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Gürcü S, Irmak Kaya Z, Uncu A, Yorulmaz G, Ilgin S. Evaluation of serum neopterin levels in severe COVID-19 patients: An observational study. Medicine (Baltimore) 2024; 103:e38996. [PMID: 39058886 PMCID: PMC11272344 DOI: 10.1097/md.0000000000038996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
In patients with coronavirus disease (COVID-19), a massive inflammatory response is a significant cause of morbidity and mortality. Inflammatory markers are prognostic indicators of disease severity and the ultimate clinical outcome. Several studies have demonstrated a correlation between serum levels of neopterin, which can be an immune system marker, disease severity, and poor outcomes in COVID-19 patients. Our study aimed to determine the diagnostic significance of neopterin in conjunction with routinely measured inflammatory markers in patients with severe COVID-19. Serum neopterin, C-reactive protein (CRP), albumin levels, and complete blood count were determined in 39 patients with severe COVID-19 and 30 healthy individuals. Demographic characteristics, serum neopterin levels, and other laboratory data were compared between patients and healthy volunteers and statistically analyzed. High neopterin levels were observed in patients with severe COVID-19 compared to healthy volunteers. Furthermore, albumin levels were decreased, while CRP levels were increased in patients, statistically significantly. Also, positive correlations were shown between serum neopterin levels and serum CRP levels, while negative correlations were shown between serum neopterin levels and serum albumin levels. Systemic inflammation markers, CRP/albumin ratio, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio were significantly higher, while lymphocyte/monocyte ratio was also significantly lower in patients with severe COVID-19 than in healthy volunteers. However, serum neopterin levels were not linked to the CRP/albumin ratio, the neutrophil/lymphocyte ratio, or the platelet/lymphocyte ratio. On the other hand, they were linked negatively to the lymphocyte/monocyte ratio. Our findings highlight the association between high neopterin levels and patients with severe COVID-19. Neopterin is correlated with traditional inflammatory biomarkers and may indicate general immune and inflammatory activation in patients with severe COVID-19.
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Affiliation(s)
- Sinem Gürcü
- Department of Pharmacy, Eskişehir City Hospital, Eskişehir, Turkey
| | - Zeynep Irmak Kaya
- Department of Internal Medicine, University of Health Sciences, Eskişehir Health Application and Research Center, Eskişehir, Turkey
| | - Ali Uncu
- Department of Medical Biochemistry, Department of Basic Medical Sciences, University of Health Sciences Eskişehir Health Application and Research Center, Eskişehir, Turkey
| | - Göknur Yorulmaz
- Department of Endocrinology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Sinem Ilgin
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
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Dasgupta S, Das S, Chakraborty D. Prediction equations for detecting COVID-19 infection using basic laboratory parameters. J Family Med Prim Care 2024; 13:2683-2691. [PMID: 39071025 PMCID: PMC11272021 DOI: 10.4103/jfmpc.jfmpc_1862_23] [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: 11/23/2023] [Revised: 01/06/2024] [Accepted: 02/04/2024] [Indexed: 07/30/2024] Open
Abstract
Objectives Coronavirus disease 2019 (COVID-19) emerged as a global pandemic during 2019 to 2022. The gold standard method of detecting this disease is reverse transcription-polymerase chain reaction (RT-PCR). However, RT-PCR has a number of shortcomings. Hence, the objective is to propose a cheap and effective method of detecting COVID-19 infection by using machine learning (ML) techniques, which encompasses five basic parameters as an alternative to the costly RT-PCR. Materials and Methods Two machine learning-based predictive models, namely, Artificial Neural Network (ANN) and Multivariate Adaptive Regression Splines (MARS), are designed for predicting COVID-19 infection as a cheaper and simpler alternative to RT-PCR utilizing five basic parameters [i.e., age, total leucocyte count, red blood cell count, platelet count, C-reactive protein (CRP)]. Each of these parameters was studied, and correlation is drawn with COVID-19 diagnosis and progression. These laboratory parameters were evaluated in 171 patients who presented with symptoms suspicious of COVID-19 in a hospital at Kharagpur, India, from April to August 2022. Out of a total of 171 patients, 88 and 83 were found to be COVID-19-negative and COVID-19-positive, respectively. Results The accuracies of the predicted class are found to be 97.06% and 91.18% for ANN and MARS, respectively. CRP is found to be the most significant input parameter. Finally, two predictive mathematical equations for each ML model are provided, which can be quite useful to detect the COVID-19 infection easily. Conclusion It is expected that the present study will be useful to the medical practitioners for predicting the COVID-19 infection in patients based on only five very basic parameters.
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Affiliation(s)
- Shirin Dasgupta
- Dr. B. C. Roy Multi Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, West Bengal, India
| | - Shuvankar Das
- Department of Civil Engineering, Indian Institute of Technology Kharagpur, West Bengal, India
| | - Debarghya Chakraborty
- Department of Civil Engineering, Indian Institute of Technology Kharagpur, West Bengal, India
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Salvio AL, Fernandes RA, Ferreira HFA, Duarte LA, Gutman EG, Raposo-Vedovi JV, Filho CHFR, da Costa Nunes Pimentel Coelho WL, Passos GF, Andraus MEC, da Costa Gonçalves JP, Cavalcanti MG, Amaro MP, Kader R, de Andrade Medronho R, Figueiredo CP, Amado-Leon LA, Alves-Leon SV. High Levels of NfL, GFAP, TAU, and UCH-L1 as Potential Predictor Biomarkers of Severity and Lethality in Acute COVID-19. Mol Neurobiol 2024; 61:3545-3558. [PMID: 37996731 PMCID: PMC11087339 DOI: 10.1007/s12035-023-03803-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Few studies showed that neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), total tubulin-associated unit (TAU), and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) may be related to neurological manifestations and severity during and after SARS-CoV-2 infection. The objective of this work was to investigate the relationship among nervous system biomarkers (NfL, TAU, GFAP, and UCH-L1), biochemical parameters, and viral loads with heterogeneous outcomes in a cohort of severe COVID-19 patients admitted in Intensive Care Unit (ICU) of a university hospital. For that, 108 subjects were recruited within the first 5 days at ICU. In parallel, 16 mild COVID-19 patients were enrolled. Severe COVID-19 group was divided between "deceased" and "survivor." All subjects were positive for SARS-CoV-2 detection. NfL, total TAU, GFAP, and UCH-L1 quantification in plasma was performed using SIMOA SR-X platform. Of 108 severe patients, 36 (33.33%) presented neurological manifestation and 41 (37.96%) died. All four biomarkers - GFAP, NfL, TAU, and UCH-L1 - were significantly higher among deceased patients in comparison to survivors (p < 0.05). Analyzing biochemical biomarkers, higher Peak Serum Ferritin, D-Dimer Peak, Gamma-glutamyltransferase, and C-Reactive Protein levels were related to death (p < 0.0001). In multivariate analysis, GFAP, NfL, TAU, UCH-L1, and Peak Serum Ferritin levels were correlated to death. Regarding SARS-CoV-2 viral load, no statistical difference was observed for any group. Thus, Ferritin, NFL, GFAP, TAU, and UCH-L1 are early biomarkers of severity and lethality of SARS-COV-2 infection and may be important tools for therapeutic decision-making in the acute phase of disease.
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Affiliation(s)
- Andreza Lemos Salvio
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Renan Amphilophio Fernandes
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Helena França Alcaraz Ferreira
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Larissa Araujo Duarte
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Elisa Gouvea Gutman
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Jessica Vasques Raposo-Vedovi
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | | | | | | | - Maria Emília Cosenza Andraus
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - João Paulo da Costa Gonçalves
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Marta Guimarães Cavalcanti
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
- Epidemiology and Evaluation Service, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - Marisa Pimentel Amaro
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
- School of Medicine, Post-Graduate Program in Infectious and Parasitic Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - Rafael Kader
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
- School of Medicine, Post-Graduate Program in Infectious and Parasitic Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - Roberto de Andrade Medronho
- Epidemiology and Evaluation Service, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | | | - Luciane Almeida Amado-Leon
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil.
| | - Soniza Vieira Alves-Leon
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil.
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil.
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Mohamed Hassan AS, Abo Gaziah SSA, Ezzelregal Awad HG, Hegab Abdelhady SM, Talaat Elkhafif NA, Hassan Mostafa NB. "Ultrastructural changes of platelets in COVID-19 and chronic viral hepatitis patients ". Ultrastruct Pathol 2024; 48:234-245. [PMID: 38619195 DOI: 10.1080/01913123.2024.2342437] [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: 01/24/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Abstract
Platelet-viral interactions are evolving as a new concern. Coagulation disorder is a major consequence of the COVID-19 infection. In chronic hepatitis virus infections, defect in coagulation factors, thrombocytopenia and platelet function abnormalities are common. A SARS-CoV-2 infection on top of chronic viral hepatitis infection can be common in areas where viral hepatitis is endemic. Here, we investigate the platelet ultrastructural changes and estimate the serum platelet factor-4 (PF-4), ferritin, CRP, and D-dimer in COVID-19 patients (n = 60), COVID-19 patients with associated chronic viral hepatitis (n = 20), and healthy subjects (n = 20). Ultrastructural changes were demonstrated in all test groups, denoting platelet activation. In chronic viral hepatitis patients, Platelet ultrastrustural apoptotic changes were also seen. Significantly high levels of PF-4 were confirmed in moderate and severe COVID-19 patients (P.value <0.001), with a cut off value of 17 ng/ml for predicting disease severity. A positive correlation of PF-4 with the level of serum ferritin, CRP, and D-dimer (p value < 0.001) was noted, while negatively correlated with platelet count and platelet granule count (p value < 0.001). In our study, chronic viral hepatitis patients presented mild COVID-19 signs, and their PF-4 level was comparable with the subgroup of mild COVID-19 infection. The platelet's critical role in COVID-19 coagulopathy and chronic viral hepatitis is evidenced by the ultrastructural changes and the high levels of PF4. Moreover, a dual viral infection poses a substantial burden on the platelets, necessitating close monitoring of the patient's coagulation profile.
