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Banerjee S, Khubchandani J, Tisinger S, Batra K, Greenway M. Mortality risk among adult americans living with cancer and elevated CRP. Cancer Epidemiol 2024; 90:102569. [PMID: 38599039 DOI: 10.1016/j.canep.2024.102569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
The role of C Reactive Protein (CRP) in predicting long-term outcomes among people living with cancer has not been well explored. We aimed to assess the role of elevated CRP in predicting all-cause mortality among a community-based sample of adult Americans living with cancer. The National Health and Nutrition Examination Survey, 1999-2010 was linked with mortality files up to December 2019 from the National Death Index. Sociodemographic and health-related variables of 30,711 participants (mean age=46.5 years) were analyzed to compute adjusted hazard ratios (HR) for all-cause mortality. The risk of mortality, in unadjusted analysis, was significantly higher among those with cancer compared to those without cancer 3.53 (95% CI= 3.13-3.98, p < 0.001). In adjusted analysis, when stratified by CRP levels (elevated=cutoff point at ≥2 mg/dL), among individuals with elevated CRP but no cancer history, the risk of mortality was significantly higher (HR=1.67, 95% CI=1.24-2.25) compared to those without cancer or elevated CRP. Among individuals with cancer but without elevated CRP as well, the risk of mortality was 20% higher compared to their counterparts. The highest risk of mortality was observed among those with both cancer and elevated CRP (HR=2.10, 95% CI=1.11-4.33). Age and income were significant predictors of these relationships. Among people living with cancer, CRP may serve as a marker for mortality and future studies should explore the pathways by which the risk of mortality may increase due to variation of CRP in cancer patients.
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Affiliation(s)
- Srikanta Banerjee
- College of Health Sciences, Walden University, Minneapolis, MN 55401, United States
| | - Jagdish Khubchandani
- College of Health, Education, and Social Transformation, New Mexico State University, Las Cruces, NM 88003, United States.
| | - Shalika Tisinger
- College of Health Sciences, Walden University, Minneapolis, MN 55401, United States
| | - Kavita Batra
- Department of Medical Education, University of Nevada, Las Vegas, Las Vegas, NV 89102, United States
| | - Maribeth Greenway
- Department of Infection Prevention and Control, Carilion Clinic, Roanoke, VA 24014, United States
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Safarnezhad Tameshkel F, Mandehgar-najafabadi M, Ahmadzadeh M, Anoushirvani A, Alibeik N, Dini P, Perumal D, Rahimian N, Karbalaie Niya MH. Evaluation of three common scoring systems in COVID-19 patients: neutrophil-lymphocyte ratio (NLR), The Acute Physiology and Chronic Health Evaluation II (APACHE II), and C-reactive protein (CRP). Ann Med Surg (Lond) 2024; 86:811-818. [PMID: 38333304 PMCID: PMC10849451 DOI: 10.1097/ms9.0000000000001503] [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: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 02/10/2024] Open
Abstract
Background As SARS-CoV-2 becomes a major global health, the authors aimed to predict the severity of the disease, the length of hospitalization, and the death rate of COVID-19 patients based on The Acute Physiology and Chronic Health Evaluation II (APACHE II) criteria, neutrophil-lymphocyte ratio (NLR), and C-reactive protein (CRP) levels to prioritize, and use them for special care facilities. Methods In a retrospective study, 369 patients with COVID-19 hospitalized in the ICU from March 2021 to April 2022, were evaluated. In addition to the APACHE II score, several of laboratory factors, such as CRP and NLR, were measured. Results The values of CRP, NLR, and APACHE II scores were significantly higher in hospitalized and intubated patients, as well as those who died 1 month and 3 months after hospital discharge than those in surviving patients. The baseline NLR levels were the strongest factor that adversely affected death in the hospital, death 1 month and 3 months after discharge, and it was able to predict death, significantly. Conclusion CRP, NLR, and APACHE II were all linked to prognostic factors in COVID-19 patients. NLR was a better predictor of disease severity, the need for intubation, and death than the other two scoring tools.
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Affiliation(s)
| | | | - Mozhgan Ahmadzadeh
- Department of Cellular & Molecular, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | | | | | | | - Dhayaneethie Perumal
- Commission for Academic Accreditation, Ministry of Education, Khalifa City, Abu Dhabi, UAE
| | | | - Mohammad Hadi Karbalaie Niya
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Virology, School of Medicine, Iran University of Medical Sciences
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Couissi A, Haboub M, Hamady S, Ettachfini T, Habbal R. Predictors of mortality in heart failure patients with reduced or mildly reduced Ejection Fraction: The CASABLANCA HF Study. Egypt Heart J 2024; 76:5. [PMID: 38252358 PMCID: PMC10803706 DOI: 10.1186/s43044-024-00436-y] [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: 08/28/2023] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Heart failure (HF) poses a significant public health challenge throughout the world and Morocco. Our objective was to delineate the epidemiological characteristics of Moroccan patients living with chronic heart failure and to identify prognostic factors correlated with CHF mortality. RESULTS A total of 1344 patients participated in this study, with survival rates at 3, 6, and 10 years recorded at 75.2%, 60%, and 34%, respectively. During the follow-up, 886 patients succumbed, representing a mortality rate of 65.9%. A Cox regression model, utilizing baseline candidate variables, was developed to predict cardiovascular (CV) mortality. Predictors all of which had a P value less than 0.05 included age, left ventricular ejection fraction (EF) at commencement (< 35%), hypertension, male sex, anemia, creatinine levels, and the number of hospitalizations due to HF decompensation. Notably, the frequency of hospitalizations emerged as the most potent predictor of mortality, with an HR of 2.5 (95% CI [2-2.9]). Almost 90% of patients with three or more readmissions for HF decompensation experienced mortality by the follow-up's conclusion. CONCLUSIONS This study offers valuable insights into risk factors and clinical outcomes in HF patients in Morocco. Factors such as male gender, advanced age, a history of hypertension, lower systolic blood pressure, rehospitalizations for HF decompensation, low left ventricular ejection fraction, anemia, and elevated creatinine levels were associated with increased mortality. Medical and health services managers should be aware of the substantial burden and future challenges posed by HF in Morocco, prompting the adoption of multidisciplinary strategies for its management and care.
