinical Laboratory, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou, China
| | - Lizhou Chen
- Department of Respiratory and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou, China
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16
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Liu Y, He H, Huang H. The role and significance of angiotensin-converting enzyme 2 peptides in the treatment of coronavirus disease 2019. J Clin Lab Anal 2021; 35:e23789. [PMID: 33951227 PMCID: PMC8183920 DOI: 10.1002/jcla.23789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/09/2021] [Accepted: 04/02/2021] [Indexed: 12/28/2022] Open
Abstract
Since the end of 2019, coronavirus disease 2019 (COVID‐19) caused by the novel coronavirus (2019‐nCoV) posed a serious threat to human health and life. Therefore, the discovery of drugs that can effectively prevent and treat COVID‐19 is urgently warranted. In this article, the role and significance of angiotensin‐converting enzyme 2 in drug development and the treatment of COVID‐19 are discussed. It was found that the binding of ACE2 to SARS‐CoV‐2‐RBD involved two core regions (31st and 353rd lysine) and 20 amino acids of the ACE2 protein. The mutation of these amino acids could lead to a great change of the binding ability of ACE2 and SARS‐CoV‐2‐RBD. This information was important for us to find more efficient ACE2 peptides to block the 2019‐nCoV infection. So during this study, we summarized the role of ACE2 in the regulation of 2019‐nCoV infection and stress, and hypothesized that the development and optimization of ACE2 peptide can effectively block 2019‐nCoV infection and reliably treat the COVID‐19.
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Affiliation(s)
- Yang Liu
- The Department of Anesthesia, Huzhou Central Hospital, Affiliated Central Hospital HuZhou University, Huzhou, China
| | - Huanzhong He
- The Department of Anesthesia, Huzhou Central Hospital, Affiliated Central Hospital HuZhou University, Huzhou, China
| | - Huilian Huang
- Key Laboratory of Molecular Medicine, Huzhou Central Hospital, Affiliated Central Hospital HuZhou University, Huzhou, China
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17
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Feng YF, Wang KP, Mo JG, Xu YH, Wang LZ, Jin C, Chen X, Yi B. The spatiotemporal trend of renal involvement in COVID-19: A pooled analysis of 17 134 patients. Int J Infect Dis 2021; 106:281-288. [PMID: 33823283 PMCID: PMC8019246 DOI: 10.1016/j.ijid.2021.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The spatiotemporal trend of renal involvement in coronavirus disease 2019 (COVID-19) patients is still unclear. Therefore, the aim of this study was to reveal the dynamics of renal involvement superimposed COVID-19 according to time and space. METHODS COVID-19 patients reporting renal involvement were included in this study. The following information was collected from relevant articles: first author, patient demographics, patient enrollment period, location, definition of acute kidney injury (AKI), prevalence of AKI, and use of renal replacement therapy (RRT). RESULTS A total of 17 134 patients were finally included. The overall prevalence of AKI in COVID-19 patients was 19%, with 7% of them undergoing RRT. The overall risk of AKI in patients enrolled before March 1, 2020 (9%) was significantly lower than that after March 1, 2020 (36%) (P < 0.00001). Moreover, the overall risk of AKI outside Asia (35%) was significantly higher than that in Asia (10%) (P < 0.00001). Additionally, similar to patients requiring RRT, AKI patients were more likely to become seriously ill or even to die (P < 0.00001). CONCLUSIONS This study found that renal involvement superimposed COVID-19, a comorbidity portending a poor prognosis, has become an increasingly serious problem over time and is more common outside Asia. Thus, more attention should be paid to the management of this specific group of patients.