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Izhari MA. SARS-CoV-2 Infection-Dependent Modulation in Vital Components of the Serum Profile of Severely SARS-CoV-2 Infected Patients. Infect Drug Resist 2024; 17:1653-1667. [PMID: 38707987 PMCID: PMC11068052 DOI: 10.2147/idr.s463238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Background COVID-19 modulates many serological biomarkers during the progress of disease severity. The study aimed to determine COVID-19 severity-associated perturbance in the serum profile. Methods A retrospective study including COVID-19-positive individuals (n = 405) was accomplished. The serum profile of COVID-19 participants was mined from laboratory records. Severity-associated alteration in the serum profile was evaluated using Pearson correlation, regression, VCramer, Bayesian posterior VCramer, and bias factor using R-base-RStudio-version-3.3.0 with a significant cut-off of p < 0.05. Results Significantly different mean ± standard deviation (SD) (highly versus moderately severe) of C-reactive protein (CRP), ferritin, neutrophil-lymphocyte ratio (NLR), D-dimer, platelets, prothrombin time (PT), partial prothrombin time (PTT), troponin 1, lactate dehydrogenase (LDH), aspartate-aminotransferase (AST), alanine aminotransferase (ALT), and AST/ALT ratio was observed (p < 0.001). Highly severe COVID-19 associated with CRP, ferritin, NLR, in D-dimer, PT, PTT, troponin 1, AST/ALT ratio, AST and ALT (adjusted odds ratio (AOR): 1.346, 1.05, 1.46, 1.33, 1.42, 1.23, 4.07, 3.9, 1.24, 1.45, p < 0.001). CRP with ferritin (r = 0.743), NLR (r = 0.77), white blood cells (WBC) (r = 0.8), troponin1 with LDH (r = 0.757), and D-dimer with platelets (r = -0.81) were highly correlated. X2pearson (p < 0.001), VCramer (0.71), Bayesian-VCramer (0.7), and bias-factor (-125) for troponin 1 indicate the strong association of troponin 1 level and with COVID-19 severity. X2pearson (p < 0.001), VCramer (1), Bayesian-VCramer (0.98), and bias-factor (-266.3) for NLR exhibited a very strong association of pathologic conditions with the high severity of the disease. Conclusion These biomarkers of inflammation (CRP, Ferritin, NLR), coagulation disorders (D-dimer, PT, and PTT) cardiac abnormality (troponin 1), and liver injury (AST/ALT) could be crucial in low-medical resource settings as potential prognosticator/predictors of the COVID-19 severity and clinical outcomes. Moreover, the outcome of this study could be leveraged for the early prediction of disease severity during SARS-CoV or Middle East Respiratory Coronavirus (MERS-CoV) infection.
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Affiliation(s)
- Mohammad Asrar Izhari
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
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Shivalingappa MD, Gachinmath S, Narayan SK. Associated Risk Factors and Clinical Outcomes of Bloodstream Infections among COVID-19 Intensive Care Unit Patients in a Tertiary Care Hospital. J Glob Infect Dis 2024; 16:60-67. [PMID: 39081505 PMCID: PMC11286086 DOI: 10.4103/jgid.jgid_108_23] [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: 06/14/2023] [Revised: 01/08/2024] [Accepted: 01/29/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction The COVID-19 infection is an ongoing public health crisis causing millions of deaths worldwide. COVID-19 patients admitted to the intensive care unit (ICU) are more vulnerable to acquire secondary bloodstream infections (sBSIs) which cause a significant morbidity and mortality. Thus, we aim to assess the risk factors of sBSIs and outcomes in COVID-19 ICU patients. Methods One hundred blood culture samples with growth (cases) and other 100 blood culture with no growth(controls) were collected.. All the demographic data, laboratory data and antimicrobial resistance pattern were analysed . Blood culture bottle received in the Microbiology laboratory were loaded into Automated blood culture system. Flagged bottles were processed for final identification by MALDI TOF and automated antibiotic susceptibility testing. Flagged bottles were processed for final identification by MALDI TOF and automated antibiotic susceptibility testing. Results Raised C-reactive protein (CRP) (P = 0.0035), interleukin-6 (P = 0.0404), mechanical ventilation (MV) (P = 0.024), prior antimicrobial exposure (P = 0.002), longer ICU stay with median 11 days (P = 0.022), and higher mortality rate (P = 0.001) were significantly associated with the BSI. A significant proportion of BSIs were Gram-negative bacteria (n = 115) such as Acinetobacter baumannii 38 (33%) and Klebsiella pneumoniae 30 (26%). Monomicrobial organisms in blood yielded a higher proportion in our study 72 (72%). The highest resistance for Acinetobacter species (50) was observed with ceftazidime 29 (96.6%) amikacin 48 (96%), meropenem 48 (96%), cefotaxime 47 (94%), ciprofloxacin 46 (92%), and netilmicin 46 (92%). K. pneumoniae was highly resistant to cefotaxime 29 (96.6%), ceftazidime 29 (96.6%), ciprofloxacin 22 (73.3%), and cefuroxime 21 (70%). Among Gram-positive organisms, Enterococcus species showed that a resistance for high-level gentamicin and penicillin was 66.6%. Conclusions Raised CRP, need of MV, prior antimicrobial exposure, and longer ICU stay should alarm clinicians for BSI. Hence, our study highlights the associated risk factors for BSI and emphasizes adherence to hospital infection control policies and antibiotic stewardship program.
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Affiliation(s)
| | - Supriya Gachinmath
- Department of Microbiology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
| | - Shiva Kumar Narayan
- Department of Critical Care Medicine, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
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Bastin A, Abbasi F, Roustaei N, Abdesheikhi J, Karami H, Gholamnezhad M, Eftekhari M, Doustimotlagh A. Severity of oxidative stress as a hallmark in COVID-19 patients. Eur J Med Res 2023; 28:558. [PMID: 38049886 PMCID: PMC10696844 DOI: 10.1186/s40001-023-01401-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/27/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION Understanding the mechanisms and identifying effective treatments for the COVID-19 outbreak are imperative. Therefore, this study aimed to assess the antioxidant status and oxidative stress parameters as potential pivotal mechanisms in asymptomatic, non-severe, and severe COVID-19 patients. METHODS This study is a case-control study that was performed on patients referred to the Persian Gulf Martyrs Hospital of Bushehr University of Medical Sciences, Bushehr, Iran, from May 2021 to September 2021. A total of 600 COVID-19 patients (non-severe and severe group) and 150 healthy volunteers of the same age and sex were selected during the same period. On the first day of hospitalization, 10 ml of venous blood was taken from subjects. Then, hematological, biochemical, serological, antioxidant and oxidative stress parameters were determined. RESULTS Our results indicated that ESR, CRP, AST, ALT, and LDH significantly augmented in the severe group as compared to the non-severe and normal groups (P ≤ 0.05). It was observed that the levels of FRAP, G6PD activity, and SOD activity significantly reduced in the non-severe patients in comparison with the severe and normal groups (P ≤ 0.05). We found that MDA content and NO metabolite markedly increased in severe patients as compared to the non-severe group. CONCLUSIONS Taken together, it seems that the balance between antioxidants and oxidants was disturbed in COVID-19 patients in favor of oxidant markers. In addition, this situation caused more aggravation in severe patients as compared to the non-severe group.
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Affiliation(s)
- Alireza Bastin
- Clinical Research Development Center, "The Persian Gulf Martyrs" Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Clinical Biochemistry, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Abbasi
- Department of Infectious Disease, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Narges Roustaei
- Department of Biostatistics and Epidemiology, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Jahangir Abdesheikhi
- Department of Clinical Immunology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hossein Karami
- Clinical Research Development Center, "The Persian Gulf Martyrs" Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Gholamnezhad
- Department of Infectious Disease, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mahdieh Eftekhari
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Department of Pharmacognosy and Pharmaceutical Biotechnology, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Amirhossein Doustimotlagh
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
- Department of Clinical Biochemistry, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
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Gurung S, Karki S, Pathak BD, Yadav GK, Bhatta G, Thapa S, Banmala S, Thapa AJ, Roka K. Gastrointestinal symptoms among COVID-19 patients presenting to a primary health care center of Nepal: A cross-sectional study. Health Sci Rep 2023; 6:e1568. [PMID: 37720170 PMCID: PMC10501051 DOI: 10.1002/hsr2.1568] [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: 05/02/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023] Open
Abstract
Background and Aim Coronavirus disease 2019 (COVID-19) is a major public health problem causing significant morbidity and mortality worldwide. Apart from respiratory symptoms, gastrointestinal symptoms like nausea, vomiting, diarrhea, and abdominal discomfort are quite common among COVID-19 patients. The gastrointestinal tract can be a potential site for virus replication and feces a source of transmission. Thus, ignorance of enteric symptoms can hinder effective disease control. The objective of this study is to see the gastrointestinal manifestation of the disease and its effect on morbidity and mortality. Methods This observational cross-sectional retrospective study was carried out among 165 laboratory-confirmed COVID-19 patients in primary health care of Gorkha, Nepal from March 1, 2021 to March 1, 2022. A systematic random sampling method was adopted while data were entered and analyzed by Statistical Package for Social Sciences version 21. Results Of 165 patients, 97 patients (58.78%) had enteric involvement. Among gastrointestinal symptoms, diarrhea in 67 patients (40.6%) and nausea and/or vomiting in 66 patients (40%) were the most common symptoms, followed by abdominal pain in 27 patients (16.4%) and anorexia in 19 patients (11.5%). Of the majority of cases with gastrointestinal involvement, 63 (63%) were below 50 years of age. Many of the patients who received vaccination had gastrointestinal symptoms (79%). Complications like acute respiratory distress syndrome, shock, and arrhythmia developed in 9.7% of patients, with the death of eight patients. COVID-19 vaccination was associated with 4.32 times higher odds of having gastrointestinal involvement in subsequent COVID-19 infection. Conclusions Diarrhea followed by nausea/vomiting was among the most common gastrointestinal symptoms affecting younger age groups in our study. Enteric symptoms were more common among vaccinated people rather than among nonvaccinated ones.
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Affiliation(s)
- Shekhar Gurung
- Department of Internal MedicineBharatpur HospitalChitwanNepal
| | - Saurab Karki
- Nepalese Army Institute of Health Sciences (NAIHS)Shree Birendra Hospital, ChhauniKathmanduNepal
| | | | - Gopal K. Yadav
- Department of Internal MedicinePokhariya HospitalParsaNepal
| | | | | | - Sabin Banmala
- Nepalese Army Institute of Health Sciences (NAIHS)Shree Birendra Hospital, ChhauniKathmanduNepal
| | - Anil J. Thapa
- Nepalese Army Institute of Health Sciences (NAIHS)Shree Birendra Hospital, ChhauniKathmanduNepal
| | - Kumar Roka
- Nepalese Army Institute of Health Sciences (NAIHS)Shree Birendra Hospital, ChhauniKathmanduNepal
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Atef M, Eid H, Amin M, Shehata M, Shaarawy A, Nabawy O, Wahba A, Aboseif A, Rakha M, Zaki M, Mohammed E, Albalsha A, Nour S, Rezk A, Shaheen M, Kabil A. Assessment of C-reactive protein levels as an indicator for lung infiltrates in patients with COVID-19 pneumonia. J Med Life 2023; 16:1028-1031. [PMID: 37900075 PMCID: PMC10600661 DOI: 10.25122/jml-2023-0104] [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: 04/10/2023] [Accepted: 05/31/2023] [Indexed: 10/31/2023] Open
Abstract
Lung infiltrates are frequently observed in patients with COVID-19 infection and require specialized management. Identifying reliable laboratory parameters to reduce the need for chest CT scans in non-desaturation patients is of great interest. This study aimed to investigate the potential of C-reactive protein (CRP) as an indicator to identify the presence of lung infiltrates in early COVID-19 infection. The study was conducted at Al-Azhar University hospitals from May 2021 to March 2022 and included 210 patients with COVID-19 infection confirmed by positive PCR, all of whom were previously healthy, non-smokers, and non-hypoxemic. CRP levels were assessed and correlated with lung infiltrates observed in CT chest examinations. The mean value of CRP was 40.3±14.3 mg/L in males and 36.6±15.2 mg/L among females. One hundred sixty-two patients had pneumonic infiltrates, while 48 had no infiltrates. The mean value of CRP was 45.02±10.2 mg/L in patients with radiological infiltrates and 18.8±7.8 mg/L in patients without radiological infiltrates. Based on our findings, a CRP value greater than 29.8 mg/L was suggested as a cut-off value to indicate the presence of lung infiltrates. CRP is a simple laboratory marker that, at certain limits, may point to the presence of pneumonic infiltrates in early non-hypoxemic patients with COVID-19 infection.
