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Mansoori A, Hosseini N, Ghazizadeh H, Aghasizadeh M, Drroudi S, Sahranavard T, Izadi HS, Amiriani A, Farkhani EM, Ferns GA, Ghayour-Mobarhan M, Moohebati M, Esmaily H. Association between biochemical and hematologic factors with COVID-19 using data mining methods. BMC Infect Dis 2023; 23:897. [PMID: 38129798 PMCID: PMC10734144 DOI: 10.1186/s12879-023-08676-0] [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: 02/27/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND AND AIM Coronavirus disease (COVID-19) is an infectious disease that can spread very rapidly with important public health impacts. The prediction of the important factors related to the patient's infectious diseases is helpful to health care workers. The aim of this research was to select the critical feature of the relationship between demographic, biochemical, and hematological characteristics, in patients with and without COVID-19 infection. METHOD A total of 13,170 participants in the age range of 35-65 years were recruited. Decision Tree (DT), Logistic Regression (LR), and Bootstrap Forest (BF) techniques were fitted into data. Three models were considered in this study, in model I, the biochemical features, in model II, the hematological features, and in model II, both biochemical and homological features were studied. RESULTS In Model I, the BF, DT, and LR algorithms identified creatine phosphokinase (CPK), blood urea nitrogen (BUN), fasting blood glucose (FBG), total bilirubin, body mass index (BMI), sex, and age, as important predictors for COVID-19. In Model II, our BF, DT, and LR algorithms identified BMI, sex, mean platelet volume (MPV), and age as important predictors. In Model III, our BF, DT, and LR algorithms identified CPK, BMI, MPV, BUN, FBG, sex, creatinine (Cr), age, and total bilirubin as important predictors. CONCLUSION The proposed BF, DT, and LR models appear to be able to predict and classify infected and non-infected people based on CPK, BUN, BMI, MPV, FBG, Sex, Cr, and Age which had a high association with COVID-19.
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Affiliation(s)
- Amin Mansoori
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nafiseh Hosseini
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran
| | - Hamideh Ghazizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Division of Clinical Biochemistry, CALIPER Program, Pediatric Laboratory Medicine, the Hospital for Sick Children, Toronto, ON, Canada
| | - Malihe Aghasizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Drroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Sahranavard
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanie Salmani Izadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Amiriani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Mosa Farkhani
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, BN1 9PH, Sussex, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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2
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Hardy N, Vegivinti CTR, Mehta M, Thurnham J, Mebane A, Pederson JM, Tarchand R, Shivakumar J, Olaniran P, Gadodia R, Ganguly A, Kelagere Y, Nallabolu RR, Gaddam M, Keesari PR, Pulakurthi YS, Reddy R, Kallmes K, Musunuru TN. Mortality of COVID-19 in patients with hematological malignancies versus solid tumors: a systematic literature review and meta-analysis. Clin Exp Med 2023; 23:1945-1959. [PMID: 36795239 PMCID: PMC9933827 DOI: 10.1007/s10238-023-01004-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023]
Abstract
Cancer patients are more vulnerable to COVID-19 compared to the general population, but it remains unclear which types of cancer have the highest risk of COVID-19-related mortality. This study examines mortality rates for those with hematological malignancies (Hem) versus solid tumors (Tumor). PubMed and Embase were systematically searched for relevant articles using Nested Knowledge software (Nested Knowledge, St Paul, MN). Articles were eligible for inclusion if they reported mortality for Hem or Tumor patients with COVID-19. Articles were excluded if they were not published in English, non-clinical studies, had insufficient population/outcomes reporting, or were irrelevant. Baseline characteristics collected included age, sex, and comorbidities. Primary outcomes were all-cause and COVID-19-related in-hospital mortality. Secondary outcomes included rates of invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission. Effect sizes from each study were computed as logarithmically transformed odds ratios (ORs) with random-effects, Mantel-Haenszel weighting. The between-study variance component of random-effects models was computed using restricted effects maximum likelihood estimation, and 95% confidence intervals (CIs) around pooled effect sizes were calculated using Hartung-Knapp adjustments. In total, 12,057 patients were included in the analysis, with 2,714 (22.5%) patients in the Hem group and 9,343 (77.5%) patients in the Tumor group. The overall unadjusted odds of all-cause mortality were 1.64 times higher in the Hem group compared to the Tumor group (95% CI: 1.30-2.09). This finding was consistent with multivariable models presented in moderate- and high-quality cohort studies, suggestive of a causal effect of cancer type on in-hospital mortality. Additionally, the Hem group had increased odds of COVID-19-related mortality compared to the Tumor group (OR = 1.86 [95% CI: 1.38-2.49]). There was no significant difference in odds of IMV or ICU admission between cancer groups (OR = 1.13 [95% CI: 0.64-2.00] and OR = 1.59 [95% CI: 0.95-2.66], respectively). Cancer is a serious comorbidity associated with severe outcomes in COVID-19 patients, with especially alarming mortality rates in patients with hematological malignancies, which are typically higher compared to patients with solid tumors. A meta-analysis of individual patient data is needed to better assess the impact of specific cancer types on patient outcomes and to identify optimal treatment strategies.