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Affiliation(s)
- Yi-Fu Feng
- Department of General Surgery, Taizhou Central Hospital, Taizhou 318000, China
| | - Kun-Peng Wang
- Department of General Surgery, Taizhou Central Hospital, Taizhou 318000, China
| | - Jing-Gang Mo
- Department of General Surgery, Taizhou Central Hospital, Taizhou 318000, China
| | - Ying-He Xu
- Department of Intensive Care Unit, Taizhou Central Hospital, Taizhou 318000, China
| | - Lie-Zhi Wang
- Department of General Surgery, Taizhou Central Hospital, Taizhou 318000, China
| | - Chong Jin
- Department of General Surgery, Taizhou Central Hospital, Taizhou 318000, China
| | - Xiang Chen
- Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510655, China; Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Hepatobiliary and Pancreatic Surgery, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Bin Yi
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Cardiothoracic Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
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18
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Ouyang L, Yu M, Zhu Y, Gong J. Respiratory supports of COVID-19 patients in intensive care unit: A systematic review. Heliyon 2021; 7:e06813. [PMID: 33898856 PMCID: PMC8051865 DOI: 10.1016/j.heliyon.2021.e06813] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/06/2021] [Accepted: 04/12/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION We aimed to describe the respiratory supports and determine their association with clinical outcomes of COVID-19 patients in intensive care unit (ICU). METHODS A systemic literature search was conducted in PubMed, EMBASE, MedRxiv and BioRxiv database from December 2019 to 2 July 2020. Studies reporting the application of respiratory supports in COVID-19 patients admitted to ICU were included. RESULTS Forty studies with 15320 COVID-19 patients were included in this systematic review. The proportion of invasive mechanical ventilation (IMV) application in ICU patients with COVID-19 was 73.8%. Further analysis elucidated that the use rate of IMV in Asia, Europe and North America was 47%, 76.2% and 80.2%, respectively. The proportion of patients treated with prone positioning and IMV was 29.4%. 25.5% of COVID-19 patients requiring IMV developed ventilator-associated pneumonia. The mortality of patients treated with IMV was 51.1%, while only 17.5% of critically ill COVID-19 patients treated with non-IMV respiratory support died. Additionally, the utilization rate of IMV in non-survival patients was shown 17.26-folds (95%CI 2.89-103.24, p = 0.002) higher than that in survival patients, while the use rate of ECMO was no significant difference. CONCLUSIONS Our findings highlight respiratory supports of COVID-19 patients admitted to ICU in different continents. IMV is a life-saving strategy for critically ill COVID-19 patients with ARDS, yet the mortality remains very high.
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Affiliation(s)
- Lichen Ouyang
- Department of Immunology, School of Medicine, Jianghan University, Wuhan, China
| | - Muqing Yu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zhu
- Reproductive Medicine Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Gong
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- The First Clinical College, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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19
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Lv DF, Ying QM, He YW, Liang J, Zhang JH, Lu BB, Qian GQ, Chu JG, Weng XB, Chen XQ, Mu QT. Differential diagnosis of coronavirus disease 2019 pneumonia or influenza A pneumonia by clinical characteristics and laboratory findings. J Clin Lab Anal 2021; 35:e23685. [PMID: 33576536 PMCID: PMC7891506 DOI: 10.1002/jcla.23685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 01/08/2023] Open
Abstract
Background Pneumonia caused by the 2019 novel Coronavirus (COVID‐2019) shares overlapping signs and symptoms, laboratory findings, imaging features with influenza A pneumonia. We aimed to identify their clinical characteristics to help early diagnosis. Methods We retrospectively retrieved data for laboratory‐confirmed patients admitted with COVID‐19–induced or influenza A–induced pneumonia from electronic medical records in Ningbo First Hospital, China. We recorded patients' epidemiological and clinical features, as well as radiologic and laboratory findings. Results The median age of influenza A cohort was higher and it exhibited higher temperature and higher proportion of pleural effusion. COVID‐19 cohort exhibited higher proportions of fatigue, diarrhea and ground‐glass opacity and higher levels of lymphocyte percentage, absolute lymphocyte count, red‐cell count, hemoglobin and albumin and presented lower levels of monocytes, c‐reactive protein, aspartate aminotransferase, alkaline phosphatase, serum creatinine. Multivariate logistic regression analyses showed that fatigue, ground‐glass opacity, and higher level of albumin were independent risk factors for COVID‐19 pneumonia, while older age, higher temperature, and higher level of monocyte count were independent risk factors for influenza A pneumonia. Conclusions In terms of COVID‐19 pneumonia and influenza A pneumonia, fatigue, ground‐glass opacity, and higher level of albumin tend to be helpful for diagnosis of COVID‐19 pneumonia, while older age, higher temperature, and higher level of monocyte count tend to be helpful for the diagnosis of influenza A pneumonia.