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Affiliation(s)
- Moaz Atef
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hoda Eid
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohammad Amin
- Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamad Shehata
- Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Shaarawy
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Osama Nabawy
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Wahba
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Aboseif
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Rakha
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Zaki
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Eid Mohammed
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abdullah Albalsha
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Sameh Nour
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Amr Rezk
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Shaheen
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Kabil
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Cortes-Telles A, Figueroa-Hurtado E, Ortiz-Farias DL, Zavorsky GS. Modeling mortality risk in patients with severe COVID-19 from Mexico. Front Med (Lausanne) 2023; 10:1187288. [PMID: 37324144 PMCID: PMC10263446 DOI: 10.3389/fmed.2023.1187288] [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: 03/15/2023] [Accepted: 05/08/2023] [Indexed: 06/17/2023] Open
Abstract
Background Severe acute respiratory syndrome caused by a coronavirus (SARS-CoV-2) is responsible for the COVID-19 disease pandemic that began in Wuhan, China, in December 2019. Since then, nearly seven million deaths have occurred worldwide due to COVID-19. Mexicans are especially vulnerable to the COVID-19 pandemic as Mexico has nearly the worst observed case-fatality ratio (4.5%). As Mexican Latinos represent a vulnerable population, this study aimed to determine significant predictors of mortality in Mexicans with COVID-19 who were admitted to a large acute care hospital. Methods In this observational, cross-sectional study, 247 adult patients participated. These patients were consecutively admitted to a third-level referral center in Yucatan, Mexico, from March 1st, 2020, to August 31st, 2020, with COVID-19-related symptoms. Lasso logistic and binary logistic regression were used to identify clinical predictors of death. Results After a hospital stay of about eight days, 146 (60%) patients were discharged; however, 40% died by the twelfth day (on average) after hospital admission. Out of 22 possible predictors, five crucial predictors of death were found, ranked by the most to least important: (1) needing to be placed on a mechanical ventilator, (2) reduced platelet concentration at admission, (3) increased derived neutrophil to lymphocyte ratio, (4) increased age, and (5) reduced pulse oximetry saturation at admission. The model revealed that these five variables shared ~83% variance in outcome. Conclusion Of the 247 Mexican Latinos patients admitted with COVID-19, 40% died 12 days after admission. The patients' need for mechanical ventilation (due to severe illness) was the most important predictor of mortality, as it increased the odds of death by nearly 200-fold.
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Affiliation(s)
- Arturo Cortes-Telles
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Yucatan, Mexico
| | - Esperanza Figueroa-Hurtado
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Yucatan, Mexico
| | - Diana Lizbeth Ortiz-Farias
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Yucatan, Mexico
| | - Gerald Stanley Zavorsky
- Department of Physiology and Membrane Biology, University of California, Davis, CA, United States
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Tian Y, Ran H, Wen X, Fu G, Zhou X, Liu R, Pan T. Probiotics improve symptoms of patients with COVID-19 through gut-lung axis: a systematic review and meta-analysis. Front Nutr 2023; 10:1179432. [PMID: 37284648 PMCID: PMC10239816 DOI: 10.3389/fnut.2023.1179432] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Background Multi system symptoms such as gastrointestinal tract and respiratory tract exist in coronavirus disease 2019 (COVID-19) patients. There is a lack of reliable evidence to prove that probiotics are effective in improving these symptoms. In this study, we aimed to evaluate the efficacy of probiotics in meta-analysis. Methods We systematically searched PubMed, Embase, Web of Science, and Cochrane Library up to February 15, 2023. Randomized controlled trials or high quality retrospective studies comparing the efficacy of probiotics as supplementation with non-probiotics in improving symptoms for patients with COVID-19 were included. This meta-analysis assessed endpoints using Review Manager 5.3. Result Ten citations comprising 1198 patients with COVID-19 were included. The results showed that probiotics could increase the number of people with overall symptom improvement (RR = 1.62, 95% CI [1.10, 2.38], P = 0.01) and shorten the duration (days) of overall symptoms (MD = -1.26, 95% CI [-2.36, -0.16], P = 0.02). For the duration (days) of specific symptoms, probiotics could improve diarrhea (MD = -2.12, 95% CI [-2.41, -1.83], P < 0.00001), cough (MD = -2.21, 95% CI [-4.56, 0.13], P = 0.06) and shortness of breath (MD = -1.37, 95% CI [-2.22, -0.53], P = 0.001). Probiotics had no obvious effect on fever, headache and weakness. For inflammation, probiotics could effectively reduce C-reactive Protein (CRP) serum level (mg/L) (MD = -4.03, 95% CI [-5.12, -2.93], P < 0.00001). Regarding hospital stay (days), probiotics group was shorter than non-probiotics group (MD = -0.98, 95% CI [-1.95, -0.01], P = 0.05). Conclusion To some extent probiotics could improve the overall symptoms, inflammatory reaction and shorten hospital stay of patients with COVID-19. Probiotics may improve gastrointestinal symptoms (such as improving intestinal flora and reducing the duration of diarrhea) and further improve respiratory symptoms through the gut-lung axis. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=398309, identifier: CRD42023398309.
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Affiliation(s)
- Yong Tian
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Department of Gastroenterology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
| | - Hongmei Ran
- Department of Gastroenterology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
| | - Xudong Wen
- Department of Gastroenterology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
| | - Guochuan Fu
- Department of Gastroenterology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
| | - Xiaofang Zhou
- Department of Gastroenterology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
| | - Rui Liu
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Tao Pan
- Department of Gastroenterology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
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12
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Gebrecherkos T, Challa F, Tasew G, Gessesse Z, Kiros Y, Gebreegziabxier A, Abdulkader M, Desta AA, Atsbaha AH, Tollera G, Abrahim S, Urban BC, Schallig H, Rinke de Wit T, Wolday D. Prognostic Value of C-Reactive Protein in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Northern Ethiopia. Infect Drug Resist 2023; 16:3019-3028. [PMID: 37215303 PMCID: PMC10199690 DOI: 10.2147/idr.s410053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose To evaluate the role of C-reactive protein (CRP) in predicting severe COVID-19 patients. Methods A prospective observational cohort study was conducted from July 15 to October 28, 2020, at Kuyha COVID-19 isolation and treatment center hospital, Mekelle City, Northern Ethiopia. A total of 670 blood samples were collected serially. SARS-CoV-2 infection was confirmed by RT-PCR from nasopharyngeal swabs and CRP concentration was determined using Cobas Integra 400 Plus (Roche). Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results Overall, COVID-19 patients had significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0-127.8) mg/L vs 0.9 (IQR: 0.5-1.9) mg/L; p=0.0004)]. Those with severe COVID-19 clinical presentation had significantly higher median CRP levels compared to those with non-severe cases [166.1 (IQR: 48.6-332.5) mg/L vs 2.4 (IQR: 1.2-7.6) mg/L; p<0.00001)]. Moreover, COVID-19 patients exhibited higher median CRP levels at baseline [58 (IQR: 2.0-127.8) mg/L] that decreased significantly to 2.4 (IQR: 1.4-3.9) mg/L after 40 days after symptom onset (p<0.0001). Performance of CRP levels determined using ROC analysis distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73-0.91; p=0.001; 77.4% sensitivity and 89.4% specificity). In multivariable analysis, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 for those who have higher ages and comorbidities (ARR 3.99, 95% CI: 1.35-11.82; p=0.013). Conclusion CRP was found to be an independent determinant factor for severe COVID-19 patients. Therefore, CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.
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Affiliation(s)
- Teklay Gebrecherkos
- Department of Medical Microbiology and Immunology, College of Health Sciences (CHS), Mekelle University (MU), Mekelle, Tigray, Ethiopia
| | - Feyissa Challa
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Department of Bacteriology, Parasitology and Zoonosis, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zekarias Gessesse
- Department of Internal Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Yazezew Kiros
- Department of Internal Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | | | - Mahmud Abdulkader
- Department of Medical Microbiology and Immunology, College of Health Sciences (CHS), Mekelle University (MU), Mekelle, Tigray, Ethiopia
| | - Abraham Aregay Desta
- Public Health Research and Emergency Management, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Ataklti Hailu Atsbaha
- Department of Microbiology, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Getachew Tollera
- Research and Technology Transfer Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abrahim
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Britta C Urban
- Department of Clinical Sciences, Respiratory Clinical Research Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Henk Schallig
- Department of Medical Microbiology and Infection Prevention, Experimental Parasitology Unit, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Tobias Rinke de Wit
- Amsterdam Institute of Global Health and Development, Department of Global Health, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Joep-Lange Institute, Amsterdam, the Netherlands
| | - Dawit Wolday
- Department of Medical Microbiology and Immunology, College of Health Sciences (CHS), Mekelle University (MU), Mekelle, Tigray, Ethiopia
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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13
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Grujičić D, Mirkov L, Banković D, Virijević K, Marinković D, Milošević-Djordjević O. Homozygous-Recessive Characteristics as a Biomarker of Predisposition for COVID-19. Clin Nurs Res 2023; 32:589-600. [PMID: 36695163 PMCID: PMC9902784 DOI: 10.1177/10547738221147754] [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] [Indexed: 01/26/2023]
Abstract
Coronavirus disease (COVID-19), a new form of severe acute respiratory syndrome, has caused a global pandemic. The aim of this study was to analyze homozygous-recessive characteristics (HRC) in the group of COVID-19 patients, considering their gender, forms of the disease (mild and severe symptoms), risk factors: hypertension, diabetes mellitus type 2, hyperlipidemia, smoking habits, and the distribution of ABO blood group. Using the HRC test, we analyzed 20 HRCs in a sample of 321 individuals: 205 patients and 116 controls. The average HRC in patients was significantly higher than controls, as well as in patients with severe symptoms compared to patients with mild symptoms. The patients with higher HRC (cut-off ≤5.5) experienced a significantly increased risk of disease of 2.3 times (OR = 2.315, p < .0005). Our results indicate that the HRC test could be used as a screening in recognizing predisposition for COVID-19.
