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Hedayati-Ch M, Ebrahim-Saraie HS, Bakhshi A. Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis. Front Immunol 2024; 15:1341168. [PMID: 38690274 PMCID: PMC11058842 DOI: 10.3389/fimmu.2024.1341168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which appeared in 2019, has been classified as critical and non-critical according to clinical signs and symptoms. Critical patients require mechanical ventilation and intensive care unit (ICU) admission, whereas non-critical patients require neither mechanical ventilation nor ICU admission. Several factors have been recently identified as effective factors, including blood cell count, enzymes, blood markers, and underlying diseases. By comparing blood markers, comorbidities, co-infections, and their relationship with mortality, we sought to determine differences between critical and non-critical groups. Method We used Scopus, PubMed, and Web of Science databases for our systematic search. Inclusion criteria include any report describing the clinical course of COVID-19 patients and showing the association of the COVID-19 clinical courses with blood cells, blood markers, and bacterial co-infection changes. Twenty-one publications were eligible for full-text examination between 2019 to 2021. Result The standard difference in WBC, lymphocyte, and platelet between the two clinical groups was 0.538, -0.670, and -0.421, respectively. Also, the standard difference between the two clinical groups of CRP, ALT, and AST was 0.482, 0.402, and 0.463, respectively. The odds ratios for hypertension and diabetes were significantly different between the two groups. The prevalence of co-infection also in the critical group is higher. Conclusion In conclusion, our data suggest that critical patients suffer from a suppressed immune system, and the inflammation level, the risk of organ damage, and co-infections are significantly high in the critical group and suggests the use of bacteriostatic instead of bactericides to treat co-infections.
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Affiliation(s)
- Mojtaba Hedayati-Ch
- Department of Microbiology, Virology and Microbial Toxins, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Microbial Toxins Physiology Group (MTPG), Universal Scientific Education and Research Network (USERN), Rasht, Iran
| | - Hadi Sedigh Ebrahim-Saraie
- Department of Microbiology, Virology and Microbial Toxins, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Bakhshi
- Member of Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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2
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Zhao J, Xie Y, Meng Z, Liu C, Wu Y, Zhao F, Ma X, Christopher TA, Lopez BJ, Wang Y. COVID-19 and cardiovascular complications: updates of emergency medicine. EMERGENCY AND CRITICAL CARE MEDICINE 2023; 3:104-114. [PMID: 38314258 PMCID: PMC10836842 DOI: 10.1097/ec9.0000000000000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV-2 variants, has become a global pandemic resulting in significant morbidity and mortality. Severe cases of COVID-19 are characterized by hypoxemia, hyper-inflammation, cytokine storm in lung. Clinical studies have reported an association between COVID-19 and cardiovascular disease (CVD). Patients with CVD tend to develop severe symptoms and mortality if contracted COVID-19 with further elevations of cardiac injury biomarkers. Furthermore, COVID-19 itself can induce and promoted CVD development, including myocarditis, arrhythmia, acute coronary syndrome, cardiogenic shock, and venous thromboembolism. Although the direct etiology of SARS-CoV-2 induced cardiac injury remains unknown and under-investigated, it is suspected that it is related to myocarditis, cytokine-mediated injury, microvascular injury, and stress-related cardiomyopathy. Despite vaccinations having provided the most effective approach to reducing mortality overall, an adapted treatment paradigm and regular monitoring of cardiac injury biomarkers is critical for improving outcomes in vulnerable populations at risk for severe COVID-19. In this review, we focus on the latest progress in clinic and research on the cardiovascular complications of COVID-19 and provide a perspective of treating cardiac complications deriving from COVID-19 in Emergency Medicine.
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Affiliation(s)
- Jianli Zhao
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL, USA
| | - Yaoli Xie
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
| | - Zhijun Meng
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
| | - Caihong Liu
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
| | - Yalin Wu
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL, USA
| | - Fujie Zhao
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL, USA
| | - Xinliang Ma
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Bernard J. Lopez
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
| | - Yajing Wang
- Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL, USA
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Wei KC, Wang WH, Wu CL, Chang SH, Huang YT. Heart failure after dengue infection- a population-based self-controlled case-series study. Travel Med Infect Dis 2023; 53:102589. [PMID: 37230157 DOI: 10.1016/j.tmaid.2023.102589] [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: 10/09/2022] [Revised: 04/06/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Major cardiovascular events (MACEs) have been described with dengue infection. Among these MACEs, heart failure (HF) is the most common but has not been thoroughly assessed. This study aimed to evaluate the association between dengue and HF. METHODS Under the self-controlled case-series study design, we used the Notifiable Infectious Disease dataset linkage with the National Health Insurance claims data to obtain the study subjects. All laboratory-confirmed dengue cases who were hospitalized for HF after dengue infection within one year between 2009 and 2015 in Taiwan were included. We identified the first 7 and 14 days after dengue infection as the risk intervals. The incidence rate ratio (IRR) and 95% confidence interval (CI) for HF were estimated by conditional Poisson regression. RESULTS Among the 65,906 dengue patients, 230 had admission for HF after dengue infection within one year. The IRR of HF admission within the first week after dengue infection was 27.2456.50 (95% C.I. 43.88-72.75). This risk was highest in >60 years (IRR = 59.32, 95% C.I. 45.43-77.43) and lower in 0-40 years (IRR = 25.82, 95% C.I. 2.89-231.02). The risk was nearly nine times higher among admission (for dengue infection) than among nonadmission cases (IRR 75.35 vs. 8.61, p < 0.0001). The risks increased slightly in the second week 8.55 and became less obvious after the third and fourth week. CONCLUSIONS Patients with dengue infection have a risk of developing acute heart failure within one week, especially in >60 years, men, and dengue admission subjects. The findings emphasize the awareness of diagnosis and further appropriate treatment of HF.