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Affiliation(s)
- Ding-Feng Lv
- School of Medicine, Ningbo University, Ningbo, China.,Department of Blood Transfusion, Ningbo First Hospital, Ningbo, China.,Department of Laboratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Qi-Ming Ying
- Department of Blood Transfusion, Ningbo First Hospital, Ningbo, China
| | - Yi-Wen He
- Department of Blood Transfusion, Ningbo First Hospital, Ningbo, China
| | - Jun Liang
- Department of Blood Transfusion, Ningbo First Hospital, Ningbo, China
| | - Ji-Hong Zhang
- Department of Medical Statistics, Ningbo First Hospital, Ningbo, China
| | - Bei-Bei Lu
- Department of Environment and Occupational Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Guo-Qing Qian
- Department of Infectious Disease, Ningbo First Hospital, Ningbo, China
| | - Jin-Guo Chu
- Department of General Practice, Ningbo First Hospital, Ningbo, China
| | - Xing-Bei Weng
- Department of Blood Transfusion, Ningbo First Hospital, Ningbo, China
| | - Xue-Qin Chen
- Department of Chinese Traditional Medicine, Ningbo First Hospital, Ningbo, China
| | - Qi-Tian Mu
- Laboratory of Stem Cell Transplantation, Ningbo First Hospital, Ningbo, China
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Affiliation(s)
- James P Hayes
- Respiratory Unit, Cavan Monaghan Hospital, RCSI Group, Lisdaran, Cavan H12 Y7W1, Ireland
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21
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Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clin Microbiol Infect 2021; 27:520-531. [PMID: 33418017 PMCID: PMC7785281 DOI: 10.1016/j.cmi.2020.12.018] [Citation(s) in RCA: 455] [Impact Index Per Article: 151.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
Background The proportion of patients infected with SARS-CoV-2 that are prescribed antibiotics is uncertain, and may contribute to patient harm and global antibiotic resistance. Objective The aim was to estimate the prevalence and associated factors of antibiotic prescribing in patients with COVID-19. Data Sources We searched MEDLINE, OVID Epub and EMBASE for published literature on human subjects in English up to June 9 2020. Study Eligibility Criteria We included randomized controlled trials; cohort studies; case series with ≥10 patients; and experimental or observational design that evaluated antibiotic prescribing. Participants The study participants were patients with laboratory-confirmed SARS-CoV-2 infection, across all healthcare settings (hospital and community) and age groups (paediatric and adult). Methods The main outcome of interest was proportion of COVID-19 patients prescribed an antibiotic, stratified by geographical region, severity of illness and age. We pooled proportion data using random effects meta-analysis. Results We screened 7469 studies, from which 154 were included in the final analysis. Antibiotic data were available from 30 623 patients. The prevalence of antibiotic prescribing was 74.6% (95% CI 68.3–80.0%). On univariable meta-regression, antibiotic prescribing was lower in children (prescribing prevalence odds ratio (OR) 0.10, 95% CI 0.03–0.33) compared with adults. Antibiotic prescribing was higher with increasing patient age (OR 1.45 per 10 year increase, 95% CI 1.18–1.77) and higher with increasing proportion of patients requiring mechanical ventilation (OR 1.33 per 10% increase, 95% CI 1.15–1.54). Estimated bacterial co-infection was 8.6% (95% CI 4.7–15.2%) from 31 studies. Conclusions Three-quarters of patients with COVID-19 receive antibiotics, prescribing is significantly higher than the estimated prevalence of bacterial co-infection. Unnecessary antibiotic use is likely to be high in patients with COVID-19.