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14
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Shrestha AB, Pokharel P, Singh H, Shrestha S, Fioni. Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19: A Systematic Review, Meta-Analysis, and Trial Sequence Analysis. Clin Med Insights Circ Respir Pulm Med 2023; 17:11795484231152304. [PMID: 36710717 PMCID: PMC9875321 DOI: 10.1177/11795484231152304] [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: 05/02/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to find the association between serum Krebs von den Lungen-6 (KL-6) and the severity of Coronavirus disease 2019 (COVID-19) infection. DATA SOURCES Databases of Embase, PubMed, Web of Science, Science Direct, and Google Scholar were searched for studies reporting KL-6 levels in COVID-19 patients, published between January 2020 and September 30 2022. DATA SYNTHESIS For comparison between the groups, standard mean difference (SMD) and 95% confidence intervals (CI) were computed as the effect sizes. Sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were measured to assess the diagnostic power of KL-6. In addition, the summary receiver operating characteristics curve (sROC) was constructed to summarize the true positive (TP), and false positive (FP) rates. To validate the findings of meta-analysis, Trial Sequential Analysis (TSA) was conducted. RESULTS Altogether 497 severe COVID-19 patients and 934 non-severe (mild to moderate) COVID-19 patients were included. Pooling of 12 studies indicated that the serum KL-6 level had significant association with severity of COVID-19 infection: standard mean difference = 1.18 (95% CI: 0.93-1.43), p = 0.01; I2: 58.56%]. Pooled diagnostic parameters calculated from eight studies were: sensitivity 0.53 (95% CI: 0.47-0.59); specificity 0.90 (95% CI: 0.88-0.93); positive likelihood ratio 4.80 (95% CI: 3.53-6.53); negative likelihood ratio 0.46 (95% CI: 0.32-0.68); and area under curve: 0.8841. Additionally, TSA verified the adequacy of sample size and robustness of the meta-analysis. CONCLUSION Serum KL-6 level has a moderate degree of correlation with the severity of COVID-19 infection but has low sensitivity. So, it is not recommended as a screening test for severe COVID-19 infection.
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Affiliation(s)
- Abhigan Babu Shrestha
- Department of Internal Medicine, M Abdur Rahim Medical College,
Dinajpur, Bangladesh,Abhigan Babu Shrestha, Department of
Internal Medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh.
| | | | - Harendra Singh
- Department of Anesthesiology, Tribhuvan University Teaching
Hospital, Kathmandu, Nepal
| | - Sajina Shrestha
- Department of Internal Medicine, KIST Medical
College, Imadol, Nepal
| | - Fioni
- Faculty of Medicine, Universitas Prima
Indonesia, Medan, Indonesia
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15
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Hopkins FR, Govender M, Svanberg C, Nordgren J, Waller H, Nilsdotter-Augustinsson Å, Henningsson AJ, Hagbom M, Sjöwall J, Nyström S, Larsson M. Major alterations to monocyte and dendritic cell subsets lasting more than 6 months after hospitalization for COVID-19. Front Immunol 2023; 13:1082912. [PMID: 36685582 PMCID: PMC9846644 DOI: 10.3389/fimmu.2022.1082912] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction After more than two years the Coronavirus disease-19 (COVID-19) pandemic continues to burden healthcare systems and economies worldwide, and it is evident that the effects on the immune system can persist for months post-infection. The activity of myeloid cells such as monocytes and dendritic cells (DC) is essential for correct mobilization of the innate and adaptive responses to a pathogen. Impaired levels and responses of monocytes and DC to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is likely to be a driving force behind the immune dysregulation that characterizes severe COVID-19. Methods Here, we followed a cohort of COVID-19 patients hospitalized during the early waves of the pandemic for 6-7 months. The levels and phenotypes of circulating monocyte and DC subsets were assessed to determine both the early and long-term effects of the SARS-CoV-2 infection. Results We found increased monocyte levels that persisted for 6-7 months, mostly attributed to elevated levels of classical monocytes. Myeloid derived suppressor cells were also elevated over this period. While most DC subsets recovered from an initial decrease, we found elevated levels of cDC2/cDC3 at the 6-7 month timepoint. Analysis of functional markers on monocytes and DC revealed sustained reduction in program death ligand 1 (PD-L1) expression but increased CD86 expression across almost all cell types examined. Finally, C-reactive protein (CRP) correlated positively to the levels of intermediate monocytes and negatively to the recovery of DC subsets. Conclusion By exploring the myeloid compartments, we show here that alterations in the immune landscape remain more than 6 months after severe COVID-19, which could be indicative of ongoing healing and/or persistence of viral antigens.
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Affiliation(s)
- Francis R. Hopkins
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Melissa Govender
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Cecilia Svanberg
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Johan Nordgren
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Hjalmar Waller
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Åsa Nilsdotter-Augustinsson
- Division of Infection and Inflammation, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,Department of Infectious Diseases, Linköping University, Linköping, Sweden
| | - Anna J. Henningsson
- Division of Infection and Inflammation, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,Division of Clinical Microbiology, Department of Laboratory Medicine in Jönköping, Ryhov County Hospital, Jönköping, Sweden
| | - Marie Hagbom
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Johanna Sjöwall
- Division of Infection and Inflammation, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,Department of Infectious Diseases, Linköping University, Linköping, Sweden
| | - Sofia Nyström
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,Department of Clinical Immunology and Transfusion Medicine, Linköping University, Linköping, Sweden
| | - Marie Larsson
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,*Correspondence: Marie Larsson,
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Pan DZ, Odorizzi PM, Schoenichen A, Abdelghany M, Chen S, Osinusi A, Patterson SD, Downie B, Juneja K, Wallin JJ. Remdesivir improves biomarkers associated with disease severity in COVID-19 patients treated in an outpatient setting. COMMUNICATIONS MEDICINE 2023; 3:2. [PMID: 36596885 PMCID: PMC9809529 DOI: 10.1038/s43856-022-00232-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Remdesivir (RDV) is an intravenous antiviral with activity against SARS-CoV-2 for treatment of hospitalized COVID-19 patients with moderate-to-severe disease. Biomarkers associated with clinical outcomes have been identified for COVID-19, but few evaluated in context of antiviral treatment. Here, we assessed baseline (day 1, prior to first RDV dose) biomarkers and the impact of RDV treatment on longitudinal biomarker readouts. METHODS Recently, RDV was evaluated in high-risk, non-hospitalized patients with confirmed SARS-CoV-2 infection and was highly effective at preventing disease progression. The randomized, double-blind, placebo-controlled Phase 3 study included 562 participants who received at least 1 dose of study drug, of which 312 consented for longitudinal biomarker assessments at baseline, day 3, and day 14. We assessed sixteen baseline biomarkers and the impact of RDV treatment on longitudinal biomarker readouts. RESULTS Six well-known, inflammation-associated biomarkers are elevated at baseline in participants meeting the primary endpoint of hospitalization or death by day 28. Moreover, in comparison to placebo, biomarkers in RDV-treated participants show accelerated improvement, including reduction of soluble angiopoietin-2, D-dimer, and neutrophil-to-lymphocyte ratio, as well as an increase in lymphocyte counts. CONCLUSIONS Overall, the findings in this study suggest that RDV treatment may accelerate the improvement of multiple biomarkers of COVID-19 severity, which are associated with better clinical outcomes during infection. These findings have implications for better understanding the activity of antiviral treatments in COVID-19.
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Affiliation(s)
- David Z. Pan
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Pamela M. Odorizzi
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Andre Schoenichen
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Mazin Abdelghany
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Shuguang Chen
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Anu Osinusi
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Scott D. Patterson
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Bryan Downie
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Kavita Juneja
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
| | - Jeffrey J. Wallin
- grid.418227.a0000 0004 0402 1634Gilead Sciences Inc., Foster City, CA 94404 USA
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Yu T, Dong J, Qi Q, Lv Q, Li J, Huang C, Cai X. A Nomogram for Predicting Delayed Viral Shedding in Non-Severe SARS-CoV-2 Omicron Infection. Infect Drug Resist 2023; 16:2487-2500. [PMID: 37138833 PMCID: PMC10150765 DOI: 10.2147/idr.s407620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
Purpose The Omicron variant of SARS-CoV-2 has emerged as a significant global concern, characterized by its rapid transmission and resistance to existing treatments and vaccines. However, the specific hematological and biochemical factors that may impact the clearance of Omicron variant infection remain unclear. The present study aimed to identify easily accessible laboratory markers that are associated with prolonged virus shedding in non-severe patients with COVID-19 caused by the Omicron variant. Patients and Methods A retrospective cohort study was conducted on 882 non-severe COVID-19 patients who were diagnosed with the Omicron variant in Shanghai between March and June 2022. The least absolute shrinkage and selection operator regression model was used for feature selection and dimensional reduction, and multivariate logistic regression analysis was performed to construct a nomogram for predicting the risk of prolonged SARS-CoV-2 RNA positivity lasting for more than 7 days. The receiver operating characteristic (ROC) curve and calibration curves were used to assess predictive discrimination and accuracy, with bootstrap validation. Results Patients were randomly divided into derivation (70%, n = 618) and validation (30%, n = 264) cohorts. Optimal independent markers for prolonged viral shedding time (VST) over 7 days were identified as Age, C-reactive protein (CRP), platelet count, leukocyte count, lymphocyte count, and eosinophil count. These factors were subsequently incorporated into the nomogram utilizing bootstrap validation. The area under the curve (AUC) in the derivation (0.761) and validation (0.756) cohorts indicated good discriminative ability. The calibration curve showed good agreement between the nomogram-predicted and actual patients with VST over 7 days. Conclusion Our study confirmed six factors associated with delayed VST in non-severe SARS-CoV-2 Omicron infection and constructed a Nomogram which may assist non-severely affected patients to better estimate the appropriate length of self-isolation and optimize their self-management strategies.
