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Abujabal M, Shalaby MA, Abdullah L, Albanna AS, Elzoghby M, Alahmadi GG, Sethi SK, Temsah MH, Aljamaan F, Alhasan K, Kari JA. Common Prognostic Biomarkers and Outcomes in Patients with COVID-19 Infection in Saudi Arabia. Trop Med Infect Dis 2023; 8:tropicalmed8050260. [PMID: 37235308 DOI: 10.3390/tropicalmed8050260] [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: 02/15/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Background: COVID-19 is a respiratory disease that eventually became a pandemic, with 300 million people infected around the world. Alongside the improvement in COVID-19 management and vaccine development, identifying biomarkers for COVID-19 has recently been reported to help in early prediction and managing severe cases, which might improve outcomes. Our study aimed to find out if there is any correlation between clinical severity and elevated hematological and biochemical markers in COVID-19 patients and its effect on the outcome. Methods: We have collected retrospective data on socio-demographics, medical history, biomarkers, and disease outcomes from five hospitals and health institutions in the Kingdom of Saudi Arabia. Results: Pneumonia was the most common presentation of COVID-19 in our cohort. The presence of abnormal inflammatory biomarkers (D-dimer, CRP, troponin, LDH, ferritin, and t white blood cells) was significantly associated with unstable COVID-19 disease. In addition, patients with evidence of severe respiratory disease, particularly those who required mechanical ventilation, had higher biomarkers when compared to those with stable respiratory conditions (p < 0.001). Conclusion: Identifying biomarkers predicts outcomes for COVID-19 patients and may significantly help in their management.
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Affiliation(s)
- Mashael Abujabal
- Pediatric Nephrology Unit, Faculty of Medicine and Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mohamed A Shalaby
- Pediatric Nephrology Unit, Faculty of Medicine and Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Layla Abdullah
- Pediatric Nephrology Unit, Faculty of Medicine and Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Amr S Albanna
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
| | - Mohamed Elzoghby
- Pediatric Intensive Care Unit, Pediatrics Department, College of Medicine, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia
| | - Ghadeer Ghazi Alahmadi
- Department of Pediatric, College of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sidharth Kumar Sethi
- Kidney and Renal Transplant Institute, Medanta, The Medicity Hospital, Gurgaon 122001, India
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Prince Abdullah bin Khaled Coeliac Disease Research Chair, King Saud University, Riyadh 11362, Saudi Arabia
| | - Fadi Aljamaan
- Critical Care Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Department of Kidney and Pancreas Transplantation, Solid Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 12713, Saudi Arabia
| | - Jameela A Kari
- Pediatric Nephrology Unit, Faculty of Medicine and Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Diagnosis and Stratification of COVID-19 Infections Using Differential Plasma Levels of D-Dimer: A Two-Center Study from Saudi Arabia. MICROBIOLOGY RESEARCH 2023. [DOI: 10.3390/microbiolres14010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: D-dimer, generated upon the degradation of fibrin, is extensively used to detect thrombosis in various diseases. It is also explored as a marker for thrombosis in cases with COVID-19 disease. Few studies have confirmed its utility as a marker for assessing disease severity. Objectives: The current research was undertaken to determine the role of D-dimer in patients with COVID-19 and to investigate any association with the progression and severity of the disease in the Saudi population. Methods: Clinical indices in confirmed COVID-19 patients were collected from tertiary care hospitals in Aljouf and Qassim regions. The plasma D-dimer levels were quantified directly in the samples collected from COVID-19 patients (n = 148) using an immunofluorescence assay, and the data were presented in Fibrinogen Equivalent Units (mg/L). The collected data of D-dimer were analyzed based on COVID-19 severity, age, and the gender of patients. Results: The findings show that the plasma D-dimer concentrations were significantly (p = 0.0027) elevated in COVID-19 cases (n = 148), compared to in the normal healthy uninfected controls (n = 309). Moreover, the D-dimer levels were analyzed according to the severity of the disease in the patients. The data revealed that D-dimer concentrations were significantly increased in patients with mild infection to moderate disease, and the levels were the highest in patients with severe COVID-19 disease (p < 0.05). Our analysis demonstrates that the D-dimer levels have no association with the age or gender of COVID-19 patients (p > 0.05) in the study population. Conclusions: D-dimer can serve as a biomarker not only for the detection of COVID-19 infection, but also for determining the severity of infection of COVID-19 disease.