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Shi S, Liu X, Xiao J, Wang H, Chen L, Li J, Han K. Prediction of adverse clinical outcomes in patients with coronavirus disease 2019. J Clin Lab Anal 2021; 35:e23598. [PMID: 32989838 PMCID: PMC7536920 DOI: 10.1002/jcla.23598] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This study aims to investigate blood and biochemical laboratory findings in patients with coronavirus disease (COVID-19) and analyze the potential predictors of poor outcome in patients with COVID-19. METHODS The clinical, laboratory, and outcome data of 87 patients with COVID-19 were collected and retrospectively analyzed. Only data collected at the time of admission were used in the analysis for predictors of poor outcome. These patients were divided into two groups: the adverse prognosis group (36 patients) and the non-adverse prognosis group (51 patients). The adverse prognosis of COVID-19 patients was defined as admission to the intensive care unit or death. RESULTS On the univariate analysis, age, white blood cell (WBC) count, neutrophil counts, lymphocytes count, neutrophils-to-lymphocytes ratio (NLR), interleukin-6, albumin-to-globulin ratio (AGR), albumin, lactate dehydrogenase, glutamyl transpeptidase, and blood glucose were found to be the significant predictors. On the multivariate analysis, the predictors of poor outcome of patients with COVID-19 were NLR (OR = 2.741, [95% CI = 1.02 ~ 7.35], P = .045) and IL-6 (OR = 1.405, [95% CI = 1.04 ~ 1.89, P = .025]). The receiver operating characteristic (ROC) curve revealed that the AUC of NLR, interleukin-6, pneumonia severity index (PSI) score, and Confusion-Urea-Respiratory Rate-Blood pressure-65 (CURB-65) score were 0.883, 0.852, 0.824, and 0.782, respectively. CONCLUSION High interleukin-6 (6 pg/mL, cuff value) and NLR (4.48, cuff value) can be used to predict poor outcomes in patients with COVID-19 on admission, thus can serve as a beneficial tool for timely identifying COVID-19 patients prone to poor outcome and reduce patient mortality through early intervention.
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Affiliation(s)
- Si Shi
- The Respiratory DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Xiaohui Liu
- The Respiratory DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Jinling Xiao
- The Respiratory DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Hongwei Wang
- The Respiratory DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Liyan Chen
- The Infectious DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Jianing Li
- The Respiratory DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Kaiyu Han
- The Respiratory DepartmentThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
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Yan X, Wang S, Ma P, Yang B, Si D, Liu G, Liu L, Ding M, Yang W, Li J, Sun H, Yang P. Cardiac injury is associated with inflammation in geriatric COVID-19 patients. J Clin Lab Anal 2021; 35:e23654. [PMID: 33210392 PMCID: PMC7744922 DOI: 10.1002/jcla.23654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Geriatric patients with coronavirus disease (COVID-19) are at high risk of developing cardiac injury. Identifying the factors that affect high-sensitivity cardiac troponin I may indicate the cause of cardiac injury in elderly patients, and this could hopefully assist in protecting heart function in this patient population. METHODS One hundred and eighty inpatients who were admitted for COVID-19 were screened. Patients older than 60 years were included in this study, and the clinical characteristics and laboratory results of the cohort were analyzed. The correlation between cardiac injury and clinical/laboratory variables was statistically analyzed, and further logistic regression was performed to determine how these variables influence cardiac injury in geriatric patients. RESULTS Age (p < 0.001) significantly correlated with cardiac injury, whereas sex (p = 0.372) and coexisting diseases did not. Rising procalcitonin (p = 0.001), interleukin-2 receptor (p < 0.001), interleukin 6 (p = 0.001), interleukin 10 (p < 0.001), tumor necrosis factor α (p = 0.001), high-sensitivity C-reactive protein (p = 0.001), D-dimer (p < 0.001), white blood cells (p < 0.001), neutrophils (p = 0.001), declining lymphocytes (p < 0.001), and natural killer cells (p = 0.005) were associated with cardiac injury and showed predictive ability in the multivariate logistic regression. CONCLUSION Our results suggest that age and inflammatory factors influence cardiac injury in elderly patients. Interfering with inflammation in this patient population may potentially confer cardiac protection.