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Affiliation(s)
- Tianyu Yu
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
| | - Jiangnan Dong
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
| | - Qi Qi
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
| | - Qiang Lv
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
| | - Jun Li
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
| | - Chaojun Huang
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
| | - Xiaoyan Cai
- Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China
- Correspondence: Xiaoyan Cai, Department of General Surgery, Gongli Hospital of Shanghai Pudong New Area, Shanghai, 200135, People’s Republic of China, Tel/Fax +86-21-58858730, Email
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Bouayed MZ, Laaribi I, Chatar CEM, Benaini I, Bouazzaoui MA, Oujidi Y, Berrichi S, El Aidouni G, Bkiyar H, Abda N, Housni B. C-Reactive Protein (CRP): A poor prognostic biomarker in COVID-19. Front Immunol 2022; 13:1040024. [PMID: 36451818 PMCID: PMC9702806 DOI: 10.3389/fimmu.2022.1040024] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/25/2022] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic continues to be rampant with considerable morbidity and mortality worldwide since its emergence in December 2019. Several studies have focused on identifying different predictive factors of poor prognosis, including biological markers, such as C Reactive Protein among others. The objective of our work was to determine whether the CRP levels on admission to the intensive care unit are predictive of an unfavorable evolution of patients with COVID-19 through the experience of the Anesthesia and Intensive Care Unit of the University Hospital of Oujda and to compare our results with those reported in the literature. METHODS We conducted a retrospective, monocentric, descriptive and analytical study in the Department of Anesthesia and Intensive Care of the Mohammed VI University Hospital of Oujda, Morocco, between March 2020 and October 2021, including all critically ill patients admitted to the department during this period and meeting the inclusion criteria. The baseline admission CRP value was arbitrarily set at 100mg/d, thus conditioning the division of our patients into two groups (group 1: CRP < 100mg/L, group 2: CRP ≥ 100mg/L). RESULTS Among our 1035 included patients, 291 patients with had a CRP<100mlg/L (group 1) and 744 presented a CRP level equal or superior to 100mg/L (group 2). Lung parenchymal involvement was more severe or even critical (CT involvement > 75%) in group 2 (60.8%) compared to group 1 (39.2%). In group 2, 79.8% of patients were mechanically ventilated, compared to 20.2% of patients in group 1. Finally, the mortality rate in patients with a CRP ≥ 100mg/l was 77.4%, compared with 22.6% for patients with a CRP < 100mg/l. These findings are all statistically highly significant (p<0.001). CONCLUSION Given the high contagiousness of the virus and the emergence of several variants, the management of the COVID-19 pandemic has focused more on prevention through vaccination against the virus, but also on an early identification of patients likely to evolve unfavorably for a personalized management.
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Affiliation(s)
- Mohamed Zakaria Bouayed
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
| | - Ilyass Laaribi
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
| | | | - Iliass Benaini
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
| | - Mohammed Amine Bouazzaoui
- Laboratory of Epidemiology, Clinical Research, and Public Health, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Younes Oujidi
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
| | - Samia Berrichi
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
| | - Ghizlane El Aidouni
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
| | - Houssam Bkiyar
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
- Simulation Center, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Naima Abda
- Laboratory of Epidemiology, Clinical Research, and Public Health, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Brahim Housni
- Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital, Oujda, Morocco
- Simulation Center, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
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19
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Delen LA, Gok A, Kasapoglu US, Cagasar O, Gok Z, Berber N, Derya S, Tetik B. EFFECTS OF HYDROXYCHLOROQUINE PLUS FAVIPIRAVIR TREATMENT ON THE CLINICAL COURSE AND BIOMARKERS IN HOSPITALIZED COVID-19 PATIENTS WITH PNEUMONIA. Acta Clin Croat 2022; 61:403-411. [PMID: 37492367 PMCID: PMC10364115 DOI: 10.20471/acc.2022.61.03.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 06/25/2021] [Indexed: 07/27/2023] Open
Abstract
Background The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clinical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumonia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient's clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection. Patients and methods This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination. Results A total of 69 patients were included in the study, and the mean age was 60.09±15.56 years. A statistically significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517). Conclusion Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.
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Affiliation(s)
- Leman Acun Delen
- Department of Anesthesiology and Reanimation, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Abdullah Gok
- Department of Anesthesiology and Reanimation, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Umut Sabri Kasapoglu
- Department of Critical Care Medicine, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Ozlem Cagasar
- Department of Infectious Diseases and Clinical Microbiology, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Zarife Gok
- Department of Ophthalmology, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Nurcan Berber
- Department of Chest Diseases, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Serdar Derya
- Department of Traumatology and Emergency Medicine, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey
| | - Bora Tetik
- Department of Neurosurgery, Inonu University School of Medicine, Malatya, Turkey
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20
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Louisa M, Cahyadi D, Nilasari D, Soetikno V. Lack of Correlation Between Soluble Angiotensin-Converting Enzyme 2 and Inflammatory Markers in Hospitalized COVID-19 Patients with Hypertension. Infect Drug Resist 2022; 15:4799-4807. [PMID: 36045873 PMCID: PMC9420737 DOI: 10.2147/idr.s369771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to investigate the correlation of plasma soluble angiotensin-converting enzyme 2, sACE2, and several inflammatory markers in COVID-19 patients requiring hospitalization with hypertension. Additionally, we analyzed the effects of renin-angiotensin-aldosterone-system, RAAS, inhibitors on the levels of sACE2 and inflammatory marker levels in patients with COVID-19. Patients and Methods This cross-sectional study involved patients with COVID-19 who required hospitalization on a stable dose of antihypertensive drugs. The study included three hospitals in Jakarta and Tangerang, Indonesia, between December 2020 and June 2021. We classified eligible subjects into two groups: patients with COVID-19 treated with antihypertensive RAAS inhibitors or non-RAAS inhibitors. Results We found no correlation between sACE2 and all the inflammatory and coagulation markers studied (high-sensitivity C-reactive protein, IL-6, IL-10, IL6/IL10, tumor necrosis factor-α, neutrophil-to-lymphocyte ratio, and D-dimer) in COVID-19 patients with hypertension. Further analysis showed lower sACE2 concentrations and IL-6/IL-10 ratio in patients treated with RAAS inhibitors vs those treated with non-RAAS inhibitors. Conclusion We found no correlation between ACE2 and inflammatory markers. Using RAAS inhibitors resulted in a lower sACE2 and IL-6/IL-10 ratio. The type of antihypertensive treatments has a neutral effect on disease severity and outcome in COVID-19 patients with hypertension. However, to firmly-established these effects, our findings should be confirmed in a much larger population.
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Affiliation(s)
- Melva Louisa
- Department of Pharmacology and Therapeutics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Daniel Cahyadi
- Master Program in Biomedical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dina Nilasari
- Department of Clinical Research, Siloam Hospitals, Jakarta, Indonesia.,Faculty of Medicine, University of Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Vivian Soetikno
- Department of Pharmacology and Therapeutics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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21
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Suzuki K, Ichikawa T, Suzuki S, Tanino Y, Kakinoki Y. Clinical characteristics of the severe acute respiratory syndrome coronavirus 2 omicron variant compared with the delta variant: a retrospective case-control study of 318 outpatients from a single sight institute in Japan. PeerJ 2022; 10:e13762. [PMID: 35935257 PMCID: PMC9354737 DOI: 10.7717/peerj.13762] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/29/2022] [Indexed: 01/17/2023] Open
Abstract
Background Clinical characteristics, including laboratory parameters, of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant have been limited. Methods This retrospective case-control study was conducted in a single hospital. Patients with coronavirus disease 2019 (COVID-19) who visited the Asahikawa City Hospital outpatient department as new patients and underwent blood tests were included in this study. We analyzed the data from January 2022 to April 2022 during the Omicron phase and from April 2021 to October 2021 during the Delta phase. Patients who were treated at other hospitals after visiting our hospital were excluded. All blood tests were performed before treatment for COVID-19 was initiated. Demographic information, laboratory data, and clinical courses were extracted from electronic medical records. We matched the two groups by age and comorbidities and compared their characteristics. We also analyzed factors associated with pneumonia in the Omicron phase. Results A total of 151 Omicron patients and 167 delta patients were analyzed in this study. The mean age, rate of comorbidities, and vaccination were significantly higher in the Omicron group. The number of patients with pneumonia or those requiring oxygen, admissions, or both was significantly lower in the Omicron group. Lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, aspartate aminotransferase (AST), and neutrophil-to-lymphocyte ratio (NLR) levels were significantly lower in the Omicron group. Compared with the mild symptom and pneumonia groups in the Omicron group, older age, higher body mass index (BMI), higher non-vaccination, higher LDH, and higher CRP levels were associated with the pneumonia group. Conclusion The Omicron variant is associated with a reduction in hospitalization and the risk of pneumonia compared to the delta variant in a real-life clinical setting. In the Omicron variant, the risk of pneumonia is related to high-risk factors, laboratory data such as LDH and CRP levels, and no vaccination.
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Affiliation(s)
- Keiko Suzuki
- Department of General Internal Medicine, Asahikawa City Hospital, Asahikawa, Hokkaido, Japan
| | - Takaya Ichikawa
- Department of Hematology, Asahikawa City Hospital, Asahikawa, Hokkaido, Japan
| | - Satoshi Suzuki
- Department of General Internal Medicine, Asahikawa City Hospital, Asahikawa, Hokkaido, Japan
| | - Yoko Tanino
- Department of Respiratory Medicine, Asahikawa City Hospital, Asahikawa, Hokkaido, Japan
| | - Yasutaka Kakinoki
- Department of Hematology, Asahikawa City Hospital, Asahikawa, Hokkaido, Japan
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22
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Tufa A, Gebremariam TH, Manyazewal T, Getinet T, Webb DL, Hellström PM, Genet S. Inflammatory mediators profile in patients hospitalized with COVID-19: A comparative study. Front Immunol 2022; 13:964179. [PMID: 35958594 PMCID: PMC9359079 DOI: 10.3389/fimmu.2022.964179] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/01/2022] [Indexed: 01/08/2023] Open
Abstract
Abnormal inflammatory mediator concentrations during SARS-CoV-2 infection may represent disease severity. We aimed to assess plasma inflammatory mediator concentrations in patients with SARS-CoV-2 in Addis Ababa, Ethiopia. In this study, 260 adults: 126 hospitalized patients with confirmed COVID-19 sorted into severity groups: severe (n=68) and mild or moderate (n=58), and 134 healthy controls were enrolled. We quantified 39 plasma inflammatory mediators using multiplex ELISA. Spearman rank correlation and Mann-Whitney U test were used to identify mechanistically coupled inflammatory mediators and compare disease severity. Compared to healthy controls, patients with COVID-19 had significantly higher levels of interleukins 1α, 2, 6, 7, 8, 10 and 15, C-reactive protein (CRP), serum amyloid A (SAA), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion protein 1 (VCAM-1), IFN-γ-inducible protein-10 (IP-10, CXCL10), macrophage inflammatory protein-1 alpha (MIP-1α, CCL3), eotaxin-3 (CCL26), interferon-gamma (IFN-γ), tumor necrosis factor-α (TNF-α), basic fibroblast growth factor (bFGF), placental growth factor (PlGF), and fms-like tyrosine kinase 1 (Flt-1). Patients with severe COVID-19 had higher IL-10 and lower macrophage-derived chemokine (MDC, CCL22) compared to the mild or moderate group (P<0.05). In the receiver operating characteristic curve, SAA, IL-6 and CRP showed strong sensitivity and specificity in predicting the severity and prognosis of COVID-19. Greater age and higher CRP had a significant association with disease severity (P<0.05). Our findings reveal that CRP, SAA, VCAM-1, CXCL10, CCL22 and IL-10 levels are promising biomarkers for COVID-19 disease severity, suggesting that plasma inflammatory mediators could be used as warning indicators of COVID-19 severity, aid in COVID-19 prognosis and treatment.