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Affiliation(s)
| | | | - Mansi Mehta
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - John M Pederson
- Nested Knowledge, Inc, St Paul, MN, USA
- Superior Medical Experts, St. Paul, MN, USA
| | | | - Jeevan Shivakumar
- Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, USA
| | | | - Ritika Gadodia
- Medstar Washington Hospital Center/Georgetown University, Washington, DC, USA
| | - Arup Ganguly
- University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Yashaswini Kelagere
- Department of Pediatrics, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | | | | | - Praneeth R Keesari
- Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Rohit Reddy
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Tejo N Musunuru
- Department of Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, USA.
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3
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Wilkerson RG, Annous Y, Farhy E, Hurst J, Smedley AD. Home Pulse Oximetry Monitoring during the COVID-19 Pandemic: An Assessment of Patient Engagement and Compliance. HEALTH POLICY AND TECHNOLOGY 2023; 12:100776. [PMID: 38620095 PMCID: PMC10291857 DOI: 10.1016/j.hlpt.2023.100776] [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] [Indexed: 04/17/2024]
Abstract
Objectives Patients with suspected COVID-19 remain at risk for clinical deterioration after discharge and may benefit from home oxygen saturation (SpO2) monitoring using portable pulse oximeter devices. Our study aims to evaluate patient engagement and compliance with a home SpO2 monitoring program. Methods This is a single center, prospective pilot study of patients being discharged from the ED or urgent care after evaluation of symptoms consistent with COVID-19. Subjects were given a portable pulse oximeter and instructed to obtain measurements at rest and with exertion twice daily for 14 days. Patients were contacted daily to collect recorded data. If attempts to contact the patient were unsuccessful for 3 consecutive days, patients were considered lost to follow up. The primary outcome of interest was patient engagement in the program which was defined as the percentage of patients that completed the 14-day study period, meaning they were not lost to follow up. Secondary outcomes included compliance with performing the SpO2 readings. Patient compliance was calculated as a percentage of completed readings out of the total expected readings. Results Fifty patients were enrolled - 2 withdrew and 1 was a screen failure. Overall, engagement in the program was 46.8% with no significant difference between those who tested positive for SARS-CoV-2 versus those who tested negative (48.2% vs 45%, p = 0.831). Median compliance overall was 42.9% (IQR 22.22-78.57). Median compliance for the positive group was 50.0% (IQR 20-85.71) and 42.86% (IQR 22.92-76.44) for the negative group (p= 0.838). Conclusion Our study demonstrated that there was acceptable engagement and compliance in a 14-day home SpO2 monitoring program. These results support the use of home pulse oximetry monitoring in a select group of mildly ill patients with suspected COVID-19.
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Affiliation(s)
- R Gentry Wilkerson
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Youssef Annous
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Eli Farhy
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Jonathan Hurst
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Angela D Smedley
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
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Korb VG, Schultz IC, Beckenkamp LR, Wink MR. A Systematic Review of the Role of Purinergic Signalling Pathway in the Treatment of COVID-19. Int J Mol Sci 2023; 24:ijms24097865. [PMID: 37175571 PMCID: PMC10178215 DOI: 10.3390/ijms24097865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/27/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health concern. Three years since its origin, despite the approval of vaccines and specific treatments against this new coronavirus, there are still high rates of infection, hospitalization, and mortality in some countries. COVID-19 is characterised by a high inflammatory state and coagulation disturbances that may be linked to purinergic signalling molecules such as adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine (ADO), and purinergic receptors (P1 and P2). These nucleotides/nucleosides play important roles in cellular processes, such as immunomodulation, blood clot formation, and vasodilation, which are affected during SARS-CoV-2 infection. Therefore, drugs targeting this purinergic pathway, currently used for other pathologies, are being evaluated in preclinical and clinical trials for COVID-19. In this review, we focus on the potential of these drugs to control the release, degradation, and reuptake of these extracellular nucleotides and nucleosides to treat COVID-19. Drugs targeting the P1 receptors could have therapeutic efficacy due to their capacity to modulate the cytokine storm and the immune response. Those acting in P2X7, which is linked to NLRP3 inflammasome activation, are also valuable candidates as they can reduce the release of pro-inflammatory cytokines. However, according to the available preclinical and clinical data, the most promising medications to be used for COVID-19 treatment are those that modulate platelets behaviour and blood coagulation factors, mainly through the P2Y12 receptor.