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Affiliation(s)
- Abdessamad Couissi
- Cardiology Department of Ibn Rochd University Hospital , Casablanca, Morocco.
- Hassan II University, Faculty of Medicine and Pharmacy of Casablanca, Casablanca, Morocco.
| | - Meryem Haboub
- Cardiology Department of Ibn Rochd University Hospital , Casablanca, Morocco
| | - Siyam Hamady
- Cardiology Department of Ibn Rochd University Hospital , Casablanca, Morocco
| | - Taha Ettachfini
- Cardiology Department of Ibn Rochd University Hospital , Casablanca, Morocco
| | - Rachida Habbal
- Cardiology Department of Ibn Rochd University Hospital , Casablanca, Morocco
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Arvunescu AM, Ionescu RF, Cretoiu SM, Dumitrescu SI, Zaharia O, Nanea IT. Inflammation in Heart Failure-Future Perspectives. J Clin Med 2023; 12:7738. [PMID: 38137807 PMCID: PMC10743797 DOI: 10.3390/jcm12247738] [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: 11/05/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Chronic heart failure is a terminal point of a vast majority of cardiac or extracardiac causes affecting around 1-2% of the global population and more than 10% of the people above the age of 65. Inflammation is persistently associated with chronic diseases, contributing in many cases to the progression of disease. Even in a low inflammatory state, past studies raised the question of whether inflammation is a constant condition, or if it is, rather, triggered in different amounts, according to the phenotype of heart failure. By evaluating the results of clinical studies which focused on proinflammatory cytokines, this review aims to identify the ones that are independent risk factors for heart failure decompensation or cardiovascular death. This review assessed the current evidence concerning the inflammatory activation cascade, but also future possible targets for inflammatory response modulation, which can further impact the course of heart failure.
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Affiliation(s)
- Alexandru Mircea Arvunescu
- Department of Internal Medicine and Cardiology, “Prof. Dr. Th. Burghele” Clinical Hospital, 061344 Bucharest, Romania; (O.Z.); (I.T.N.)
- Department of Cardio-Thoracic Pathology, Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050471 Bucharest, Romania
| | - Ruxandra Florentina Ionescu
- Department of Cardiology I, Central Military Emergency Hospital “Dr Carol Davila”, 030167 Bucharest, Romania (S.I.D.)
- Department of Morphological Sciences, Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Sanda Maria Cretoiu
- Department of Morphological Sciences, Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Silviu Ionel Dumitrescu
- Department of Cardiology I, Central Military Emergency Hospital “Dr Carol Davila”, 030167 Bucharest, Romania (S.I.D.)
- Department of Cardiology, Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Ondin Zaharia
- Department of Internal Medicine and Cardiology, “Prof. Dr. Th. Burghele” Clinical Hospital, 061344 Bucharest, Romania; (O.Z.); (I.T.N.)
- Department of Cardio-Thoracic Pathology, Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050471 Bucharest, Romania
| | - Ioan Tiberiu Nanea
- Department of Internal Medicine and Cardiology, “Prof. Dr. Th. Burghele” Clinical Hospital, 061344 Bucharest, Romania; (O.Z.); (I.T.N.)
- Department of Cardio-Thoracic Pathology, Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050471 Bucharest, Romania
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Kato CD, Nsubuga J, Niyonzima N, Kitibwa A, Matovu E, Othieno E, Ssebugere P, Tumwine AA, Namayanja M. Immunological and biochemical biomarker alterations among SARS-COV-2 patients with varying disease phenotypes in Uganda. BMC Infect Dis 2023; 23:857. [PMID: 38057707 DOI: 10.1186/s12879-023-08854-0] [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: 05/11/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023] Open
Abstract
Every novel infection requires an assessment of the host response coupled with identification of unique biomarkers for predicting disease pathogenesis, treatment targets and diagnostic utility. Studies have exposed dysregulated inflammatory response induced by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as significant predictor or cause of disease severity/prognosis and death. This study evaluated inflammatory biomarkers induced by SARS-CoV-2 in plasma of patients with varying disease phenotypes and healthy controls with prognostic or therapeutic potential. We stratified SARS-CoV-2 plasma samples based on disease status (asymptomatic, mild, severe, and healthy controls), as diagnosed by RT-PCR SARS-CoV-2. We used a solid phase sandwich and competitive Enzyme-Linked Immunosorbent Assay (ELISA) to measure levels of panels of immunological (IFN-γ, TNF-α, IL-6, and IL-10) and biochemical markers (Ferritin, Procalcitonin, C-Reactive Protein, Angiotensin II, Homocysteine, and D-dimer). Biomarker levels were compared across SARS-CoV-2 disease stratification. Plasma IFN-γ, TNF-α, IL-6, and IL-10 levels were significantly (P < 0.05) elevated in the severe SARS-CoV-2 patients as compared to mild, asymptomatic, and healthy controls. Ferritin, Homocysteine, and D-dimer plasma levels were significantly elevated in severe cases over asymptomatic and healthy controls. Plasma C-reactive protein and Angiotensin II levels were significantly (P < 0.05) higher in mild than severe cases and healthy controls. Plasma Procalcitonin levels were significantly higher in asymptomatic than in mild, severe cases and healthy controls. Our study demonstrates the role of host inflammatory biomarkers in modulating the pathogenesis of COVID-19. The study proposes a number of potential biomarkers that could be explored as SARS-CoV-2 treatment targets and possible prognostic predictors for a severe outcome. The comprehensive analysis of prognostic biomarkers may contribute to the evidence-based management of COVID-19 patients.