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Affiliation(s)
- Abdisa Tufa
- Department of Medical Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Haile Gebremariam
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegahun Manyazewal
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Getinet
- School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Dominic-Luc Webb
- Gastroenterology and Hepatology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Per M. Hellström
- Gastroenterology and Hepatology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Solomon Genet
- Department of Medical Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Timpau AS, Miftode RS, Leca D, Timpau R, Miftode IL, Petris AO, Costache II, Mitu O, Nicolae A, Oancea A, Jigoranu A, Tuchilus CG, Miftode EG. A Real Pandora's Box in Pandemic Times: A Narrative Review on the Acute Cardiac Injury Due to COVID-19. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071085. [PMID: 35888173 PMCID: PMC9318707 DOI: 10.3390/life12071085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 01/08/2023]
Abstract
The intricate relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the cardiovascular system is an extensively studied pandemic topic, as there is an ever-increasing amount of evidence that reports a high prevalence of acute cardiac injury in the context of viral infection. In patients with Coronavirus disease 2019, COVID-19, a significant increase in serum levels of cardiac troponin or other various biomarkers was observed, suggesting acute cardiac injury, thus predicting both a severe course of the disease and a poor outcome. Pathogenesis of acute cardiac injury is not yet completely elucidated, though several mechanisms are allegedly involved, such as a direct cardiomyocyte injury, oxygen supply-demand inequity caused by hypoxia, several active myocardial depressant factors during sepsis, and endothelial dysfunction due to the hyperinflammatory status. Moreover, the increased levels of plasma cytokines and catecholamines and a significantly enhanced prothrombotic environment may lead to the destabilization and rupture of atheroma plaques, subsequently triggering an acute coronary syndrome. In the present review, we focus on describing the epidemiology, pathogenesis, and role of biomarkers in the diagnosis and prognosis of patients with acute cardiac injury in the setting of the COVID-19 pandemic. We also explore some novel therapeutic strategies involving immunomodulatory therapy, as well as their role in preventing a severe form of the disease, with both the short-term outcome and the long-term cardiovascular sequelae being equally important in patients with SARS-CoV-2 induced acute cardiac injury.
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Affiliation(s)
- Amalia-Stefana Timpau
- Department of Infectious Diseases (Internal Medicine II), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-S.T.); (D.L.); (I.-L.M.); (E.-G.M.)
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
| | - Radu-Stefan Miftode
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
- Correspondence: (R.-S.M.); (I.I.C.)
| | - Daniela Leca
- Department of Infectious Diseases (Internal Medicine II), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-S.T.); (D.L.); (I.-L.M.); (E.-G.M.)
| | - Razvan Timpau
- Department of Radiology and Medical Imaging, St. Spiridon Emergency Hospital, 700115 Iasi, Romania;
| | - Ionela-Larisa Miftode
- Department of Infectious Diseases (Internal Medicine II), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-S.T.); (D.L.); (I.-L.M.); (E.-G.M.)
| | - Antoniu Octavian Petris
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
| | - Irina Iuliana Costache
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
- Correspondence: (R.-S.M.); (I.I.C.)
| | - Ovidiu Mitu
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
| | - Ana Nicolae
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
| | - Alexandru Oancea
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
| | - Alexandru Jigoranu
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.O.P.); (O.M.); (A.N.); (A.O.); (A.J.)
| | - Cristina Gabriela Tuchilus
- Department of Preventive Medicine and Interdisciplinarity (Microbiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania;
| | - Egidia-Gabriela Miftode
- Department of Infectious Diseases (Internal Medicine II), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-S.T.); (D.L.); (I.-L.M.); (E.-G.M.)
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El-Khaiat MM, El-lehlah AM, Kesheita MA, Abdel-Samiee M, Teima AAA. Association between thrombocytopenia and the severity of Covid-19 infection among hospitalized Egyptian patients. Ann Med Surg (Lond) 2022; 79:103973. [PMID: 35721787 PMCID: PMC9188120 DOI: 10.1016/j.amsu.2022.103973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022] Open
Abstract
Background COVID-19, which is caused by the corona virus 2 that causes severe acute respiratory syndrome, causes a respiratory and systemic illness that in 10–15% of patients escalates to a severe form of pneumonia. Thrombocytopenia is frequent in patients with COVID-19. We aimed to evaluate the association between thrombocytopenia and the severity of COVID-19 infection in hospitalized patients. Methods A cross-sectional study was done on 800 Egyptian patients with confirmed covid-19 infection. They were divided into Group I (Mild): 200 symptomatic patients meeting the case definition for COVID-19 without radiological evidence of pneumonia or hypoxia. Group II (Moderate): 200 patients with clinical signs of non-severe pneumonia and radiological evidence of pneumonia. Group III (Severe): 200 patients with clinical signs of pneumonia plus: respiratory or lung dysfunction. Group IV: 200 critically ill patient in ICU: Acute respiratory distress syndrome (ARDS). Results: there was a highly statistically significant difference between the studied groups regarding thrombocytopenia (p < 0.001). Thrombocytopenia was statistically higher in severe and critically ill patients. In addition, a statistically significant difference found in outcome among the studied groups (p < 0.05) {critically ill (40%), severe (17.5%)}. The most common cause of death was respiratory failure, which occurred in 28 severe patients (80%) and 65 critically ill patients (81.25%), followed by hemorrhage due to thrombocytopenia, which occurred in 7 severe patients (20%) and 15 critically ill patients, respectively (18.75%). Conclusion The Platelet count is a straightforward, inexpensive, as well as easily available laboratory parameter that is frequently linked to severe covid-19 infection and a significant death risk. The latest novel corona virus disease pandemic shows a significant health concern. Thrombocytopenia is frequent in COVID-19, statistically higher in severe and critically ill patients. The common cause of death was respiratory failure, occurred in severe patients (80%) & critically ill patients (81.25%). The 2nd one is hemorrhage due to thrombocytopenia, occurred in severe patients (20%) & critically ill patients (18.75%). Plateletcount is a simple, inexpensive, and readily available laboratory parameter that is frequently linked to severe covid-19 infection and a significant death risk.
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A Pilot Study on COVID-19 Positive Subjects: An Excerpt of Post-Infection-Pro-Diabetic Disposition & Related Consequences in Correlation to Hepato-Pancreatic Bio-Markers, Pro-Inflammatory Cytokines and Other Risk Factors. Indian J Clin Biochem 2022; 38:182-192. [PMID: 35756691 PMCID: PMC9206463 DOI: 10.1007/s12291-022-01054-8] [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: 02/28/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
COVID-19, a global pandemic that led to increased morbidity and mortality worldwide since its outcome at the end of the year 2019. A newly discovered variant of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) was the arbitrator for spreading the syndrome by droplet transmission causing multi-organ failure in many occasions. A post-infection-pro-diabetic disposition was found evident in this study with the persistence of hepato-pancreatic aberrations in respect of reference range of tissue specific bio-markers in hospital admitted COVID-19 cases. The results of this study show that hyperglycemia is a risk factor in precipitating disease oriented complications to the patients with COVID-19 disease. A post-infection follow- up on glycemic-index and related complexities is a vital need to the COVID-19 infected convalescent subjects. Implementation of guidelines on social measure and awareness of anti-viral interventions may be the only way to prevent COVID-19 transmission.
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Potential Role of Certain Biomarkers Such as Vitamin B12, ROS, Albumin, as Early Predictors for Prognosis of COVID-19 Outcomes. MEDICINES (BASEL, SWITZERLAND) 2022; 9:medicines9060036. [PMID: 35736249 PMCID: PMC9229029 DOI: 10.3390/medicines9060036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 01/10/2023]
Abstract
COVID-19 disease is still a major global concern because of its morbidity and its mortality in severe disease. Certain biomarkers including Reactive Oxygen Species (ROS), vitamins, and trace elements are known to play a crucial role in the pathophysiology of the disease. The aim of our study was to evaluate how certain biomarkers, such as ROS, biochemical indicators, trace elements in serum blood of 139 COVID-19 hospitalized patients, and 60 non-COVID cases according to age and sex variations, can serve as the predictors for prognosis of COVID-19 outcome. An attempt of correlating these biomarkers with the severity of the disease as well as with each other is represented. All subjects were hospitalized from April 2021 until June 2021. A statistically significant increase of B12 levels (p = 0.0029) and ROS levels (p < 0.0001) as well as a decrease in albumin and Total Protein (T.P.) levels (p < 0.001) was observed especially in the early stage of the disease before CRP and ferritin elevation. Additionally, a statistically significant increase in ferritin (p = 0.007), B12 (p = 0.035, sALT p = 0.069, Glucose p = 0.012 and urea p = 0.096 and a decrease in Ca p = 0.005, T.P p = 0.052 albumin p = 0.046 between stage B (CRP values 6−30 mg/L) and C (CRP values 30−100 mg/L) was evident. Thus, this study concludes that clinicians could successfully employ biomarkers such as vitamin B12, ROS and albumin as possible prognosis tools for an early diagnosis. In addition, the total biochemical profile can assist in the understanding of the severity of COVID-19 disease, and could potentially lead to a better diet or early pharmaceutical treatment to prevent some of the more acute symptoms.