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Affiliation(s)
- Vitoria Guero Korb
- Laboratório de Biologia Celular, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil
| | - Iago Carvalho Schultz
- Laboratório de Biologia Celular, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil
| | - Liziane Raquel Beckenkamp
- Laboratório de Biologia Celular, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil
| | - Márcia Rosângela Wink
- Laboratório de Biologia Celular, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Sala 304 Centro, Porto Alegre 90050-170, RS, Brazil
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5
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Sher EK, Ćosović A, Džidić-Krivić A, Farhat EK, Pinjić E, Sher F. Covid-19 a triggering factor of autoimmune and multi-inflammatory diseases. Life Sci 2023; 319:121531. [PMID: 36858313 PMCID: PMC9969758 DOI: 10.1016/j.lfs.2023.121531] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023]
Abstract
SARS-CoV-2 virus has attracted a lot of attention globally due to the autoimmune and inflammatory processes that were observed during the development of Covid-19 disease. Excessive activation of immune response and triggering of autoantibodies synthesis as well as an excessive synthesis of inflammatory cytokines and the onset of cytokine storm has a vital role in the disease outcome and the occurring autoimmune complications. This scenario is reminiscent of infiltration of lymphocytes and monocytes in specific organs and the increased production of autoantibodies and chemoattractants noted in other inflammatory and autoimmune diseases. The main goal of this study is to investigate the complex inflammatory processes that occur in Covid-19 disease and to find similarities with other inflammatory diseases such as multiple sclerosis (MS), acute respiratory distress syndrome (ARDS), rheumatoid arthritis (RA) and Kawasaki syndrome to advance existing diagnostic and therapeutic protocols. The therapy with Interferon-gamma (IFN-γ) and the use of S1P receptor modulators showed promising results. However, there are many unknowns about these mechanisms and possible novel therapies. Therefore, the inflammation and autoimmunity triggered by Covid-19 should be further investigated to improve existing diagnostic procedures and therapeutic protocols for Covid-19.
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Affiliation(s)
- Emina Karahmet Sher
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom.
| | - Adnan Ćosović
- Faculty of Pharmacy, University of Modern Sciences - CKM, Mostar 88000, Bosnia and Herzegovina
| | - Amina Džidić-Krivić
- International Society of Engineering Science and Technology, Nottingham, United Kingdom; Department of Neurology, Cantonal Hospital Zenica, Zenica 72000, Bosnia and Herzegovina
| | - Esma Karahmet Farhat
- International Society of Engineering Science and Technology, Nottingham, United Kingdom; Department of Food and Nutrition Research, Juraj Strossmayer University of Osijek, Faculty of Food Technology, Croatia
| | - Emma Pinjić
- International Society of Engineering Science and Technology, Nottingham, United Kingdom; Department of Radiology, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, United States
| | - Farooq Sher
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom.
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Erkens R, Duse D, Wernly B, Flaatten H, Fjølner J, Bruno RR, Wolff G, Artigas A, Kelm M, Beil M, Sviri S, Schaller SJ, Fuest K, Szczeklik W, Piayda K, Elhadi M, Joannidis M, Nedergaard HK, Oeyen S, Moreno R, Leaver S, de Lange DW, Guidet B, Jung C. Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study. Clin Hemorheol Microcirc 2023; 84:309-320. [PMID: 37248892 DOI: 10.3233/ch-231790] [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] [Indexed: 05/31/2023]
Abstract
AIMS Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients. METHODS In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell (RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded. RESULTS In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality. CONCLUSION The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients.
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Affiliation(s)
- Ralf Erkens
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Dragos Duse
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Bernhard Wernly
- Department of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Hans Flaatten
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jesper Fjølner
- Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Raphael Romano Bruno
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Georg Wolff
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Antonio Artigas
- Department of Intensive Care Medicine, Parc Tauli Hospital Universitari, Institut d'Investigació I Innovacio Par tauli (I3PT-CERCA), CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Barcelona, Spain
| | - Malte Kelm
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- CARID (Cardiovascular Research Institute Düsseldorf), Düsseldorf, Germany
| | - Michael Beil
- Department of Medical Intensive Care, Hadassah University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sigal Sviri
- Department of Medical Intensive Care, Hadassah University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Stefan J Schaller
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK, CCM), Charitè-Universitätsmedizin Berlin, Freie Universiätt Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kristina Fuest
- Klinikum Rechts der Isar, Department of Anaesthesiology & Intensive Care Medicine, School of Medicine, Technical University Munich, Munich, Germany
| | - Wojciech Szczeklik
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Kerstin Piayda
- Department of Cardiology and Angiology, Universitätsklinikum Gießen und Marburg, Gießen, Germany
| | | | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Helene Korvenius Nedergaard
- Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sandra Oeyen
- Department of Intensive Care 1K12IC, Ghent University Hospital, Ghent, Belgium
| | - Rui Moreno
- Unidade de Cuidados Intensivos Neurocríticos e Trauma, Hospital de São José, Centro Hospitalar Universitério de Lisboa Central, Faculdade de Ciências Médicas de Lisboa, Nova Médical School, Lisbon, Portugal
| | - Susannah Leaver
- General Intensive Care, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Dylan W de Lange
- Department of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, The Netherlands
| | - Bertrand Guidet
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe: Épidémiologie Hospitalière Qualité et Organisation des Soins, Paris, France
- Assistance Publique -Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale,, Paris, France
| | - Christian Jung
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
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Fan C, Wu Y, Rui X, Yang Y, Ling C, Liu S, Liu S, Wang Y. Animal models for COVID-19: advances, gaps and perspectives. Signal Transduct Target Ther 2022; 7:220. [PMID: 35798699 PMCID: PMC9261903 DOI: 10.1038/s41392-022-01087-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19, caused by SARS-CoV-2, is the most consequential pandemic of this century. Since the outbreak in late 2019, animal models have been playing crucial roles in aiding the rapid development of vaccines/drugs for prevention and therapy, as well as understanding the pathogenesis of SARS-CoV-2 infection and immune responses of hosts. However, the current animal models have some deficits and there is an urgent need for novel models to evaluate the virulence of variants of concerns (VOC), antibody-dependent enhancement (ADE), and various comorbidities of COVID-19. This review summarizes the clinical features of COVID-19 in different populations, and the characteristics of the major animal models of SARS-CoV-2, including those naturally susceptible animals, such as non-human primates, Syrian hamster, ferret, minks, poultry, livestock, and mouse models sensitized by genetically modified, AAV/adenoviral transduced, mouse-adapted strain of SARS-CoV-2, and by engraftment of human tissues or cells. Since understanding the host receptors and proteases is essential for designing advanced genetically modified animal models, successful studies on receptors and proteases are also reviewed. Several improved alternatives for future mouse models are proposed, including the reselection of alternative receptor genes or multiple gene combinations, the use of transgenic or knock-in method, and different strains for establishing the next generation of genetically modified mice.