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Ray S, Banerjee A, Swift A, Fanstone JW, Mamalakis M, Vorselaars B, Wilkie C, Cole J, Mackenzie LS, Weeks S. A robust COVID-19 mortality prediction calculator based on Lymphocyte count, Urea, C-Reactive Protein, Age and Sex (LUCAS) with chest X-rays. Sci Rep 2022; 12:18220. [PMID: 36309547 PMCID: PMC9617052 DOI: 10.1038/s41598-022-21803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/04/2022] [Indexed: 01/08/2023] Open
Abstract
There have been numerous risk tools developed to enable triaging of SARS-CoV-2 positive patients with diverse levels of complexity. Here we presented a simplified risk-tool based on minimal parameters and chest X-ray (CXR) image data that predicts the survival of adult SARS-CoV-2 positive patients at hospital admission. We analysed the NCCID database of patient blood variables and CXR images from 19 hospitals across the UK using multivariable logistic regression. The initial dataset was non-randomly split between development and internal validation dataset with 1434 and 310 SARS-CoV-2 positive patients, respectively. External validation of the final model was conducted on 741 Accident and Emergency (A&E) admissions with suspected SARS-CoV-2 infection from a separate NHS Trust. The LUCAS mortality score included five strongest predictors (Lymphocyte count, Urea, C-reactive protein, Age, Sex), which are available at any point of care with rapid turnaround of results. Our simple multivariable logistic model showed high discrimination for fatal outcome with the area under the receiving operating characteristics curve (AUC-ROC) in development cohort 0.765 (95% confidence interval (CI): 0.738-0.790), in internal validation cohort 0.744 (CI: 0.673-0.808), and in external validation cohort 0.752 (CI: 0.713-0.787). The discriminatory power of LUCAS increased slightly when including the CXR image data. LUCAS can be used to obtain valid predictions of mortality in patients within 60 days of SARS-CoV-2 RT-PCR results into low, moderate, high, or very high risk of fatality.
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Affiliation(s)
- Surajit Ray
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Abhirup Banerjee
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, UK
| | - Andrew Swift
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | | | - Michail Mamalakis
- School of Computer Science, University of Sheffield, 211 Portobello, Sheffield City Centre, Sheffield, S1 4DP, UK
| | - Bart Vorselaars
- School of Mathematics and Physics, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, UK
| | - Craig Wilkie
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Joby Cole
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Louise S Mackenzie
- School of Applied Sciences, University of Brighton, Brighton, BN2 4AT, UK.
| | - Simonne Weeks
- School of Applied Sciences, University of Brighton, Brighton, BN2 4AT, UK
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Alsagaby SA, Alharbi NK, Alhumaydhi FA, Alsubaie F, Bosaeed M, Aljouie A, Assiri AM, Alshammari K. Risk factors of SARS-CoV-2 infection in cancer patients pre- and post-vaccination. PLoS One 2022; 17:e0272869. [PMID: 35943973 PMCID: PMC9362932 DOI: 10.1371/journal.pone.0272869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Severe complications from COVID-19 and poor responses to SARS-CoV-2 vaccination were commonly reported in cancer patients compared to those without cancer. Therefore, the identification of predisposing factors to SARS-CoV-2 infection in cancer patients would assist in the prevention of COVID-19 and improve vaccination strategies. The literature lacks reports on this topic from the Kingdom of Saudi Arabia (KSA). Therefore, we studied clinical and laboratory data of 139 cancer patients from King Abdulaziz Medical City, Riyadh, KSA.