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Affiliation(s)
- Kai-Che Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Hwa Wang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; College of Management, I-Shou University, Kaohsiung, Taiwan
| | - Chia-Ling Wu
- Center for Big Data Analytics and Statistics, Department of Medical Research and Development, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
| | - Shang-Hung Chang
- Center for Big Data Analytics and Statistics, Department of Medical Research and Development, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan; Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Department of Medical Research and Development, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan; Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan.
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4
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Dadras O, SeyedAlinaghi S, Karimi A, Shamsabadi A, Qaderi K, Ramezani M, Mirghaderi SP, Mahdiabadi S, Vahedi F, Saeidi S, Shojaei A, Mehrtak M, Azar SA, Mehraeen E, Voltarelli FA. COVID‐19 mortality and its predictors in the elderly: A systematic review. Health Sci Rep 2022; 5:e657. [PMID: 35620541 PMCID: PMC9125886 DOI: 10.1002/hsr2.657] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Aims Older people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID‐19) patients and its predictors in this age group. Methods We searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two‐step screening process consisting of title/abstract and full‐text screenings to identify the eligible studies. Results Summarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X‐ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d‐dimer levels, 25‐hydroxy vitamin D serum deficiencies, high C‐reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin–angiotensin–aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti‐CD6 monoclonal antibody) in combination with other antivirals reduces COVID‐19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID‐19 mortality. Conclusion Overall, a critical consideration is necessary for the care and management of COVID‐19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID‐19 is independently associated with the patient's age. Elderly patients with COVID‐19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.
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Affiliation(s)
- Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk Behaviors Tehran Iran
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk Behaviors Tehran Iran
| | - Amirali Karimi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology Esfarayen Faculty of Medical Sciences Esfarayen Iran
| | - Kowsar Qaderi
- Kermanshah University of Medical Sciences Kermanshah Iran
| | - Maryam Ramezani
- Department of Health Management, Policy and Economics School of Public Health, Tehran University of Medical Sciences Tehran Iran
| | | | - Sara Mahdiabadi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Farzin Vahedi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Solmaz Saeidi
- Department of Nursing University of Medical Sciences; Khalkhal Khalkhal Iran
| | - Alireza Shojaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk Behaviors Tehran Iran
| | - Mohammad Mehrtak
- School of Medicine and Allied Medical Sciences Ardabil University of Medical Sciences Ardabil Iran
| | - Shiva A. Azar
- School of Pharmacy Shiraz University of Medical Sciences Shiraz Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology Khalkhal University of Medical Sciences Khalkhal Iran
| | - Fabrício A. Voltarelli
- Graduation Program in Health Sciences Faculty of Medicine, Federal University of Mato Grosso Cuiabá Mato Grosso Brazil
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5
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Dadras O, SeyedAlinaghi S, Karimi A, Shamsabadi A, Qaderi K, Ramezani M, Mirghaderi SP, Mahdiabadi S, Vahedi F, Saeidi S, Shojaei A, Mehrtak M, Azar SA, Mehraeen E, Voltarelli FA. COVID-19 mortality and its predictors in the elderly: A systematic review. Health Sci Rep 2022. [PMID: 35620541 DOI: 10.1002/hsr1002.1657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND AND AIMS Older people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID-19) patients and its predictors in this age group. METHODS We searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two-step screening process consisting of title/abstract and full-text screenings to identify the eligible studies. RESULTS Summarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X-ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d-dimer levels, 25-hydroxy vitamin D serum deficiencies, high C-reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin-angiotensin-aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti-CD6 monoclonal antibody) in combination with other antivirals reduces COVID-19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID-19 mortality. CONCLUSION Overall, a critical consideration is necessary for the care and management of COVID-19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID-19 is independently associated with the patient's age. Elderly patients with COVID-19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.