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Affiliation(s)
- Changfa Fan
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
| | - Yong Wu
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
| | - Xiong Rui
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100083, China
| | - Yuansong Yang
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
| | - Chen Ling
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
- College of Life Sciences, Northwest University; Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, 710069, China
| | - Susu Liu
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
| | - Shunan Liu
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), National Rodent Laboratory Animal Resources Center, Beijing, 102629, China
| | - Youchun Wang
- Division of HIV/AIDS and Sexually Transmitted Virus Vaccines, Institute for Biological Product Control, National Institutes for Food and Drug Control (NIFDC), Beijing, China.
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Outcomes of Cancer Patients with COVID-19 in a Hospital System in the Chicago Metropolitan Area. Cancers (Basel) 2022; 14:cancers14092209. [PMID: 35565336 PMCID: PMC9105648 DOI: 10.3390/cancers14092209] [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: 02/08/2022] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 01/27/2023] Open
Abstract
Patients with a history of malignancy have been shown to be at an increased risk of COVID-19-related morbidity and mortality. Poorer clinical outcomes in that patient population are likely due to the underlying systemic illness, comorbidities, and the cytotoxic and immunosuppressive anti-tumor treatments they are subjected to. We identified 416 cancer patients with SARS-CoV-2 infection being managed for their malignancy at Northwestern Medicine in Chicago, Illinois, between March and July of 2020. Seventy-five (18.0%) patients died due to COVID-related complications. Older age (>60), male gender, and current treatment with immunotherapy were associated with shorter overall survival. Laboratory findings showed that higher platelet counts, ALC, and hemoglobin were protective against critical illness and death from COVID-19. Conversely, elevated inflammatory markers such as ferritin, d-dimer, procalcitonin, CRP, and LDH led to worse clinical outcomes. Our findings suggest that a thorough clinical and laboratory assessment of infected patients with cancer might help identify a more vulnerable population and implement more aggressive proactive strategies.
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Guerrero-Romero F, Mercado M, Rodríguez-Morán M, Ramírez-Renteria C, Martínez-Aguilar G, Marrero-Rodríguez D, Ferreira-Hermosillo A, Simental-Mendía LE, Remba-Shapiro I, Gamboa-Gómez CI, Albarrán-Sánchez A, Sanchez-García ML. Magnesium-to-Calcium Ratio and Mortality from COVID-19. Nutrients 2022; 14:nu14091686. [PMID: 35565654 PMCID: PMC9101802 DOI: 10.3390/nu14091686] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 02/05/2023] Open
Abstract
Obesity, type 2 diabetes, arterial hypertension, decrease in immune response, cytokine storm, endothelial dysfunction, and arrhythmias, which are frequent in COVID-19 patients, are associated with hypomagnesemia. Given that cellular influx and efflux of magnesium and calcium involve the same transporters, we aimed to evaluate the association of serum magnesium-to-calcium ratio with mortality from severe COVID-19. The clinical and laboratory data of 1064 patients, aged 60.3 ± 15.7 years, and hospitalized by COVID-19 from March 2020 to July 2021 were analyzed. The data of 554 (52%) patients discharged per death were compared with the data of 510 (48%) patients discharged per recovery. The ROC curve showed that the best cut-off point of the magnesium-to-calcium ratio for identifying individuals at high risk of mortality from COVID-19 was 0.20. The sensitivity and specificity were 83% and 24%. The adjusted multivariate regression model showed that the odds ratio between the magnesium-to-calcium ratio ≤0.20 and discharge per death from COVID-19 was 6.93 (95%CI 1.6-29.1) in the whole population, 4.93 (95%CI 1.4-19.1, p = 0.003) in men, and 3.93 (95%CI 1.6-9.3) in women. In conclusion, our results show that a magnesium-to-calcium ratio ≤0.20 is strongly associated with mortality in patients with severe COVID-19.