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Affiliation(s)
- Charles Drago Kato
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda.
| | - Julius Nsubuga
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda.
| | | | - Annah Kitibwa
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Enock Matovu
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Emmanuel Othieno
- Department of Pathology, Soroti University, P.O. Box 211, Soroti, Uganda
| | - Patrick Ssebugere
- Department of Chemistry, College of Natural Sciences, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Amanda Agnes Tumwine
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Monica Namayanja
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda
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Garofalo M, Corso R, Tomasoni D, Adamo M, Lombardi CM, Inciardi RM, Gussago C, Di Mario C, Metra M, Pagnesi M. Inflammation in acute heart failure. Front Cardiovasc Med 2023; 10:1235178. [PMID: 38045909 PMCID: PMC10690826 DOI: 10.3389/fcvm.2023.1235178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Acute heart failure (AHF) represents a common clinical scenario that requires prompt evaluation and therapy and that is characterized by a high risk of mortality or subsequent rehospitalizations. The pathophysiology leading to AHF decompensation is still not fully understood. Significant activation of inflammatory pathways has been identified in patients with AHF, particularly in its most severe forms, and it has been hypothesized that systemic inflammation has a role in AHF pathogenesis. Several inflammatory mediators and cytokines, such as high sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-6, interleukin-1, soluble suppression of tumorigenicity 2 and galectin-3, have been shown to play a role in the pathogenesis, development and worsening of this condition with an independent prediction of adverse outcomes. This manuscript reviews the prevalence and prognostic value of systemic inflammation in AHF, as well as the potential role of anti-inflammatory therapies, focusing on available evidence from clinical trials and ongoing studies.
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Affiliation(s)
- Manuel Garofalo
- Department of Cardiology, Careggi University Hospital, Florence, Italy
| | - Rossana Corso
- Department of Internal Medicine, ASST Sette Laghi, Varese, Italy
| | - Daniela Tomasoni
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Marianna Adamo
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Carlo M. Lombardi
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Riccardo M. Inciardi
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Cristina Gussago
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Carlo Di Mario
- Department of Cardiology, Careggi University Hospital, Florence, Italy
| | - Marco Metra
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Matteo Pagnesi
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
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Nukovic JA, Opancina V, Zdravkovic N, Prodanovic N, Pejcic A, Opancina M, Nukovic JJ, Vojinovic R, Dulovic D, Jukovic F, Hamzagic N, Nukovic M, Markovic NV. Brixia Chest X-ray Score, Laboratory Parameters and Vaccination Status for Prediction of Mortality in COVID-19 Hospitalized Patients. Diagnostics (Basel) 2023; 13:2122. [PMID: 37371019 DOI: 10.3390/diagnostics13122122] [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: 04/28/2023] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Chest X-ray has verified its role as a crucial tool in COVID-19 assessment due to its practicability, especially in emergency units, and Brixia score has proven as a useful tool for COVID-19 pneumonia grading. The aim of our study was to investigate correlations between main laboratory parameters, vaccination status, and Brixia score, as well as to confirm if Brixia score is a significant independent predictor of unfavorable outcome (death) in COVID-19 patients. The study was designed as a cross-sectional multicentric study. It included patients with a diagnosed COVID-19 infection who were hospitalized. This study included a total of 279 patients with a median age of 62 years. The only significant predictor of unfavorable outcome (death) was Brixia score (adjusted odds ratio 1.148, p = 0.022). In addition, the results of the multiple linear regression analysis (R2 = 0.334, F = 19.424, p < 0.001) have shown that male gender (B = 0.903, p = 0.046), severe COVID-19 (B = 1.970, p < 0.001), and lactate dehydrogenase (B = 0.002, p < 0.001) were significant positive predictors, while albumin level (B = -0.211, p < 0.001) was a significant negative predictor of Brixia score. Our results provide important information about factors influencing Brixia score and its usefulness in predicting the unfavorable outcome (death) of COVID-19 patients. These findings have clinical relevance, especially in epidemic circumstances.
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Affiliation(s)
- Jusuf A Nukovic
- Faculty of Pharmacy and Health Travnik, University of Travnik, 72270 Travnik, Bosnia and Herzegovina
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | - Valentina Opancina
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Nebojsa Zdravkovic
- Department of Medical Statistics and Informatics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Nikola Prodanovic
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Ana Pejcic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Miljan Opancina
- Department of Medical Statistics and Informatics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Military Medical Academy, Faculty of Medicine, University of Defense, 11000 Belgrade, Serbia
| | - Jasmin J Nukovic
- Faculty of Pharmacy and Health Travnik, University of Travnik, 72270 Travnik, Bosnia and Herzegovina
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | - Radisa Vojinovic
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Dragan Dulovic
- Military Medical Academy, Faculty of Medicine, University of Defense, 11000 Belgrade, Serbia
| | - Fehim Jukovic
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | | | - Merisa Nukovic
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | - Nenad V Markovic
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
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Abeid ST, Mezedawee AAS, Alam YSJ. EXPLORING THE INFLUENCE OF NEUTROPHIL-LYMPHOCYTE RATIO ON OUTCOME PREDICTION OF SEVERELY-ILL PATIENTS WITH COVID-19. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 75:2926-2932. [PMID: 36723305 DOI: 10.36740/wlek202212106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim: The study conducted to have a better understanding on the role of neutrophil-lymphocyte ratio in the determination of the prognosis of COVID-19 and to assist in predicting disease severity. PATIENTS AND METHODS Materials and methods: A total of 96 patients within age group 18-80 years who were verified positive for the COVID-19 by PCR, and admitted to (Al-Sader Medical City) in Al-Najaf City between (July to October 2020) were enrolled in a cohort retrospective study, Neutrophil to lymphocyte ratio was calculated via taking the absolute neutrophil count divided by the absolute lymphocyte count. Other parameters like (renal function tests, D-dimer, C-reactive protein, serum ferritin) also has been studied in relation to outcome of patients with COVID-19. RESULTS Results: The Neutrophil-lymphocyte ratio was significantly associated with low oxygen saturation and poor outcome. A significant difference was found between two clusters in CRP, serum ferritin, and D-dimer level. In addition, age and obstructive airway disease were important clinical predictors for poor outcome. CONCLUSION Conclusions: The study was a useful prognostic marker linked with poor outcome in patients admitted for COVID-19 pneumonia. Other inflammatory markers, such as ferritin, CRP, and D-dimer were also associated with critical illness and increased mortality from COVID-19 disease.