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Khan A, Iqtadar S, Mumtaz SU, Heinrich M, Pascual-Figal DA, Livingstone S, Abaidullah S. Oral Co-Supplementation of Curcumin, Quercetin, and Vitamin D3 as an Adjuvant Therapy for Mild to Moderate Symptoms of COVID-19—Results From a Pilot Open-Label, Randomized Controlled Trial. Front Pharmacol 2022; 13:898062. [PMID: 35747751 PMCID: PMC9211374 DOI: 10.3389/fphar.2022.898062] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Curcumin, quercetin, and vitamin D3 (cholecalciferol) are common natural ingredients of human nutrition and reportedly exhibit promising anti-inflammatory, immunomodulatory, broad-spectrum antiviral, and antioxidant activities. Objective: The present study aimed to investigate the possible therapeutic benefits of a single oral formulation containing supplements curcumin, quercetin, and cholecalciferol (combinedly referred to here as CQC) as an adjuvant therapy for early-stage of symptomatic coronavirus disease 2019 (COVID-19) in a pilot open-label, randomized controlled trial conducted at Mayo Hospital, King Edward Medical University, Lahore, Pakistan. Methods: Reverse transcriptase polymerase chain reaction (RT-PCR) confirmed, mild to moderate symptomatic COVID-19 outpatients were randomized to receive either the standard of care (SOC) (n = 25) (control arm) or a daily oral co-supplementation of 168 mg curcumin, 260 mg quercetin, and 9 µg (360 IU) of cholecalciferol, as two oral soft capsules b.i.d. as an add-on to the SOC (n = 25) (CQC arm) for 14 days. The SOC includes paracetamol with or without antibiotic (azithromycin). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR test, acute symptoms, and biochemistry including C-reactive protein (CRP), D-dimer, lactate dehydrogenase, ferritin, and complete blood count were evaluated at baseline and follow-up day seven. Results: Patients who received the CQC adjuvant therapy showed expedited negativization of the SARS-CoV-2 RT-PCR test, i.e., 15 (60.0%) vs. five (20.0%) of the control arm, p = 0.009. COVID-19- associated acute symptoms were rapidly resolved in the CQC arm, i.e., 15 (60.0%) vs. 10 (40.0%) of the control arm, p = 0.154. Patients in the CQC arm experienced a greater fall in serum CRP levels, i.e., from (median (IQR) 34.0 (21.0, 45.0) to 11.0 (5.0, 16.0) mg/dl as compared to the control arm, i.e., from 36.0 (28.0, 47.0) to 22.0 (15.0, 25.0) mg/dl, p = 0.006. The adjuvant therapy of co-supplementation of CQC was safe and well-tolerated by all 25 patients and no treatment-emergent effects, complications, side effects, or serious adverse events were reported. Conclusion: The co-supplementation of CQC may possibly have a therapeutic role in the early stage of COVID-19 infection including speedy negativization of the SARS-CoV-2 RT-PCR test, resolution of acute symptoms, and modulation of the hyperinflammatory response. In combination with routine care, the adjuvant co-supplementation of CQC may possibly help in the speedy recovery from early-stage mild to moderate symptoms of COVID-19. Further research is warranted. Clinical Trial Registration:Clinicaltrials.gov, identifier NCT05130671
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Affiliation(s)
- Amjad Khan
- INEOS Oxford Institute for AMR Research, University of Oxford, Oxford, United Kingdom
- Department of Biochemistry, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
- *Correspondence: Amjad Khan,
| | - Somia Iqtadar
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Sami Ullah Mumtaz
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Michael Heinrich
- UCL School of Pharmacy, University of London, London, United Kingdom
| | - Domingo A. Pascual-Figal
- Department of Cardiology, University of Murcia Hospital Universitario Virgen de la Arrixaca Murcia, Murcia, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Sajid Abaidullah
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
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28
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Mohseni Afshar Z, Barary M, Babazadeh A, Tavakoli Pirzaman A, Hosseinzadeh R, Alijanpour A, Allahgholipour A, Miri SR, Sio TT, Sullman MJM, Carson‐Chahhoud K, Ebrahimpour S. The role of cytokines and their antagonists in the treatment of COVID-19 patients. Rev Med Virol 2022; 33:e2372. [PMID: 35621229 PMCID: PMC9347599 DOI: 10.1002/rmv.2372] [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: 01/20/2022] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 01/28/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has various presentations, of which immune dysregulation or the so-called cytokine storm syndrome (COVID-CSS) is prominent. Even though cytokines are vital regulators of body immunoinflammatory responses, their exaggerated release can be harmful. This hyperinflammatory response is more commonly observed during severe COVID-19 infections, caused by the excessive release of pro-inflammatory cytokines, such as interleukin-1 (IL-1), IL-6, IL-8, tumour necrosis factor, granulocyte-macrophage colony-stimulating factor, and interferon-gamma, making their blockers and antagonists of great interest as therapeutic options in this condition. Thus, the pathophysiology of excessive cytokine secretion is outlined, and their most important blockers and antagonists are discussed, mainly focussing on tocilizumab, an interleukin-6 receptor blocker approved to treat severe COVID-19 infections.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Mohammad Barary
- Student Research CommitteeVirtual School of Medical Education and ManagementShahid Beheshti University of Medical SciencesTehranIran,Students' Scientific Research Center (SSRC)Tehran University of Medical SciencesTehranIran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | | | | | | | - Amirreza Allahgholipour
- Student Research CommitteeSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Seyed Rouhollah Miri
- Cancer Research CenterCancer Institute of IranTehran University of Medical ScienceTehranIran
| | - Terence T. Sio
- Department of Radiation OncologyMayo ClinicPhoenixArizonaUSA
| | - Mark J. M. Sullman
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus,Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
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29
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Extensive Study on Hematological, Immunological, Inflammatory Markers, and Biochemical Profile to Identify the Risk Factors in COVID-19 Patients. Int J Inflam 2022; 2022:5735546. [PMID: 35721343 PMCID: PMC9200592 DOI: 10.1155/2022/5735546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Tissue damage caused by COVID-19 could be detected by several clinical indicators including hematological, immunological, biochemical, and inflammatory markers. This study was to detect these clinical parameters to reveal the correlation between the factors and their roles in the development of COVID-19, to explore the hazard factors in severe cases. Materials and Methods A total of 200 participants of both sexes were included in the study, with an age range of (25–72) years, categorized into three main groups: 50 healthy individuals, 62 mild infected patients, and 88 severe infected patients with pneumonia. Different hematological and clinical parameters were included in the analysis (Basrah city, Iraq). Serum levels of interleukin-6 (IL-6), ferritin, and high-sensitivity C-reactive protein (hs-CRP) were assessed for all participants using an enzyme-linked immunosorbent assay (ELISA). The liver, renal, and cardiac functions were assessed by clinical chemistry testing. Results COVID-19 patients had leukocytosis, with an increased number of neutrophils and a decreased lymphocyte count, according to our findings. In regard to inflammatory parameters, both ESR and hs-CRP showed significant differences between the two groups, whereas IL-6 was significantly higher in the total severe group compared to the other two groups. Biochemical results revealed that each lactate dehydrogenase (LDH), ferritin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) had significant changes in the total severe group. Among pneumonic with an O2 requirement and pneumonic without an O2 requirement, there were significant differences in immunological and inflammatory markers (p > 0.05). The neutrophils-lymphocytes ratio (NLR) was highly elevated in severe who required O2. Moreover, IL-6, lymphocytes, and neutrophils were possible risk factors for COVID-19 infection, with the strongest influence of IL-6 with a high odds ratio (OR: 24.138, 95% CI: 8.437–30.65, p < 0.01). Furthermore, there were significant correlations among the indicators. Conclusion Each of IL-6, lymphocytes, and neutrophils might represent major factors in the severity of COVID-19 and IL-6 plays the main role in inducing the inflammatory and pathophysiology process that is known as the cytokine storm.
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30
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Díaz-Troyano N, Gabriel-Medina P, Weber S, Klammer M, Barquín-DelPino R, Castillo-Ribelles L, Esteban A, Hernández-González M, Ferrer-Costa R, Pumarola T, Rodríguez-Frías F. Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2. Diagnostics (Basel) 2022; 12:diagnostics12040886. [PMID: 35453934 PMCID: PMC9031748 DOI: 10.3390/diagnostics12040886] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 02/07/2023] Open
Abstract
Predicting disease severity in patients infected with SARS-CoV-2 is difficult. Soluble angiotensin-converting enzyme 2 (sACE2) arises from the shedding of membrane ACE2 (mACE2), which is a receptor for SARS-CoV-2 spike protein. We evaluated the predictive value of sACE2 compared with known biomarkers of inflammation and tissue damage (CRP, GDF-15, IL-6, and sFlt-1) in 850 patients with and without SARS-CoV-2 with different clinical outcomes. For univariate analyses, median differences between biomarker levels were calculated for the following patient groups (classified by clinical outcome): RT-PCR-confirmed SARS-CoV-2 positive (Groups 1−4); RT-PCR-confirmed SARS-CoV-2 negative following previous SARS-CoV-2 infection (Groups 5 and 6); and ‘SARS-CoV-2 unexposed’ patients (Group 7). Median levels of CRP, GDF-15, IL-6, and sFlt-1 were significantly higher in hospitalized patients with SARS-CoV-2 compared with discharged patients (all p < 0.001), whereas levels of sACE2 were significantly lower (p < 0.001). ROC curve analysis of sACE2 provided cut-offs for predicting hospital admission (≤0.05 ng/mL (positive predictive value: 89.1%) and ≥0.42 ng/mL (negative predictive value: 84.0%)). These findings support further investigation of sACE2, as a single biomarker or as part of a panel, to predict hospitalization risk and disease severity in patients with SARS-CoV-2 infection.
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Affiliation(s)
- Noelia Díaz-Troyano
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
- Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Pablo Gabriel-Medina
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
- Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Stephen Weber
- Roche Diagnostics GmbH, 82377 Penzberg, Germany; (S.W.); (M.K.)
| | - Martin Klammer
- Roche Diagnostics GmbH, 82377 Penzberg, Germany; (S.W.); (M.K.)
| | - Raquel Barquín-DelPino
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
| | - Laura Castillo-Ribelles
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
- Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Angels Esteban
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
| | - Manuel Hernández-González
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
- Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- Immunology Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | - Roser Ferrer-Costa
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
| | - Tomas Pumarola
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
- Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- Microbiology Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | - Francisco Rodríguez-Frías
- Biochemistry Department (Clinical Laboratories), Vall d’Hebron University Hospital, 08035 Barcelona, Spain; (N.D.-T.); (P.G.-M.); (R.B.-D.); (L.C.-R.); (A.E.); (R.F.-C.)
- Vall d’Hebron Research Institute, 08035 Barcelona, Spain; (M.H.-G.); (T.P.)
- Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- Correspondence:
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31
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Bokhary DH, Bokhary NH, Seadawi LE, Moafa AM, Khairallah HH, Bakhsh A. The Role of Demographic, Clinical, and Laboratory Characteristics in Predicting the In-Hospital Outcomes of Patients With COVID-19. Cureus 2022; 14:e23418. [PMID: 35475059 PMCID: PMC9027949 DOI: 10.7759/cureus.23418] [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: 03/23/2022] [Indexed: 01/08/2023] Open
Abstract
Objective In this study, we aimed to analyze the role of initial patient characteristics obtained at admission (including sociodemographic, clinical, and laboratory findings) in predicting the outcomes in patients with coronavirus disease 2019 (COVID-19). Methods This descriptive, retrospective cohort study included all hospital-admitted COVID-19-confirmed cases at a tertiary academic center in Jeddah, the Kingdom of Saudi Arabia (KSA), from March to June 2020. A total of 656 patients with a mean age of 50 ± 19.4 years were included. Results Of all the patients recruited, 19.3% required ICU admission, and 19% required mechanical ventilation. The majority (79.9%) of the patients recovered from COVID-19 and were discharged, while 20.1% of them died. Patients with advanced age (p=0.005), male sex (p=0.009), low platelet counts (p=0.015), low hemoglobin levels (p=0.004), low albumin levels (p=0.003), high alkaline phosphatase levels (p=0.002), high blood urea nitrogen levels (p<0.001), and high lactate dehydrogenase levels (p<0.001) were more likely to die. Conclusion Based on our findings, it can be inferred that mortality in COVID-19 is highly associated with advanced age and male gender, low platelet counts, low hemoglobin levels, low albumin levels, high alkaline phosphatase levels, high blood urea nitrogen levels, high lactate dehydrogenase levels, tachypnea, and requirement for mechanical ventilation.