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Affiliation(s)
- Fernando Guerrero-Romero
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
- Correspondence: ; Tel.: +52-1-618-1450481
| | - Moises Mercado
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Martha Rodríguez-Morán
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Claudia Ramírez-Renteria
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Gerardo Martínez-Aguilar
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Daniel Marrero-Rodríguez
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Aldo Ferreira-Hermosillo
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Luis E. Simental-Mendía
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Ilan Remba-Shapiro
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Claudia I. Gamboa-Gómez
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Alejandra Albarrán-Sánchez
- Department of Internal Medicine, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
| | - Miriam L. Sanchez-García
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
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Mertoglu C, Huyut MT, Olmez H, Tosun M, Kantarci M, Coban TA. COVID-19 is more dangerous for older people and its severity is increasing: a case-control study. Med Gas Res 2022; 12:51-54. [PMID: 34677152 PMCID: PMC8562399 DOI: 10.4103/2045-9912.325992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) triggers important changes in routine blood tests. In this retrospective case-control study, biochemical, hematological and inflammatory biomarkers between March 10, 2020, and November 30, 2020 from 3969 COVID-19 patients (3746 in the non-intensive care unit (non-ICU) group and 223 in the ICU group) were analyzed by dividing into three groups as spring, summer and autumn. In the non-ICU group, lymphocyte to monocyte ratio was lower in autumn than the other two seasons and neutrophil to lymphocyte ratio was higher in autumn than the other two seasons. Also, monocyte and platelet were higher in spring than autumn; and eosinophil, hematocrit, hemoglobin, lymphocyte, and red blood cells decreased from spring to autumn. In the non-ICU group, alanine aminotransferase and gamma-glutamyltransferase gradually increased from spring to autumn, while albumin, alkaline phosphatase, calcium, total bilirubin and total protein gradually decreased. Additionally, C-reactive protein was higher in autumn than the other seasons, erythrocyte sedimentation rate was higher in autumn than summer. The changes in routine blood biomarkers in COVID-19 varied from the emergence of the disease until now. Also, the timely changes of blood biomarkers were mostly more negative, indicating that the disease progresses severely. The study was approved by the Erzincan Binali Yildirim University Non-interventional Clinical Trials Ethic Committee (approval No. 86041) on June 21, 2021.
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Affiliation(s)
- Cuma Mertoglu
- Department of Clinical Biochemistry, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
- Department of Clinical Biochemistry, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Mehmet Tahir Huyut
- Department of Biostatistics, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Hasan Olmez
- Department of Pulmonology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Mustafa Tosun
- Department of Pulmonology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Mecit Kantarci
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Taha Abdulkadir Coban
- Department of Clinical Biochemistry, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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Shahid MF, Malik A, Siddiqi FA, Fazal I, Hammad M, Saeed A, Abbas N. Neutrophil-to-Lymphocyte Ratio and Absolute Lymphocyte Count as Early Diagnostic Tools for Corona Virus Disease 2019. Cureus 2022; 14:e22863. [PMID: 35399415 PMCID: PMC8982500 DOI: 10.7759/cureus.22863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/07/2022] Open
Abstract
Background and objectives In comparison to real-time polymerase chain reaction (RT-PCR) testing, blood-related parameters including absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) carry an indeterminate potential in the assessment of corona virus disease 2019 (COVID-19). Our main objective was to assess their efficacy in timely identification of COVID-19 patients and to determine whether these biomarkers can be employed as an early diagnostic tool in patients presenting with symptoms suggestive of COVID-19. Methodology This cross-sectional study was conducted at the Emergency Department of a Tertiary Care Hospital in Rawalpindi, Pakistan from November 2020 to March 2021. Patients suspected to have COVID-19 on a clinical basis (fever, cough or shortness of breath) were selected by using convenience non-probability sampling. RT-PCR was used to diagnose COVID-19 after evaluating NLR and ALC of the sample population. An NLR = 3.5 and ALC < 1 x 103 cells/mm3 was considered as the cut-off value. Statistical analysis was conducted via SPSS 23.0 (IBM Corp., Armonk, NY). Chi-square and independent t-tests were used to correlate various data variables, while p-value <0.05 was considered significant. Results Out of the 172 subjects included in the study, the mean age was 40.6 ± 10.0 years, while 51% of individuals were males. Fever was found to be the most prevalent complaint (94%). Double RT-PCR testing showed that 51.2% of the population was RT-PCR positive, having a mean ALC of 1.4 ± 0.9 x 103/mm3, significantly lower than RT-PCR negative cases (p < 0.001). In addition, NLR was drastically elevated for RT-PCR-positive individuals (p < 0.001) while it also had a distinctly high specificity of 91.7% among COVID-19 patients. Additionally, NLR did not correlate with any of the baseline patient-related parameters (presenting complaint, age, and gender). Conclusion NLR and ALC are potentially efficacious measures for an early diagnosis of COVID-19, and can be possibly utilized for an early diagnosis of COVID-19 suspects.