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Affiliation(s)
- Samir Taha Abeid
- DEPARTMENT OF MEDICINE, COLLEGE OF MEDICINE, UNIVERSITY OF KUFA, NAJAF, IRAQ
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C-Reactive Protein and White Blood Cell Count in Cardiogenic Shock. J Clin Med 2023; 12:jcm12030965. [PMID: 36769613 PMCID: PMC9917886 DOI: 10.3390/jcm12030965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/09/2023] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
This study examines the prognostic impact of C-reactive protein (CRP) and white blood cell (WBC) counts in patients with cardiogenic shock (CS). Data regarding the prognostic impact of inflammatory biomarkers in CS are scarce. All consecutive patients with CS from 2019 to 2021 admitted to a cardiac intensive care unit (ICU) were included at one institution. Laboratory measurements were retrieved from the day of admission (i.e., day 1), as well as days 2, 3, 4, and 8. The primary endpoint was 30-day all-cause mortality. Statistical analyses included univariate t-tests, Spearman's correlations, C-statistics, Kaplan-Meier, and Cox regression analyses. From a total of 240 consecutive patients admitted with CS, 55% died within 30 days. CRP levels on days 3 to 8 were associated with reliable discrimination for 30-day all-cause mortality (area under the curve (AUC): 0.623-0.754), whereas CRP on day 1 was not (AUC = 0.514). In line, CRP > 100 mg/L on day 3 (56% vs. 37%; log-rank p = 0.023; HR = 1.702; 95% CI 1.060-2.735; p = 0.028) and especially a CRP increase of at least 200% from days 1 to day 3 (51% vs. 35%; log-rank p = 0.040; HR = 1.720; 95% CI 1.006-2.943; p = 0.048) were associated with an increased risk of all-cause mortality. Furthermore, WBC on day 1 discriminated 30-day all-cause mortality (AUC = 0.605; p = 0.005) with an increased risk of all-cause mortality in patients admitted with WBC > 10 × 106/mL (59% vs. 40%; log-rank p = 0.036; HR = 1.643; 95% CI 1.010-2.671; p = 0.045). In conclusion, WBC count on admission as well as CRP levels during the course of ICU treatment were associated with 30-day all-cause mortality. Specifically, an increase of CRP levels by at least 200% from day 1 to day 3 during the course of ICU treatment was associated with an increased risk of 30-day all-cause mortality. The present study is one of the first to describe the prognostic value of inflammatory biomarkers in consecutive all-comer CS patients treated at a cardiac ICU.
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Wang J, Xie L, Lyu P, Zhou F, Cai HL, Qi RX, Zhang Q. Short-Term Prognostic Efficacy of mGPS and LCS in Patients With Acute Heart Failure. Front Cardiovasc Med 2022; 9:944424. [PMID: 35865381 PMCID: PMC9295910 DOI: 10.3389/fcvm.2022.944424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Aim Systemic inflammation plays an important role in the occurrence and development of acute heart failure. The modified Glasgow Prognostic Score (mGPS) and “lymphocyte C-reactive protein score” (LCS) are used to assess the inflammation levels in cancer patients. The purpose of this study was to assess the prognostic value of these two inflammation-related scoring systems in patients with acute heart failure. Methods Two hundred and fifty patients with acute heart failure were enrolled in this study. The mGPS and LCS scores were recorded after admission. All patients were divided into 2 groups: the death group and the survival group according to the 3-month follow-up results. The predictive values of mGPS and LCS were assessed using receiver-operating characteristic (ROC) analyses. Univariate and multivariate logistic analyses were used to evaluate the relationships between variables and endpoint. Results The levels of mGPS and LCS in the death group were significantly higher than those in the survival group (P < 0.05). The areas under the ROC curve of the mGPS and LCS for predicting death were 0.695 (95%CI: 0.567~0.823) and 0.736 (95%CI: 0.616~0.856), respectively. Multivariate analysis demonstrated that both LCS, LVEF and serum direct bilirubin were independent predictors of all-cause death, excluding mGPS. Conclusions Compared with mGPS, LCS is independently associated with short-term outcomes in patients with acute heart failure. LCS was a clinically promising and feasible prognostic scoring system for patients with acute heart failure.