Methods
The cancer patients fall into three categories; (i) uninfected with SARS-CoV-2 pre-vaccination and remained uninfected post-vaccination (control group; n = 114; 81%), (ii) pre-vaccination infected group (n = 16; 11%), or (iii) post-vaccination infected group (n = 9; 6%). Next, the clinical and lab data of the three groups of patients were investigated.
Results
Comorbidity factors like diabetes and hemodialysis were associated with the risk of infection in cancer patients before the vaccination (p<0.05). In contrast to breast cancer, papillary thyroid cancer was more prevalent in the infected patients pre- and post-vaccination (p<0.05). Pre-vaccination infected group had earlier cancer stages compared with the control group (p = 0.01). On the other hand, combined therapy was less commonly administrated to the infected groups versus the control group (p<0.05). Neutrophil to lymphocyte ratio was lower in the post-vaccination infected group compared to the control group (p = 0.01).
Conclusion
Collectively, this is the first study from KSA to report potential risk factors of SARS-CoV-2 infection in cancer patients pre- and post-vaccination. Further investigations on these risk factors in a larger cohort are worthwhile to draw a definitive conclusion about their roles in predisposing cancer patients to the infection.
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Affiliation(s)
- Suliman A. Alsagaby
- Department of Medical Laboratories Sciences, College of Applied Medical Sciences, Majmaah University, AL-Majmaah, Saudi Arabia
- * E-mail:
| | - Naif Khalaf Alharbi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Fahad A. Alhumaydhi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Faisal Alsubaie
- Assistant Agency for Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohammad Bosaeed
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
- King Abdulaziz Medical City (KAMC), Ministry of National Guard–Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Abdulrhman Aljouie
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Abdullah M. Assiri
- Assistant Agency for Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Kanan Alshammari
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
- King Abdulaziz Medical City (KAMC), Ministry of National Guard–Health Affairs (MNG-HA), Riyadh, Saudi Arabia
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COVID-19 Severity and Mortality in Two Pandemic Waves in Poland and Predictors of Poor Outcomes of SARS-CoV-2 Infection in Hospitalized Young Adults. Viruses 2022; 14:v14081700. [PMID: 36016322 PMCID: PMC9413321 DOI: 10.3390/v14081700] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023] Open
Abstract
SARS-CoV-2 variants pose a significant threat to global public health. However, their influence on disease severity, especially among young adults who may exhibit different clinical characteristics, is debatable. In this retrospective study of 229 young adults hospitalized with COVID-19, we investigated the differences between Poland's second and third waves of the pandemic. To identify potential predictors of severe COVID-19 in young adults, we analyzed patient characteristics and laboratory findings between survivors and non-survivors and we performed logistic regression to assess the risk of death, mechanical ventilation, and intensive care unit treatment. We found no increase in COVID-19 severity comparing the third and second waves of the pandemic, indicating that the alpha variant had no influence on disease severity. In addition, we found that factors, such as obesity, comorbidities, lung involvement, leukocytosis, neutrophilia, lymphopenia, higher IG count, the neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin, interleukin-6, D-Dimer, lactate dehydrogenase, high-sensitive troponin I, creatine kinase-myocardial band, myoglobin, N-terminal-pro-B-type natriuretic peptide, creatinine, urea and gamma-glutamyl transferase, lower estimated glomerular filtration rate, albumin, calcium and vitamin D3, possibly a decrease in red blood cell counts, hemoglobin and hematocrit, and an increase in creatine kinase during hospitalization may be associated with poor outcomes of COVID-19.