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12
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Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Pang P, Ho TY, Cheung CYY, Fong CHY, Law CY, To KKW, Lam CW, Tan KCB, Woo YC, Hung IFN, Lam KSL. The Independent Association of TSH and Free Triiodothyronine Levels With Lymphocyte Counts Among COVID-19 Patients. Front Endocrinol (Lausanne) 2022; 12:774346. [PMID: 35095756 PMCID: PMC8792436 DOI: 10.3389/fendo.2021.774346] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/16/2021] [Indexed: 12/19/2022] Open
Abstract
Background Both lymphopenia and thyroid dysfunction are commonly observed among COVID-19 patients. Whether thyroid function independently correlates with lymphocyte counts (LYM) remains to be elucidated. Methods We included consecutive adults without known thyroid disorder admitted to Queen Mary Hospital for COVID-19 from July 2020 to April 2021 who had thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3) and LYM measured on admission. Results A total of 541 patients were included. Median LYM was 1.22 x 109/L, with 36.0% of the cohort lymphopenic. 83 patients (15.4%) had abnormal thyroid function tests (TFTs), mostly non-thyroidal illness syndrome (NTIS). Patients with lymphopenia had lower TSH, fT4 and fT3 levels than those without. Multivariable stepwise linear regression analysis revealed that both TSH (standardized beta 0.160, p<0.001) and fT3 (standardized beta 0.094, p=0.023), but not fT4, remained independently correlated with LYM, in addition to age, SARS-CoV-2 viral load, C-reactive protein levels, coagulation profile, sodium levels and more severe clinical presentations. Among the 40 patients who had reassessment of TFTs and LYM after discharge, at a median of 9 days from admission, there were significant increases in TSH (p=0.031), fT3 (p<0.001) and LYM (p<0.001). Furthermore, patients who had both lymphopenia and NTIS were more likely to deteriorate compared to those who only had either one alone, and those without lymphopenia or NTIS (p for trend <0.001). Conclusion TSH and fT3 levels showed independent positive correlations with LYM among COVID-19 patients, supporting the interaction between the hypothalamic-pituitary-thyroid axis and immune system in COVID-19.
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Affiliation(s)
- David Tak Wai Lui
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Chi Ho Lee
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Wing Sun Chow
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Alan Chun Hong Lee
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Anthony Raymond Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Polly Pang
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Tip Yin Ho
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Chloe Yu Yan Cheung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Carol Ho Yi Fong
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Chun Yiu Law
- Division of Chemical Pathology, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Kelvin Kai Wang To
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Ching Wan Lam
- Department of Pathology, The University of Hong Kong Hong Kong, Hong Kong SAR, China
| | - Kathryn Choon Beng Tan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Yu Cho Woo
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Ivan Fan Ngai Hung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
| | - Karen Siu Ling Lam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital Hong Kong, Hong Kong SAR, China
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13
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Qi X, Shen L, Chen J, Shi M, Shen B. Predicting the Disease Severity of Virus Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1368:111-139. [DOI: 10.1007/978-981-16-8969-7_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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14
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Welder D, Jeon‐Slaughter H, Ashraf B, Choi S, Chen W, Ibrahim I, Bat T. Immature platelets as a biomarker for disease severity and mortality in COVID-19 patients. Br J Haematol 2021; 194:530-536. [PMID: 34132393 PMCID: PMC8444912 DOI: 10.1111/bjh.17656] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 12/19/2022]
Abstract
COVID-19, caused by SARS-CoV-2, is a contagious life-threatening viral disease that has killed more than three million people worldwide to date. Attempts have been made to identify biomarker(s) to stratify disease severity and improve treatment and resource allocation. Patients with SARS-COV-2 infection manifest with a higher inflammatory response and platelet hyperreactivity; this raises the question of the role of thrombopoiesis in COVID-19 infection. Immature platelet fraction (IPF, %) and immature platelet counts (IPC, ×109 /l) can be used to assess thrombopoiesis. This study investigates whether the level of thrombopoiesis correlates with COVID-19 severity. A large cohort of 678 well-characterized COVID-19 patients was analyzed, including 658 (97%) hospitalized and 139 (21%) admitted to the intensive care unit (ICU). Elevated percentage IPF at presentation was predictive of length of hospitalization (P < 0·01) and ICU admission (P < 0·05). Additionally, percentage IPF at the peak was significantly higher among ICU patients than non-ICU patients (6·9 ± 5·1 vs 5·3 ± 8·4, P < 0·01) and among deceased patients than recovered patients (7·9 ± 6·3 vs 5·4 ± 7·8, P < 0·01). Furthermore, IPC at the peak was significantly higher among ICU patients than non-ICU patients (18·5 ± 16·2 vs. 13·2 ± 8·3, P < 0·05) and among patients on a ventilator than those not (22·1 ± 20·1 vs.13·4 ± 8·4, P < 0·05). Our study demonstrated that elevated initial and peak values of percentage IPF and IPC might serve as prognostic biomarkers for COVID-19 progression to severe conditions.