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Affiliation(s)
- Jing Wang
- Department of Cardiology, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Ling Xie
- Department of Cardiology, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Ping Lyu
- Department of Cardiology, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Feng Zhou
- Department of Clinical Laboratory, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Hong-Li Cai
- Department of General Practice, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Rong-Xing Qi
- Department of Image, Affiliated Hospital 2 of Nantong University, Nantong, China
- Rong-Xing Qi
| | - Qing Zhang
- Department of General Practice, Affiliated Hospital 2 of Nantong University, Nantong, China
- *Correspondence: Qing Zhang
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Eftekhari Moghadam AR, Fazelinejad Z, Nashibi R, Pour MB. CT Characteristics of Coronavirus Disease 2019 Pneumonia and Its Association with C-Reactive Protein, Erythrocyte Sedimentation Rate and Gender. Adv Biomed Res 2022; 11:10. [PMID: 35284348 PMCID: PMC8906093 DOI: 10.4103/abr.abr_33_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
Background This research intended to investigate the characteristics of COVID-19, accurately evaluate radiological findings, and compare it with laboratory evidence of coronavirus. Materials and Methods A retrospective study of 120 consecutive cases with a mean age of 55.9 ± 15.82 years and laboratory-confirmed COVID-19 pneumonia was performed. On admission, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were tested. Computed tomography (CT) findings and scored pulmonary involvement were evaluated. Results An elevated level of CRP and mildly raised ESR was seen in all patients. ESR showed a meaningful difference between both genders (P < 0.05). Ninety-four (78.3%) patients showed peripheral pulmonary lesions and 119 patients had ground-glass opacity (99.2%), 110 (92.4%) had consolidation, and 9 patients (7.5%) had linear opacities. Of 120 cases, 25 (20%) had bronchial changes, 25 (20%) had air bronchogram, 11 (9.2%) had bronchial distortion, and 2 had mediastinal lymphadenopathy. The CT scores in males and females were 17.41 ± 4.86 and 14.65 ± 4.96, respectively with a significant difference between both genders (P = 0.001). CT score difference was significant between both genders (P = 0.01). The largest lung lesion diameter in both sexes (male: 46.0725.75 and female: 57.9131.14) showed a meaningful difference. CRP (r = 0.10; P < 0.05) and ESR (r = 0.15; P < 0.05) were correlated with the CT scores. Conclusion the results indicated that the infection involved lung parenchyma and interstitium. CRP and ESR levels were correlated with lung lesions and showed positive performance in predicting severity and disease monitoring.
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Affiliation(s)
- Ali Reza Eftekhari Moghadam
- Department of Anatomical Sciences, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zahra Fazelinejad
- Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roohangiz Nashibi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Bouri Pour
- Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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12
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Hanafy NAN, El-Kemary MA. Silymarin/curcumin loaded albumin nanoparticles coated by chitosan as muco-inhalable delivery system observing anti-inflammatory and anti COVID-19 characterizations in oleic acid triggered lung injury and in vitro COVID-19 experiment. Int J Biol Macromol 2022; 198:101-110. [PMID: 34968533 PMCID: PMC8712435 DOI: 10.1016/j.ijbiomac.2021.12.073] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/28/2021] [Accepted: 12/11/2021] [Indexed: 02/08/2023]
Abstract
Respiratory infected by COVID-19 represents a major global health problem at moment even after recovery from virus corona. Since, the lung lesions for infected patients are still sufferings from acute respiratory distress syndrome including alveolar septal edema, pneumonia, hyperplasia, and hyaline membranes Therefore, there is an urgent need to identify additional candidates having ability to overcome inflammatory process and can enhance efficacy in the treatment of COVID-19. The polypenolic extracts were integrated into moeties of bovine serum albumin (BSA) and then were coated by chitosan as a mucoadhesion polymer. The results of interleukin-6, and c-reactive protein showed significant reduction in group treated by Encap. SIL + CUR (64 ± 0.8 Pg/μL & 6 ± 0.5 μg/μL) compared to group treated by Cham. + CUR (102 ± 0.8 Pg/μL & 7 ± 0.5 μg/μL) respectively and free capsules (with no any drug inside) (148 ± 0.6 Pg/μL & 10 ± 0.6 μg/μL) respectively. Histopathology profile was improved completely. Additionally, encapsulating silymarin showed anti-viral activity in vitro COVID-19 experiment. It can be summarized that muco-inhalable delivery system (MIDS) loaded by silymarin can be used to overcome inflammation induced by oleic acid and to overcome COVID-19.
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Affiliation(s)
- Nemany A N Hanafy
- Nanomedicine group, Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, 33516 Kafrelsheikh, Egypt.
| | - Maged A El-Kemary
- Nanomedicine group, Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, 33516 Kafrelsheikh, Egypt.
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13
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Boyraz B, Ibisoglu E, Aslan B. The prognostic value of the nutritional prognostic index (NPI) and controlling nutritional status (CONUT) scoring systems in non-ST elevated myocardial infarction patients over 65 years of age. Aging Clin Exp Res 2022; 34:555-562. [DOI: 10.1007/s40520-021-02039-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022]
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14
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Segura-Saldaña PA, Chambergo-Michilot D, Alarcón-Santos JE, Aguilar C, Alvarez-Vargas ML, Padilla-Reyes M, Leon-Vivar R, Pariona-Javier M. Evaluating three biomarkers as prognostic factors of in-hospital mortality and severity in heart failure: A prospective cohort. Rev Port Cardiol 2022; 41:31-40. [DOI: 10.1016/j.repc.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/21/2021] [Accepted: 03/05/2021] [Indexed: 11/28/2022] Open
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15
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Cebeci Z, Cebeci AB, Coskun I, Canakci E. Can scoring systems be used for the triage of COVID-19 patients? Niger J Clin Pract 2022; 25:1779-1784. [DOI: 10.4103/njcp.njcp_1617_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Prognostic implication of uncontrolled hypertension in hospitalized patients with COVID-19. COR ET VASA 2021. [DOI: 10.33678/cor.2021.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Glasgow prognostic score can be a prognostic indicator after percutaneous coronary intervention: a two-center study in Japan. Heart Vessels 2021; 37:903-910. [PMID: 34807279 DOI: 10.1007/s00380-021-01986-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
Glasgow prognostic score (GPS) has been used to evaluate inflammatory response and nutritional status. This study aimed to investigate the impact of nutritional status on cardiac prognosis by using GPS in patients after undergoing percutaneous coronary intervention (PCI). We included 862 patients who underwent PCI for stable angina pectoris between 2015 and 2018. We used the original cutoff values, which were an albumin (Alb) level of 3.5 g/dl and a C-reactive protein (CRP) level of 0.3 mg/dl. We categorized them into the three groups: originally defined GPS (od-GPS) 0 (high Alb and low CRP), 1 (low Alb or high CRP), and 2 (low Alb and high CRP). Major adverse clinical events (MACEs) included all-cause death, nonfatal myocardial infarction, revascularization, and hospitalization for heart failure. The median follow-up period was 398.5 days. During the follow-up, MACEs occurred in 136 patients. Od-GPS 2 had higher prevalence rates in terms of chronic kidney disease (CKD; 31.7% [229/722] vs. 44.9% [53/118] vs. 63.6% [14/22], p < 0.001), hemodialysis (6.4% [46/722] vs. 14.4% [17/118] vs. 31.8% [7/22], p < 0.001), and heart failure cases (HF; 9.1% [66/722] vs. 14.4% [17/118] vs. 27.3% [6/22], p = 0.007), with higher creatinine (1.17 ± 1.37 mg/dl vs. 1.89 ± 2.60 mg/dl vs. 3.49 ± 4.01 mg/dl, p < 0.001) and brain natriuretic peptide levels (104.1 ± 304.6 pg/ml vs. 242.4 ± 565.9 pg/ml vs. 668.1 ± 872.2 pg/ml, p < 0.001) and lower low-density lipoprotein cholesterol (101.5 ± 32.9 mg/dl vs. 98.2 ± 28.8 mg/dl vs. 77.1 ± 24.3 mg/dl, p = 0.002) than od-GPS 0 and 1.Od-GPS 2 (HR 2.42; 95% CI 1.16-5.02; p = 0.018), od-GPS 1 (HR 2.09; 95% CI 1.40-3.13; p < 0.001), diabetes (HR 1.41; 95% CI 1.00-1.99; p = 0.048), CKD (HR 2.10; 95% CI 1.49-2.96; p < 0.001), and HF (HR 1.64; 95% CI 1.05-2.56; p = 0.029) were independent predictors of MACEs. A scoring system using CRP and Alb levels with a milder definition than GPS suitably predicted the risk of MACEs in the patients who underwent PCI.