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Affiliation(s)
- Xu Yan
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Shuang Wang
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Piyong Ma
- Intensive care unitChina‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Bo Yang
- Institute of Organ TransplantationTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Daoyuan Si
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Guohui Liu
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Long Liu
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Mei Ding
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Wen Yang
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Jiayu Li
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Huan Sun
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Ping Yang
- Cardiology DepartmentChina‐Japan Union Hospital of Jilin UniversityChangchunChina
- Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular DiseaseChangchunChina
- COVID Medical Team of China‐Japan Union Hospital of Jilin UniversityChangchunChina
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Asai A, Yasuoka H, Matsui M, Okamoto N, Fukunishi S, Higuchi K. Exacerbation of liver dysfunction in non-alcoholic steatohepatitis patients during the coronavirus disease 2019 (COVID-19) pandemic. J Clin Biochem Nutr 2020; 68:243-245. [PMID: 34025027 PMCID: PMC8129973 DOI: 10.3164/jcbn.20-136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
Many people were forced to stay at home, including non-alcoholic steatohepatitis (NASH) patients, however it is unclear how this home-life has affected the prognosis of NASH. In this study, we examined the influences of living at home during the coronavirus disease 2019 (COVID-19) pandemic NASH patients. In this study, we compared the clinical parameters of NASH patients without COVID-19 infection 3 months before with those 3 months after the declaration of a state of emergency. In the results, the changes of aspartate transaminase and alanine aminotransferase in the 3 months before (aspartate transaminase, -3.6 ± 13.8 U/L; alanine aminotransferase, -6.8 ± 19.5 U/L) was significantly exacerbated in the 3 months after (aspartate transaminase, 2.3 ± 7.5 U/L; alanine aminotransferase, 1.7 ± 10.4 U/L). Furthermore, the changes of the fibrosis-4 index in the 3 months before (-0.27 ± 0.84) was also significantly exacerbated in the 3 months after (0.38 ± 0.96). In conclusion, liver dysfunctions in NASH patients were exacerbated due to the emergency declaration and outing restriction which accompanied COVID-19.
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Affiliation(s)
- Akira Asai
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Hidetaka Yasuoka
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Masahiro Matsui
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Norio Okamoto
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
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Hasan SS, Capstick T, Ahmed R, Kow CS, Mazhar F, Merchant HA, Zaidi STR. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis. Expert Rev Respir Med 2020; 14:1149-1163. [PMID: 32734777 PMCID: PMC7544968 DOI: 10.1080/17476348.2020.1804365] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The acute respiratory distress syndrome (ARDS) secondary to viral pneumonitis is one of the main causes of high mortality in patients with COVID-19 (novel coronavirus disease 2019). We systematically reviewed mortality in COVID-19 patients with ARDS and the potential role of systemic corticosteroids in COVID-19 patients. METHODS Electronic databases and country-specific healthcare databases were searched to identify relevant studies/reports. The quality assessment of individual studies was conducted using the Newcastle-Ottawa Scale. Country-specific proportion of individuals with COVID-19 who developed ARDS and reported death were combined in a random-effect meta-analysis to give a pooled mortality estimate of ARDS. RESULTS The overall pooled mortality estimate among 10,815 ARDS cases in COVID-19 patients was 39% (95% CI: 23-56%). The pooled mortality estimate for China was 69% (95% CI: 67-72%). In Europe, the highest mortality estimate among COVID-19 patients with ARDS was reported in Poland (73%; 95% CI: 58-86%) while Germany had the lowest mortality estimate (13%; 95% CI: 2-29%) among COVID-19 patients with ARDS. The median crude mortality rate of COVID-19 patients with reported corticosteroid use was 28.0% (lower quartile: 13.9%; upper quartile: 53.6%). CONCLUSIONS The high mortality in COVID-19 associated ARDS necessitates a prompt and aggressive treatment strategy which includes corticosteroids. Most of the studies included no information on the dosing regimen of corticosteroid therapy, however, low-dose corticosteroid therapy or pulse corticosteroid therapy appears to have a beneficial role in the management of severely ill COVID-19 patients.