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Affiliation(s)
- Daniel Welder
- Department of Pathology, Hematopathology SectionUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Haekyung Jeon‐Slaughter
- Department of Internal MedicineVA North Texas Health Care SystemUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Bilal Ashraf
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Sung‐Hee Choi
- Department of Internal MedicineVA North Texas Health Care System and Division of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Weina Chen
- Department of Pathology, Hematopathology SectionUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Ibrahim Ibrahim
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Taha Bat
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
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Zhan XY, Li L, Hu Y, Li Q, Kong H, Ng MHL, Chen C, He Y, Huang B, Yang M. Elderly Male With Cardiovascular-Related Comorbidities Has a Higher Rate of Fatal Outcomes: A Retrospective Study in 602 Patients With Coronavirus Disease 2019. Front Cardiovasc Med 2021; 8:680604. [PMID: 34164443 PMCID: PMC8215131 DOI: 10.3389/fcvm.2021.680604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 01/08/2023] Open
Abstract
Elderly with comorbidities have shown a higher rate of fatal outcomes when suffering coronavirus disease 2019 (COVID-19). However, a delineation of clinical significances of hematologic indices and underlying comorbidities in the progression and outcome of COVID-19 remains undefined. Six hundred two COVID-19 patients with established clinical outcomes (discharged or deceased) from Hankou Hospital of Wuhan, China between January 14, 2020 and February 29, 2020 were retrospectively analyzed. Of the 602 patients with COVID-19, 539 were discharged and 63 died in the hospital. The deceased group showed higher leukocyte and neutrophil counts but lower lymphocyte and platelet counts. Longer activated partial thromboplastin time (APTT) and prothrombin time (PT), as well as higher D-dimer and C-reactive protein levels, were found in non-survivors. Our observations suggest that these parameters could serve as potential predictors for the fatal outcome and in the discharged group. A higher neutrophil count and D-dimer level but lower lymphocyte were associated with a longer duration of hospitalization. A multivariable Cox regression analysis showed that higher neutrophil count, prolonged PT, and low lymphocyte count were risk factors for patients with COVID-19. Also, we found an association of lower lymphocyte count and higher C-reactive protein levels with the elderly group and those with cardiovascular-related comorbidities. The significantly different hematologic profiles between survivors and non-survivors support that distinct hematologic signatures in COVID-19 patients will dictate different outcomes as a prognostic marker for recovery or fatality. Lymphopenia and aggressive inflammatory response might be major causes for fatal outcomes in the elderly male and especially those with cardiovascular-related comorbidities.
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Affiliation(s)
- Xiao-Yong Zhan
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Liang Li
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yuhai Hu
- Department of Clinical Laboratory, Hankou Hospital, Wuhan, China
| | - Qiang Li
- Department of Clinical Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huimin Kong
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Margaret H L Ng
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
| | - Chun Chen
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yulong He
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Bihui Huang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Mo Yang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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16
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Romero-Duarte Á, Rivera-Izquierdo M, Guerrero-Fernández de Alba I, Pérez-Contreras M, Fernández-Martínez NF, Ruiz-Montero R, Serrano-Ortiz Á, González-Serna RO, Salcedo-Leal I, Jiménez-Mejías E, Cárdenas-Cruz A. Sequelae, persistent symptomatology and outcomes after COVID-19 hospitalization: the ANCOHVID multicentre 6-month follow-up study. BMC Med 2021; 19:129. [PMID: 34011359 PMCID: PMC8134820 DOI: 10.1186/s12916-021-02003-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Long-term effects of COVID-19, also called Long COVID, affect more than 10% of patients. The most severe cases (i.e. those requiring hospitalization) present a higher frequency of sequelae, but detailed information on these effects is still lacking. The objective of this study is to identify and quantify the frequency and outcomes associated with the presence of sequelae or persistent symptomatology (SPS) during the 6 months after discharge for COVID-19. METHODS Retrospective observational 6-month follow-up study conducted in four hospitals of Spain. A cohort of all 969 patients who were hospitalized with PCR-confirmed SARS-CoV-2 from March 1 to April 15, 2020, was included. We collected all the SPS during the 6 months after discharge reported by patients during follow-up from primary care records. Cluster analyses were performed to validate the measures. The main outcome measures were return to the Emergency Services, hospital readmission and post-discharge death. Surviving patients' outcomes were collected through clinical histories and primary care reports. Multiple logistic regression models were applied. RESULTS The 797 (82.2%) patients who survived constituted the sample followed, while the rest died from COVID-19. The mean age was 63.0 years, 53.7% of them were men and 509 (63.9%) reported some sequelae during the first 6 months after discharge. These sequelae were very diverse, but the most frequent were respiratory (42.0%), systemic (36.1%), neurological (20.8%), mental health (12.2%) and infectious (7.9%) SPS, with some differences by sex. Women presented higher frequencies of headache and mental health SPS, among others. A total of 160 (20.1%) patients returned to the Emergency Services, 35 (4.4%) required hospital readmission and 8 (1.0%) died during follow-up. The main factors independently associated with the return to Emergency Services were persistent fever, dermatological SPS, arrythmia or palpitations, thoracic pain and pneumonia. CONCLUSIONS COVID-19 cases requiring hospitalization during the first wave of the pandemic developed a significant range of mid- to long-term SPS. A detailed list of symptoms and outcomes is provided in this multicentre study. Identification of possible factors associated with these SPS could be useful to optimize preventive follow-up strategies in primary care for the coming months of the pandemic.