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18
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To Determine Role of C-reactive Protein Test and Computerised Tomography Scan of Lung in Diagnosis of COVID-19. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.3.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The outbreak of novel Coronavirus Disease 2019 (COVID-19) has led the entire world to limp. The virus is causing the severe acute respiratory syndrome, with increasing morbidity and mortality. The WHO declared COVID-19 as a pandemic or public health emergency because of its morbidity and mortality. Several inflammatory markers have been used in the initial diagnosis, as well as prognostic markers in disease progression. One of the inflammatory markers is C reactive protein. The other markers that help in prognosis are ferritin, neutrophil-lymphocyte ratio, CT scan of the lung, IL6 (interleukin 6), RT PCR is reliable diagnostic evidence. Aim of the study: 1. The aim is to determine the C-reactive protein, CT (Computerised Tomography) scan of the lung, RT PCR (Reverse Transcriptase Polymerase Chain reaction) in COVID-19 patients. 2. To compare CRP & CT scan values of the lung in various age groups. A cross-sectional study was done from September 2020 to January 2021 and the results were analysed. Out of 704 COVID positive patients, the maximum number of patients were in the age group between 31 to 70. The RT PCR showed COVID positive results in 689 (97.8%) patients. The CRP values were found to be >25mg/l from 31-50 (34.7%) years and in 51-70 years of age (52%). In comparison of CT scan with CRP changes, CRP values were found to be raised when there is 25-50% (24.5%) and >50% (27.6%) involvement of lung by COVID. CT scan lung involvement was >50% in the age group between 31-50 (38.9%) and 51-70 (50%), respectively. High CRP values of >25mg/l were observed with the same age group 34.7% with the group of 31-50 and 52% with the group of 51-70, respectively. CRP correlated with the advancing age group and was found to be a good predictor of disease progression.
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19
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Kuluöztürk M, Deveci F, Turgut T, Öner Ö. The Glasgow Prognostic Score and fibrinogen to albumin ratio as prognostic factors in hospitalized patients with COVID-19. Expert Rev Respir Med 2021; 15:1061-1068. [PMID: 33905286 PMCID: PMC8127175 DOI: 10.1080/17476348.2021.1923483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Aim: This study aims to determine the prognostic value of the Glasgow Prognostic Score (GPS) and fibrinogen to albumin ratio (FAR) in patients with COVID-19. Methods: Electronic database records of 400 patients with COVID-19 were retrospectively analyzed and the initial levels of CRP, albumin, fibrinogen values were recorded. The ground-glass opacities (GGO) and consolidations were evaluated on thorax CT. Hospital mortality and the need for intensive care unit (ICU) transfer were determined as adverse outcomes. Results: It was determined that 345 patients (86.25%) were discharged while 31 patients (7.75%) were transferred to ICU in addition to 24 patients who died (6%). The rates of deaths and transfers to ICU were significantly increased in GPS 2 group compared to both GPS 0 and 1 groups. Additionally, increased FAR was observed in patients who died and transferred to ICU compared to the discharged patients. The FAR was significantly increased in patients with diffuse GGO. Logistic regression analysis indicated that FAR ≥144.59 and the presence of GPS 2 were independent predictors of the adverse outcomes in COVID-19 patients. Conclusion: Our results demonstrated that the GPS and FAR could possess a predictive value for adverse outcomes in patients with COVID-19.