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Affiliation(s)
- Syed Shahzad Hasan
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
- CONTACT Syed Shahzad Hasan University of Huddersfield, Queensgate, Huddersfield, West Yorkshire HD1 3DH, UK
| | - Toby Capstick
- Leeds Teaching Hospitals NHS Trust, St. James’s University Hospital, Leeds, UK
| | - Raees Ahmed
- Healing Lungs, HCA Conroe Hospital, Critical Care Unit, Conroe, TE, USA
| | - Chia Siang Kow
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Faizan Mazhar
- Department of Biomedical and Clinical Sciences L. Sacco, “Luigi Sacco”, University Hospital, Università Di Milano, Milan, Italy
| | - Hamid a Merchant
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Syed Tabish Razi Zaidi
- School of Healthcare, University of Leeds, Leeds, & Leeds Teaching Hospitals Trust, Leeds, UK
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Lu J, Yin Q, Li Q, Fu G, Hu X, Huang J, Chen L, Li Q, Guo Z. Clinical characteristics and factors affecting the duration of positive nucleic acid test for patients of COVID-19 in XinYu, China. J Clin Lab Anal 2020; 34:e23534. [PMID: 32860649 PMCID: PMC7595898 DOI: 10.1002/jcla.23534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 12/20/2022] Open
Abstract
Background The outbreak of a new coronavirus, COVID‐19, which was earliest reported in Wuhan, China, is now transmitting throughout the world. The aim of this study was to articulate the clinical characteristics of COVID‐19 and to reveal possible factors that may affect the persistent time of positive SARS‐CoV‐2 nucleic acid test, so as to identify which patients may deteriorate or have poor prognoses as early as possible. Methods Retrospective cohort study was carried out on 47 patients with confirmed COVID‐19 infection admitted to XinYu People's Hospital of JiangXi Province. Epidemiological, demographic, clinical, laboratorial, management, treatment, and outcome data were also collected and analyzed. Results In this study, patients were divided into two groups based on whether their SARS‐CoV‐2 nucleic acid tests in respiratory specimens turn negative within (Group Rapid or Group R) or over (Group Slow or Group S) a week. There was no significant difference in age, sex, travel or exposure history, and smoking history between the two groups. Forty‐two patients had been observed with comorbidities. Similar clinical manifestations, for instance fever, cough, sputum, and fatigue, have been observed among patients in both groups, except that patients in Group S were obviously more likely to get fatigue than patients in Group R. Both groups had shown decrease in white blood cell or lymphocyte counts. Chest X‐ray or computed tomography scan showed unilateral or bilateral infiltrates. High proportion in both groups has used nasal cannula (89.47% vs. 85.71%) to inhale oxygen. 10.53% of Group S have applied high‐flow nasal cannula, while Group R used none. The current treatment is mainly antibiotics, antiviral, and traditional Chinese medicine, while a couple of patients has used methylprednisolone. Only 1 patient out of both groups got even worse despite this active treatment. Conclusion Clinical characteristics of COVID‐19 include the exposure history and typical systemic symptoms such as fever, cough, fatigue, decreased WBC and lymphocyte counts, and infiltration in both lower lobes on CT imaging. Among them, fatigue appears to be an important factor that affects the duration of positive SARS‐CoV‐2 nucleic acid test in respiratory specimens.