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Affiliation(s)
- Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors Tehran Iran.,Department of Global Public Health and Primary Care University of Bergen Bergen Norway
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors Tehran Iran
| | - Amirali Karimi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology Esfarayen Faculty of Medical Sciences Esfarayen Iran
| | - Kowsar Qaderi
- Kermanshah University of Medical Sciences Kermanshah Iran
| | - Maryam Ramezani
- Department of Health Management, Policy and Economics School of Public Health, Tehran University of Medical Sciences Tehran Iran
| | | | - Sara Mahdiabadi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Farzin Vahedi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Solmaz Saeidi
- Department of Nursing University of Medical Sciences; Khalkhal Khalkhal Iran
| | - Alireza Shojaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors Tehran Iran
| | - Mohammad Mehrtak
- School of Medicine and Allied Medical Sciences Ardabil University of Medical Sciences Ardabil Iran
| | - Shiva A Azar
- School of Pharmacy Shiraz University of Medical Sciences Shiraz Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology Khalkhal University of Medical Sciences Khalkhal Iran
| | - Fabrício A Voltarelli
- Graduation Program in Health Sciences Faculty of Medicine, Federal University of Mato Grosso Cuiabá Mato Grosso Brazil
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Statsenko Y, Al Zahmi F, Habuza T, Almansoori TM, Smetanina D, Simiyu GL, Neidl-Van Gorkom K, Ljubisavljevic M, Awawdeh R, Elshekhali H, Lee M, Salamin N, Sajid R, Kiran D, Nihalani S, Loney T, Bedson A, Dehdashtian A, Al Koteesh J. Impact of Age and Sex on COVID-19 Severity Assessed From Radiologic and Clinical Findings. Front Cell Infect Microbiol 2022; 11:777070. [PMID: 35282595 PMCID: PMC8913498 DOI: 10.3389/fcimb.2021.777070] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background Data on the epidemiological characteristics and clinical features of COVID-19 in patients of different ages and sex are limited. Existing studies have mainly focused on the pediatric and elderly population. Objective Assess whether age and sex interact with other risk factors to influence the severity of SARS-CoV-2 infection. Material and Methods The study sample included all consecutive patients who satisfied the inclusion criteria and who were treated from 24 February to 1 July 2020 in Dubai Mediclinic Parkview (560 cases) and Al Ain Hospital (605 cases), United Arab Emirates. We compared disease severity estimated from the radiological findings among patients of different age groups and sex. To analyze factors associated with an increased risk of severe disease, we conducted uni- and multivariate regression analyses. Specifically, age, sex, laboratory findings, and personal risk factors were used to predict moderate and severe COVID-19 with conventional machine learning methods. Results Need for O2 supplementation was positively correlated with age. Intensive care was required more often for men of all ages (p < 0.01). Males were more likely to have at least moderate disease severity (p = 0.0083). These findings were aligned with the results of biochemical findings and suggest a direct correlation between older age and male sex with a severe course of the disease. In young males (18-39 years), the percentage of the lung parenchyma covered with consolidation and the density characteristics of lesions were higher than those of other age groups; however, there was no marked sex difference in middle-aged (40-64 years) and older adults (≥65 years). From the univariate analysis, the risk of the non-mild COVID-19 was significantly higher (p < 0.05) in midlife adults and older adults compared to young adults. The multivariate analysis provided similar findings. Conclusion Age and sex were important predictors of disease severity in the set of data typically collected on admission. Sexual dissimilarities reduced with age. Age disparities were more pronounced if studied with the clinical markers of disease severity than with the radiological markers. The impact of sex on the clinical markers was more evident than that of age in our study.