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Affiliation(s)
- Mutlu Kuluöztürk
- Department of Chest Diseases, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Figen Deveci
- Department of Chest Diseases, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Teyfik Turgut
- Department of Chest Diseases, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Önsel Öner
- Department of Chest Disease, Şanlıurfa Siverek State Hospital, Şanlıurfa, Turkey
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20
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Gili T, Benelli G, Buscarini E, Canetta C, La Piana G, Merli G, Scartabellati A, Viganò G, Sfogliarini R, Melilli G, Assandri R, Cazzato D, Rossi DS, Usai S, Caldarelli G, Tramacere I, Pellegata G, Lauria G. SARS-COV-2 comorbidity network and outcome in hospitalized patients in Crema, Italy. PLoS One 2021; 16:e0248498. [PMID: 33765013 PMCID: PMC7993836 DOI: 10.1371/journal.pone.0248498] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/28/2021] [Indexed: 01/10/2023] Open
Abstract
We report onset, course, correlations with comorbidities, and diagnostic accuracy of nasopharyngeal swab in 539 individuals suspected to carry SARS-COV-2 admitted to the hospital of Crema, Italy. All individuals underwent clinical and laboratory exams, SARS-COV-2 reverse transcriptase-polymerase chain reaction on nasopharyngeal swab, and chest X-ray and/or computed tomography (CT). Data on onset, course, comorbidities, number of drugs including angiotensin converting enzyme (ACE) inhibitors and angiotensin-II-receptor antagonists (sartans), follow-up swab, pharmacological treatments, non-invasive respiratory support, ICU admission, and deaths were recorded. Among 411 SARS-COV-2 patients (67.7% males) median age was 70.8 years (range 5-99). Chest CT was performed in 317 (77.2%) and showed interstitial pneumonia in 304 (96%). Fatality rate was 17.5% (74% males), with 6.6% in 60-69 years old, 21.1% in 70-79 years old, 38.8% in 80-89 years old, and 83.3% above 90 years. No death occurred below 60 years. Non-invasive respiratory support rate was 27.2% and ICU admission 6.8%. Charlson comorbidity index and high C-reactive protein at admission were significantly associated with death. Use of ACE inhibitors or sartans was not associated with outcomes. Among 128 swab negative patients at admission (63.3% males) median age was 67.7 years (range 1-98). Chest CT was performed in 87 (68%) and showed interstitial pneumonia in 76 (87.3%). Follow-up swab turned positive in 13 of 32 patients. Using chest CT at admission as gold standard on the entire study population of 539 patients, nasopharyngeal swab had 80% accuracy. Comorbidity network analysis revealed a more homogenous distribution 60-40 aged SARS-COV-2 patients across diseases and a crucial different interplay of diseases in the networks of deceased and survived patients. SARS-CoV-2 caused high mortality among patients older than 60 years and correlated with pre-existing multiorgan impairment.
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Affiliation(s)
| | | | | | - Ciro Canetta
- High Care Medical Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Emergency Medicine Unit Ospedale Maggiore di Crema, Crema, Italy
| | | | - Guido Merli
- Intensive Care Unit, Ospedale Maggiore di Crema, Crema, Italy
| | | | | | | | | | - Roberto Assandri
- Clinical Investigation Laboratory, Ospedale Maggiore di Crema, Crema, Italy
| | - Daniele Cazzato
- Department of Diagnostics and Technology, Ospedale Maggiore di Crema, Crema, Italy
| | | | - Susanna Usai
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Guido Caldarelli
- DSMN Ca’Foscari University, Venice Italy and ECLT, Venice, Italy
- ECLT, Venice, Italy
- ISC-CNR Uos "Sapienza", Rome, Italy
| | - Irene Tramacere
- Scientific Directorate, Ospedale Maggiore di Crema, Crema, Italy
| | | | - Giuseppe Lauria
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milan, Italy
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21
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Khodashahi R, Naderi H, Bojdy A, Heydari AA, Sani AT, Ghabouli MJ, Sarvghad MR, Haddad M, Arian M, Jahanian S, Mazidi S, Pasand MM, Hoseini B, Dadgarmoghaddam M, Khorsand A, Khodashahi M. Comparison the Effect of Arbidol Plus Hydroxychloroquine vs Hydroxychloroquine Alone in Treatment of COVID-19 Disease: A Randomized Clinical Trial. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210129125703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background and Aim:
The main challenging issue about coronavirus disease 2019
(COVID-19) is the production of safe and stable vaccines, which is a very long process. Due to the
emergency situation, regular and extensive screening of available and traditional drugs, which are
commonly used for the treatment of similar viral diseases, can be a reasonable option. The present
study aimed to compare the administration of hydroxychloroquine (HCQ) plus arbidol to the use of
HCQ alone in the treatment of COVID-19 infection.
Methods and Materials:
This single-blind randomized controlled trial was carried out on a total of
100 patients with COVID-19 referring to the infection ward of Imam Reza Hospital in Mashhad,
Iran, in 2020. The patients were randomly assigned to two HCQ alone and HCQ plus arbidol
groups.
Results:
According to the obtained results, hematological parameters, including white blood cell
count, hemoglobin level, lymphocyte count, and platelet count, improved in patients with
COVID-19 after the treatment with both HCQ plus arbidol and HCQ alone (P<0.005). The mean
values of the reduction time of C-reactive protein (CRP) were 4.48±1.24 and 8.22±2.08 days in the
arbidol and HCQ alone groups, respectively, indicating that CRP decreased faster in the arbidol
group than that reported for the HCQ alone group (Z=0.-7.85; P<0.000). The mean scores of hospital
stay were reported as 5.89±2.04 and 9.35±3.72 days in the arbidol and HCQ alone groups, respectively
(Z=-4.31; P<0.005). All the patients in the arbidol group survived, while 6% of the subjects
in the HCQ alone group died. In addition, the drug regimen was not changed for any patient,
and no subject was transferred to the intensive care unit in the arbidol group.
Conclusion:
In summary, the administration of both arbidol and HCQ leads to the improvement of
the hematological parameters. The present study introduced arbidol as an effective treatment for
moderate to severe patients with COVID-19, which not only reduced the time of CRP normalization
level but also decreased the hospitalization duration and mortality compared to those reported
for HCQ.