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Affiliation(s)
- Jingjing Lu
- Department of Pulmonary and Critical Care Medicine, Shanghai, East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China
| | - Qi Yin
- Department of Pulmonary and Critical Care Medicine, Shanghai, East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China
| | - Quan Li
- Department of Respiratory Medicine, Shanghai East Hospital JiAn Hospital, JiAn, JiangXi, China
| | - Gang Fu
- Department of Infectious Diseases, XinYu People's Hospital, XinYu, JiangXi, China
| | - Xueping Hu
- Department of Pulmonary and Critical Care Medicine, Shanghai, East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China
| | - Jianhao Huang
- Department of Pulmonary and Critical Care Medicine, Shanghai, East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China
| | - Lin Chen
- Department of Respiratory Medicine, Shanghai East Hospital JiAn Hospital, JiAn, JiangXi, China
| | - Qiang Li
- Department of Pulmonary and Critical Care Medicine, Shanghai, East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China
| | - Zhongliang Guo
- Department of Pulmonary and Critical Care Medicine, Shanghai, East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China
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Shi M, Chen L, Yang Y, Zhang J, Xu J, Xu G, Li B, Yin Y. Analysis of clinical features and outcomes of 161 patients with severe and critical COVID-19: A multicenter descriptive study. J Clin Lab Anal 2020; 34:e23415. [PMID: 32488958 PMCID: PMC7300573 DOI: 10.1002/jcla.23415] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study aimed to investigate clinical characteristics, laboratory indexes, treatment regimens, and short-term outcomes of severe and critical coronavirus disease 2019 (COVID-19) patients. METHODS One hundred and sixty one consecutive severe and critical COVID-19 patients admitted in intensive care unit (ICU) were retrospectively reviewed in this multicenter study. Demographic features, medical histories, clinical symptoms, lung computerized tomography (CT) findings, and laboratory indexes on admission were collected. Post-admission complications, treatment regimens, and clinical outcomes were also documented. RESULTS The mean age was 59.38 ± 16.54 years, with 104 (64.60%) males and 57 (35.40%) females. Hypertension (44 [27.33%]) and diabetes were the most common medical histories. Fever (127 [78.88%]) and dry cough (111 [68.94%]) were the most common symptoms. Blood routine indexes, hepatic and renal function indexes, and inflammation indexes were commonly abnormal. Acute respiratory distress syndrome (ARDS) was the most common post-admission complication (69 [42.86%]), followed by electrolyte disorders (48 [29.81%]), multiple organ dysfunction (MODS) (37 [22.98%]), and hypoproteinemia (36 [22.36%]). The most commonly used antiviral drug was lopinavir/ritonavir tablet. 50 (31.06%) patients died, while 78 (48.45%) patients healed and discharged, and the last 33 (20.50%) patients remained in hospital. Besides, the mean hospital stay of deaths was 21.66 ± 11.18 days, while the mean hospital stay of discharged patients was 18.42 ± 12.77 days. Furthermore, ARDS (P < .001) and MODS (P = .008) correlated with increased mortality rate. CONCLUSION Severe and critical COVID-19 presents with high mortality rate, and occurrence of ARDS or MODS greatly increases its mortality risk.
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Affiliation(s)
- Ming Shi
- Department of Respiratory Medicine, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - Lianhua Chen
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Yadong Yang
- Department of Critical Care Medicine, Huanggang Central Hospital, Huanggang, China
| | - Jingpeng Zhang
- Department of Critical Care Medicine, Huanggang Central Hospital, Huanggang, China
| | - Ji Xu
- Departmen of Critical Care Medicine, Qichun People's Hospital, Qichun, China
| | - Gang Xu
- Department of Critical Care Medicine, Wuxue People's Hospital, Wuxue, China
| | - Bin Li
- Department of Medical Laboratory, Huanggang Central Hospital, Huanggang, China
| | - Yiping Yin
- Department of Respiratory Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, China
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