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Affiliation(s)
- Yauhen Statsenko
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatmah Al Zahmi
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Tetiana Habuza
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Taleb M. Almansoori
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Darya Smetanina
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gillian Lylian Simiyu
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Klaus Neidl-Van Gorkom
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Milos Ljubisavljevic
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rasha Awawdeh
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | | | - Martin Lee
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Nassim Salamin
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Ruhina Sajid
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Dhanya Kiran
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | | | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Antony Bedson
- Radiology Department, Sheikh Shakhbout Medical City, Al Ain, United Arab Emirates
| | | | - Jamal Al Koteesh
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Radiology Department, Tawam Hospital, Al Ain, United Arab Emirates
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7
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Pujani M, Raychaudhuri S, Singh M, Kaur H, Agarwal S, Jain M, Chandoke RK, Singh K, Sidam D, Chauhan V. An analysis of hematological, coagulation and biochemical markers in COVID-19 disease and their association with clinical severity and mortality: an Indian outlook. AMERICAN JOURNAL OF BLOOD RESEARCH 2021; 11:580-591. [PMID: 35103112 PMCID: PMC8784646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The "cytokine storm" (CS) in COVID-19 leads to the worst stage of illness which can be controlled only with timely intervention. There is an urgent need to identify laboratory markers of disease progression for optimum allocation of resources in developing countries like India. METHODS A cross-sectional study was conducted on 100 COVID-19 positive patients over two months. The cases were sub-classified based on disease severity into mild to moderate (n=61), severe (n=26) and very severe (n=13) and into survivors (n=85) and non-survivors (n=15) based on survivor status. These patients were tested for hematological parameters (total blood lymphocyte counts, NLR, PLR, platelet indices etc.), coagulation markers (D-dimer, fibrin degradation products (FDP), fibrinogen etc.) and biochemical markers (LDH, ferritin, IL-6, procalcitonin, hs-CRP). RESULTS Statistically significant differences were observed in hematological variables (ANC, NLR and ESR), coagulation parameters (D-dimer, FDP, fibrinogen and thrombin time) and biochemical markers (LDH, ferritin, IL-6, procalcitonin and hs-CRP) with regard to subcategories based of disease severity as well as survivor status. There was strong correlation between NLR, D-dimer, IL-6, procalcitonin and ferritin. IL-6 emerged as the single best marker of disease severity (AUC: 0.997, P=0.00), however procalcitonin, LDH, D-dimer, FDP and NLR could also predict severe disease with a good sensitivity and specificity. CONCLUSION To conclude, study demonstrates a plethora of biomarkers which could be utilized to accurately identify the hyperinflammation and tissue damage reminiscent of cytokine storm in COVID-19 patients so that timely, safe, and effective therapies can be administered to prevent progression and potentially reduce mortality.
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Affiliation(s)
- Mukta Pujani
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - Sujata Raychaudhuri
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - Mitasha Singh
- Department of Community Medicine, ESIC Medical College and HospitalFaridabad, Haryana, India
| | | | - Shivani Agarwal
- Department of Physiology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - Manjula Jain
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - RK Chandoke
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - Kanika Singh
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - Dipti Sidam
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
| | - Varsha Chauhan
- Department of Pathology, ESIC Medical College and HospitalFaridabad, Haryana, India
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8
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Peng Q, Ma X, Liu Z, Zhao C, Zhang L, Qian Z, Zhang L. Differences in clinical characteristics between younger and older patients with COVID-19 and their relationship with the length of hospital stay. JOURNAL OF INTENSIVE MEDICINE 2021; 1:123-129. [PMID: 36943818 PMCID: PMC8163035 DOI: 10.1016/j.jointm.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/13/2021] [Accepted: 05/05/2021] [Indexed: 12/15/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic is currently threatening the health of individuals worldwide. We compared the clinical characteristics between younger patients (aged <60 years) and older patients (aged ≥60 years) with COVID-19, detected the risk factors associated with a prolonged hospital stay, and examined the treatments commonly used with a particular focus on antiviral therapies. Methods This retrospective study was conducted at the West Campus, Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology (Wuhan, China). The sample consisted of 123 patients admitted to the hospital between 9th February, 2020, and 3rd March, 2020. The data related to the demographics, laboratory findings, and treatment were analyzed to identify discrepancies between younger and older patients and those with and without primary diseases. The risk factors that contribute to a prolonged hospital stay were subsequently identified. Results Patients aged ≥60 years required longer hospital stay than younger patients (P=0.001). The percentage of lymphocytes was significantly lower in older patients and those with primary diseases (P=0.016 and P=0.042, respectively). The findings revealed that the risk factors that contributed to the length of hospital stay were age, the number of days of illness before hospitalization, white blood cell (WBC) count and albumin levels at admission, a neutrophil fraction at discharge, and antibiotic treatment. Analysis using a model that consisted of the above five risk factors for predicting prolonged hospital stay (>14 days) yielded an area under the ROC (AuROC) curve of 0.716. Antiviral and antibiotic treatments were administered to 97.6% and 39.0% of patients, respectively. The antiviral drugs most commonly administered were traditional Chinese medicine (83.7%) and arbidol (75.6%). Conclusions In this study, older patients and those with primary diseases were at a higher risk of worse clinical manifestations. The physicians who treat the patients should pay close attention to the risk factors that contribute to the length of hospital stay, which could be used for predicting prolonged hospital stay. Traditional Chinese medicine and arbidol were the most frequently used antiviral drugs. Nevertheless, the extent to which these medications can effectively treat COVID-19 warrants further investigation.
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Affiliation(s)
- Qianyi Peng
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
| | - Xinhua Ma
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
| | - Zhiyong Liu
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
| | - Chunguang Zhao
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
| | - Lei Zhang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
| | - Zhaoxin Qian
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- Corresponding author: Lina Zhang, Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Zhaoxin Qian, Department of Emergency, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
| | - Lina Zhang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan Province 410008, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province 410008, China
- Corresponding author: Lina Zhang, Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Zhaoxin Qian, Department of Emergency, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
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