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Affiliation(s)
- Rozita Khodashahi
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Naderi
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Bojdy
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Akbar Heydari
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ashraf Tavanaee Sani
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Javad Ghabouli
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Sarvghad
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboubeh Haddad
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahnaz Arian
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahrzad Jahanian
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Mazidi
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maziar Mortazavi Pasand
- Department of Infectious Diseases and Tropical Medicine ,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Binyamin Hoseini
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maliheh Dadgarmoghaddam
- Community Medicine Department, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Khorsand
- Department of Complementary and Chinese Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mandana Khodashahi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Barberis E, Vanella VV, Falasca M, Caneapero V, Cappellano G, Raineri D, Ghirimoldi M, De Giorgis V, Puricelli C, Vaschetto R, Sainaghi PP, Bruno S, Sica A, Dianzani U, Rolla R, Chiocchetti A, Cantaluppi V, Baldanzi G, Marengo E, Manfredi M. Circulating Exosomes Are Strongly Involved in SARS-CoV-2 Infection. Front Mol Biosci 2021; 8:632290. [PMID: 33693030 PMCID: PMC7937875 DOI: 10.3389/fmolb.2021.632290] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
Knowledge of the host response to the novel coronavirus SARS-CoV-2 remains limited, hindering the understanding of COVID-19 pathogenesis and the development of therapeutic strategies. During the course of a viral infection, host cells release exosomes and other extracellular vesicles carrying viral and host components that can modulate the immune response. The present study used a shotgun proteomic approach to map the host circulating exosomes’ response to SARS-CoV-2 infection. We investigated how SARS-CoV-2 infection modulates exosome content, exosomes’ involvement in disease progression, and the potential use of plasma exosomes as biomarkers of disease severity. A proteomic analysis of patient-derived exosomes identified several molecules involved in the immune response, inflammation, and activation of the coagulation and complement pathways, which are the main mechanisms of COVID-19–associated tissue damage and multiple organ dysfunctions. In addition, several potential biomarkers—such as fibrinogen, fibronectin, complement C1r subcomponent and serum amyloid P-component—were shown to have a diagnostic feature presenting an area under the curve (AUC) of almost 1. Proteins correlating with disease severity were also detected. Moreover, for the first time, we identified the presence of SARS-CoV-2 RNA in the exosomal cargo, which suggests that the virus might use the endocytosis route to spread infection. Our findings indicate circulating exosomes’ significant contribution to several processes—such as inflammation, coagulation, and immunomodulation—during SARS-CoV-2 infection. The study’s data are available via ProteomeXchange with the identifier PXD021144.
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Affiliation(s)
- Elettra Barberis
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy.,ISALIT, Novara, Italy
| | - Virginia V Vanella
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy
| | - Marco Falasca
- Metabolic Signalling Group, Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Valeria Caneapero
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy
| | - Giuseppe Cappellano
- Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy.,Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Davide Raineri
- Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy.,Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Marco Ghirimoldi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Veronica De Giorgis
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Chiara Puricelli
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Rosanna Vaschetto
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Pier Paolo Sainaghi
- Internal and Emergency Medicine Departments, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Stefania Bruno
- Città della Salute e della Scienza and Molecular Biotechnology Center, Torino, Italy
| | - Antonio Sica
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy.,Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Umberto Dianzani
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Roberta Rolla
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Annalisa Chiocchetti
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy
| | - Vincenzo Cantaluppi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Gianluca Baldanzi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy
| | - Emilio Marengo
- Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy.,Department of Sciences and Technological Innovation, University of Piemonte Orientale, Alessandria, Italy.,ISALIT, Novara, Italy
| | - Marcello Manfredi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, Novara, Italy.,ISALIT, Novara, Italy
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Ciaccio M, Agnello L. Biochemical biomarkers alterations in Coronavirus Disease 2019 (COVID-19). ACTA ACUST UNITED AC 2020; 7:365-372. [PMID: 32589600 DOI: 10.1515/dx-2020-0057] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/13/2020] [Indexed: 12/18/2022]
Abstract
Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory disease, which can evolve into multi-organ failure (MOF), leading to death. Several biochemical alterations have been described in COVID-19 patients. To date, many biomarkers reflecting the main pathophysiological characteristics of the disease have been identified and associated with the risk of developing severe disease. Lymphopenia represents the hallmark of the disease, and it can be detected since the early stage of infection. Increased levels of several inflammatory biomarkers, including c-reactive protein, have been found in COVID-19 patients and associated with an increased risk of severe disease, which is characterised by the so-called "cytokine storm". Also, the increase of cardiac and liver dysfunction biomarkers has been associated with poor outcome. In this review, we provide an overview of the main biochemical characteristics of COVID-19 and the associated biomarkers alterations.
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Affiliation(s)
- Marcello Ciaccio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Luisa Agnello
- Department of Laboratory Medicine, AOUP "P. Giaccone", Palermo, Italy
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Relationship between inflammatory biomarkers and sleep-disordered breathing in patients with heart failure. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
BACKGROUND COVID-19 is a new infectious disease, for which there is currently no treatment. It is therefore necessary to explore biomarkers to determine the extent of lung lesions and disease severity. OBJECTIVE We aimed to assess the usefulness of CRP levels in the early stage of COVID-19 and to correlate them with lung lesions and severe presentation. METHODS Confirmed cases of COVID-19 were selected at the Fever Unit in two regions of Guizhou, China. On admission CRP levels were collected, and the diameter of the largest lung lesion was measured in the most severe lung lesion by lung CT scan. Differences in the diameter and CRP levels were compared in the following groups of patients: mild group, moderate group, severe group, and critical group. RESULT CRP levels and the diameter of the largest lung lesion in the moderate group were higher than those in the mild group (Mann-Whitney test=-2.647, -2.171, P˂0.05), those in the severe group were higher than those in the moderate group (Mann-Whitney test=0.693, -2.177, P˂0.05), and those in the critical group were higher than those in the severe group (Mann-Whitney test=-0.068, -1.549, P˂0.05). The difference was statistically significant. CRP levels were positively correlated with the diameter of lung lesion and severe presentation (correlation coefficient=0.873, 0.734, P˂0.001). CONCLUSION In the early stage of COVID-19 CRP levels were positively correlated with lung lesions and could reflect disease severity.
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Affiliation(s)
- L Wang
- Department of Intensive Care Unit, People's hospital of Qiandongnan Miao and Dong Autonomous Prefecture, Kaili Guizhou 556000, China.
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