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Alharbi NK, Al-Tawfiq JA, Alwehaibe A, Alenazi MW, Almasoud A, Algaisi A, Alhumaydhi FA, Hashem AM, Bosaeed M, Alsagaby SA. Persistence of Anti-SARS-CoV-2 Spike IgG Antibodies Following COVID-19 Vaccines. Infect Drug Resist 2022; 15:4127-4136. [PMID: 35937784 PMCID: PMC9348632 DOI: 10.2147/idr.s362848] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose This study was conducted to investigate antibody immune responses induced by BNT162b2 and AZD1222 human COVID-19 vaccines in Riyadh city, Saudi Arabia. Patients and Methods ELISA was used to evaluate antibodies, against the SARS-CoV-2 spike S1 protein, in serum samples from 432 vaccinated individuals at six time points: pre-vaccination (baseline), post-prime, post-boost, 6-months, and 1 year post-vaccination, and 3 weeks post a third dose. Virus microneutralization assay was used to confirm antibody responses in a subset of samples. Results Anti-SARS-CoV-2 spike IgG were detected in most subjects post-prime, reached a peak level post-boost, and remained at high level at the 6-month follow-up. At 1 year post-vaccine, the antibody levels were low but increased to a significant level higher than the peak following a third dose. The third dose was given at an average of 250 days after the second dose. The virus microneutralization assay confirmed the neutralization activity of the induced SARS-CoV-2 IgG antibodies. The vaccines induced higher IgG titres at post-prime (p=0.0001) and 6 months (p=0.006) in previously infected individuals. An increased interval between prime and boost, more than recommended time, appeared to enhance the IgG levels (p=0004). Moreover, the vaccines induced higher IgG levels in younger subjects (p=0.01). Conclusion These data provide insights and build on the current understanding of immune responses induced by these two vaccines; and support a third boosting dose for these COVID-19 vaccines.
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Affiliation(s)
- Naif Khalaf Alharbi
- Vaccine Development Unit, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
- Correspondence: Naif Khalaf Alharbi, Email
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Diseases Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Infectious Diseases Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amal Alwehaibe
- Vaccine Development Unit, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Mohamed W Alenazi
- Vaccine Development Unit, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Abdulrahman Almasoud
- Vaccine Development Unit, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Abdullah Algaisi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Fahad A Alhumaydhi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Anwar M Hashem
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Bosaeed
- Vaccine Development Unit, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
- King Abdulaziz Medical City (KAMC), Ministry of National Guard – Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Suliman A Alsagaby
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
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Lukaszuk K, Podolak A, Malinowska P, Lukaszuk J, Jakiel G. Cross-Reactivity between Half Doses of Pfizer and AstraZeneca Vaccines-A Preliminary Study. Vaccines (Basel) 2022; 10:521. [PMID: 35455270 PMCID: PMC9028987 DOI: 10.3390/vaccines10040521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 02/02/2023] Open
Abstract
Media reports have caused a significant drop in confidence in the AstraZeneca ChAdOx1 nCoV-19 COVID-19 vector vaccine (Vaxzevria, AstraZeneca Södertälje, Sweden). This has caused many people, already vaccinated with the first dose of AstraZeneca, to refuse vaccination with this product. On the other hand, the increased demand for mRNA vaccines has resulted in a greater shortage of mRNA vaccines and cases of people being vaccinated with the AstraZeneca vaccine after the first dose of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine (Comirnaty, Pfizer/BioNTech, Mainz, Germany). Moreover, currently, 60.9% of the global population have received at least one dose of a COVID-19 vaccine, while only 10% of people in low-income countries have received at least one dose. Even less people are fully vaccinated. The present pilot study evaluated the administration of half doses of AstraZeneca and Pfizer vaccines and included the enrollment of 26 subjects who were vaccinated with a different vaccine the first and second time. The reference group included individuals undergoing vaccination with two full doses of the Pfizer vaccine (21-day interval) monitored for their antibody levels as part of a parallel study. The distribution of antibody levels was not significantly different between those who received the Pfizer vaccine alone and those receiving the AstraZeneca vaccine plus Pfizer or Pfizer and AstraZeneca. To prepare for the next pandemic waves, solving the problem of the matching of booster vaccine to the previously received doses would be advisable. The topic is important and emerging as most of the population in low-income countries is still not vaccinated. We strongly believe that vaccine equity is the most important aspect of vaccination strategies.
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Affiliation(s)
- Krzysztof Lukaszuk
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Amira Podolak
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Paulina Malinowska
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
| | - Jakub Lukaszuk
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
| | - Grzegorz Jakiel
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
- 1st Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Zelazna 90, 01-004 Warszawa, Poland
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