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Affiliation(s)
| | - Mario Rivera-Izquierdo
- Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, Granada, Spain.
- Department of Preventive Medicine and Public Health, University of Granada, Avda. de la Investigación n°11, 18016, Granada, Spain.
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain.
| | - Inmaculada Guerrero-Fernández de Alba
- Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Service of Preventive Medicine and Public Health, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Marina Pérez-Contreras
- Service of Preventive Medicine and Public Health, Hospital Universitario de Puerto Real, Puerto Real, Cádiz, Spain
| | - Nicolás Francisco Fernández-Martínez
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Rafael Ruiz-Montero
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Álvaro Serrano-Ortiz
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Rocío Ortiz González-Serna
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Inmaculada Salcedo-Leal
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Eladio Jiménez-Mejías
- Department of Preventive Medicine and Public Health, University of Granada, Avda. de la Investigación n°11, 18016, Granada, Spain
- Chair of Teaching and Research in Family Medicine, SEMERGEN-UGR, University of Granada, Granada, Spain
| | - Antonio Cárdenas-Cruz
- School of Medicine, University of Granada, Granada, Spain
- Intensive Care Unit, Hospital de Poniente, El Ejido, Almería, Spain
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Murphy P, Glavey S, Quinn J. Anemia and red blood cell abnormalities in COVID-19. Leuk Lymphoma 2021; 62:1539. [PMID: 33478282 DOI: 10.1080/10428194.2020.1869967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Philip Murphy
- Department of Hematology, Beaumont Hospital, Dublin, Ireland
| | - Siobhan Glavey
- Department of Hematology, Beaumont Hospital, Dublin, Ireland
| | - John Quinn
- Department of Hematology, Beaumont Hospital, Dublin, Ireland
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Jain A, Jain A, Prasad P, Chaudhry S, Sharma M, Khunger JM, Gupta DK, Saluja S. COVID-19 in a patient with chronic myelomonocytic leukemia: a twisting tale. Blood Res 2020; 55:278-281. [PMID: 33380560 PMCID: PMC7784132 DOI: 10.5045/br.2020.2020230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Ankur Jain
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Aditi Jain
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Pooja Prasad
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sumita Chaudhry
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Monica Sharma
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Jitender Mohan Khunger
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Dipender Kumar Gupta
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sumita Saluja
- Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A, Hassanzadeh G. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. J Mol Histol 2020; 51:613-628. [PMID: 33011887 PMCID: PMC7533045 DOI: 10.1007/s10735-020-09915-3] [Citation(s) in RCA: 261] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/26/2020] [Indexed: 02/06/2023]
Abstract
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in December 2019 form Wuhan, China leads to coronavirus disease 2019 (COVID-19) pandemic. While the common cold symptoms are observed in mild cases, COVID-19 is accompanied by multiorgan failure in severe patients. The involvement of different organs in severe patients results in lengthening the hospitalization duration and increasing the mortality rate. In this review, we aimed to investigate the involvement of different organs in COVID-19 patients, particularly in severe cases. Also, we tried to define the potential underlying mechanisms of SARS-CoV2 induced multiorgan failure. The multi-organ dysfunction is characterized by acute lung failure, acute liver failure, acute kidney injury, cardiovascular disease, and as well as a wide spectrum of hematological abnormalities and neurological disorders. The most important mechanisms are related to the direct and indirect pathogenic features of SARS-CoV2. Although the presence of angiotensin-converting enzyme 2, a receptor of SARS-CoV2 in the lung, heart, kidney, testis, liver, lymphocytes, and nervous system was confirmed, there are controversial findings to about the observation of SARS-CoV2 RNA in these organs. Moreover, the organ failure may be induced by the cytokine storm, a result of increased levels of inflammatory mediators, endothelial dysfunction, coagulation abnormalities, and infiltration of inflammatory cells into the organs. Therefore, further investigations are needed to detect the exact mechanisms of pathogenesis. Since the involvement of several organs in COVID-19 patients is important for clinicians, increasing their knowledge may help to improve the outcomes and decrease the rate of mortality and morbidity.
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Affiliation(s)
- Tahmineh Mokhtari
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fatemeh Hassani
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Neda Ghaffari
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Ebrahimi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Atousa Yarahmadi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghomareza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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