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32
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Rameshwar R, Meenakshi K, Hanumanram G, Kannan R, Magesh Kumar S, Damodaran J, Nandhini S. Post COVID assesment of right and left ventricular global longitudinal strain. Indian Heart J 2022; 74:144-147. [PMID: 35202659 PMCID: PMC8863312 DOI: 10.1016/j.ihj.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/12/2022] [Accepted: 02/20/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- R Rameshwar
- Saveetha Medical College and Hospital, Chennai, Tamilnadu
| | - K Meenakshi
- Saveetha Medical College and Hospital, Chennai, Tamilnadu.
| | | | - R Kannan
- Saveetha Medical College and Hospital, Chennai, Tamilnadu
| | - S Magesh Kumar
- Saveetha Medical College and Hospital, Chennai, Tamilnadu
| | - J Damodaran
- Saveetha Medical College and Hospital, Chennai, Tamilnadu
| | - S Nandhini
- Saveetha Medical College and Hospital, Chennai, Tamilnadu
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33
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Hijazi H, Abu Talib M, Hasasneh A, Bou Nassif A, Ahmed N, Nasir Q. Wearable Devices, Smartphones, and Interpretable Artificial Intelligence in Combating COVID-19. SENSORS (BASEL, SWITZERLAND) 2021; 21:8424. [PMID: 34960517 PMCID: PMC8709136 DOI: 10.3390/s21248424] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/23/2022]
Abstract
Physiological measures, such as heart rate variability (HRV) and beats per minute (BPM), can be powerful health indicators of respiratory infections. HRV and BPM can be acquired through widely available wrist-worn biometric wearables and smartphones. Successive abnormal changes in these indicators could potentially be an early sign of respiratory infections such as COVID-19. Thus, wearables and smartphones should play a significant role in combating COVID-19 through the early detection supported by other contextual data and artificial intelligence (AI) techniques. In this paper, we investigate the role of the heart measurements (i.e., HRV and BPM) collected from wearables and smartphones in demonstrating early onsets of the inflammatory response to the COVID-19. The AI framework consists of two blocks: an interpretable prediction model to classify the HRV measurements status (as normal or affected by inflammation) and a recurrent neural network (RNN) to analyze users' daily status (i.e., textual logs in a mobile application). Both classification decisions are integrated to generate the final decision as either "potentially COVID-19 infected" or "no evident signs of infection". We used a publicly available dataset, which comprises 186 patients with more than 3200 HRV readings and numerous user textual logs. The first evaluation of the approach showed an accuracy of 83.34 ± 1.68% with 0.91, 0.88, 0.89 precision, recall, and F1-Score, respectively, in predicting the infection two days before the onset of the symptoms supported by a model interpretation using the local interpretable model-agnostic explanations (LIME).
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Affiliation(s)
- Haytham Hijazi
- Department of Informatics Engineering, CISUC-Centre for Informatics and Systems of the University of Coimbra, University of Coimbra, P-3030-790 Coimbra, Portugal;
- Intelligent Systems Department, Palestine Ahliya University, Bethlehem P-150-199, Palestine
| | - Manar Abu Talib
- College of Computing and Informatics, University of Sharjah, Sharjah P-27272, United Arab Emirates; (A.B.N.); (N.A.); (Q.N.)
| | - Ahmad Hasasneh
- Department of Natural, Engineering, and Technology Sciences, Arab American University, Ramallah P-600-699, Palestine;
| | - Ali Bou Nassif
- College of Computing and Informatics, University of Sharjah, Sharjah P-27272, United Arab Emirates; (A.B.N.); (N.A.); (Q.N.)
| | - Nafisa Ahmed
- College of Computing and Informatics, University of Sharjah, Sharjah P-27272, United Arab Emirates; (A.B.N.); (N.A.); (Q.N.)
| | - Qassim Nasir
- College of Computing and Informatics, University of Sharjah, Sharjah P-27272, United Arab Emirates; (A.B.N.); (N.A.); (Q.N.)
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34
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Aggarwal A, Mittal A, Soneja M, Shankar SH, Naik S, Kodan P, Nischal N, Jorwal P, Ray A, Wig N. Role of systemic corticosteroids in preventing hypoxia among patients with mild COVID-19: An observational study. Drug Discov Ther 2021; 15:273-277. [PMID: 34707019 DOI: 10.5582/ddt.2021.01081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Use of systemic corticosteroids is well-established in COVID-19 patients with hypoxia; however, there is scant data on its role in patients with mild disease and prolonged symptoms as a measure to prevent disease progression. The aim of this study is to evaluate the role of systemic corticosteroids in preventing hypoxia (SpO2 ≤ 93% on room-air) among mild COVID-19 patients. An observational study was conducted among symptomatic COVID-19 patients taking oral corticosteroids and attending institute teleconsultation facility between 10th-30th June 2021. Patients who were already on corticosteroids for other indication or required oxygen supplementation before or within 24-hours of initiation of corticosteroids were excluded. A total of 140 consecutive symptomatic COVID-19 patients were included. Higher baseline C-reactive protein (OR: 1.03, 95% CI: 1.02-1.06, p < 0.001) and early systemic corticosteroid (within 7 days) initiation (OR: 6.5, 95% CI: 2.1-20.1, p = 0.001) were independent risk factors for developing hypoxia (SpO2 ≤ 93%). Progression to hypoxia was significantly higher in patients who received corticosteroids before day 7 of illness (36.7%, 95% CI, 23.4-51.7%) compared to ≥ 7 of illness (14.3%, 95% CI, 7.8-23.2%) for persistent fever. Systemic corticosteroids within 7 days from symptom-onset were harmful and increased the risk of progression to hypoxia, whereas it may decrease the risk of progression when administered on or beyond 7 days in patients with mild COVID-19 and persistent symptoms. A well-designed randomised controlled trial is required to validate the findings.
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Affiliation(s)
- Anivita Aggarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ankit Mittal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sujay Halkur Shankar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shivdas Naik
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Parul Kodan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Neeraj Nischal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pankaj Jorwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Animesh Ray
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naveet Wig
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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35
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Mohseni Afshar Z, Babazadeh A, Janbakhsh A, Mansouri F, Sio TT, Sullman MJM, Carson-Chahhoud K, Hosseinzadeh R, Barary M, Ebrahimpour S. Coronavirus disease 2019 (Covid-19) vaccination recommendations in special populations and patients with existing comorbidities. Rev Med Virol 2021; 32:e2309. [PMID: 34677889 PMCID: PMC8646697 DOI: 10.1002/rmv.2309] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 01/09/2023]
Abstract
Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a crucial step in ending the current worldwide pandemic. However, several particularly vulnerable groups in the population were not included in sufficient numbers in coronavirus disease 2019 (Covid‐19) vaccine trials. Therefore, as science advances, the advice for vaccinating these special populations against Covid‐19 will continue to evolve. This focused review provides the latest recommendations and considerations for these special populations (i.e., patients with rheumatologic and autoimmune disorders, cancer, transplant recipients, chronic liver diseases, end‐stage renal disease, neurologic disorders, psychiatric disorders, diabetes mellitus, obesity, cardiovascular diseases, chronic obstructive pulmonary disease, human immunodeficiency virus, current smokers, pregnant and breastfeeding women, the elderly, children, and patients with allergic reactions) using the currently available research evidence.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Feizollah Mansouri
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Terence T Sio
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, USA
| | - Mark J M Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus.,Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | | | - Rezvan Hosseinzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Barary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Yitbarek GY, Walle Ayehu G, Asnakew S, Ayele FY, Bariso Gare M, Mulu AT, Dagnaw FT, Melesie BD. The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review. SAGE Open Med 2021; 9:20503121211050755. [PMID: 34659766 PMCID: PMC8516378 DOI: 10.1177/20503121211050755] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/16/2021] [Indexed: 01/08/2023] Open
Abstract
Since December 2019, coronavirus diseases-2019 (COVID-19) dispersed into 200 countries and affected more than 70 million people. The clear picture of the SARS-CoV-2 infection is still under investigation. In this review, we evaluated whether C-reactive protein biomarker is able to predict the clinical outcomes or correlated with the severity of COVID-19 disease. The databases MEDLINE, Hinari, Google Scholar, and Google search were used to find potential studies published from COVID-19 epidemic until May 2021. A format prepared in Microsoft Excel spreadsheet was used to extract the appropriate details from each original report. For further review, the extracted data were exported to STATA/MP version 16.0 software. Keywords including "COVID-19," "SARS-CoV-2," and "C-reactive protein," among others were used to search relevant articles. Only studies which reported the average C-reactive protein value and COVID-19 disease stage outcomes were included. Twenty articles were included in the review. All studies found considerably higher level of C-reactive protein in patients with severe COVID-19 as compared to mildly infected patients. This review evidenced that it is still there for a given biomarker to early identify the state of progression in asymptomatic and/or mildly infected individuals into severe disease; the level of C-reactive protein may be used in predicting the likelihood of disease progression. Findings from this review showed level of C-reactive protein is a good biomarker to predict the severity of COVID-19 disease. Although COVID-19 researches are at the early stages, investigation of C-reactive protein levels throughout the disease course may have paramount importance for clinicians in early detection of severe manifestations and subsequently improve the prognosis. However, further large-scale studies are required to confirm these findings.
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Affiliation(s)
- Getachew Yideg Yitbarek
- Department of Biomedical Sciences, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Walle Ayehu
- Department of Biomedical Sciences, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fanos Yeshanew Ayele
- Department of Public Health, College of Health Science, Wollo University, Dessie, Ethiopia
| | - Moyeta Bariso Gare
- Department of Biomedical Science, College of Public Health and Medical Science, Jimma University, Jimma, Ethiopia
| | - Anemut Tilahun Mulu
- Department of Biomedical Sciences, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fentaw Teshome Dagnaw
- Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Biruk Demissie Melesie
- Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Fazal M. C-Reactive Protein a Promising Biomarker of COVID-19 Severity. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.3.201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Muntaha Fazal
- Department of Biomedical Laboratory Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
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38
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Umakanthan S, Senthil S, John S, Madhavan MK, Das J, Patil S, Rameshwaram R, Cintham A, Subramaniam V, Yogi M, Bansal A, Achutham S, Shekar C, Murthy V, Selvaraj R. The protective role of statins in COVID-19 patients: a retrospective observational study. TRANSLATIONAL MEDICINE COMMUNICATIONS 2021; 6:22. [PMID: 34604534 PMCID: PMC8475829 DOI: 10.1186/s41231-021-00102-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/19/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND To evaluate and determine the protective role of statins in COVID-19 patients. METHODS This is a retrospective cohort study conducted across five hospitals in India. Patients diagnosed with COVID-19 and hospitalized with existing and valid medical documentation were included. RESULTS This study comprised 3252 COVID-19 patients, of whom 1048 (32.2%) were on statins, with 52.4% being males. The comorbidity prevalence of hypertension was 75%, followed by diabetes 62.51% and coronary artery disease being 47.5%. At the time of hospitalization, statin users had a higher incidence of dyspnea, cough, and fatigue (95.8, 93.3, and 92.7%). The laboratory results revealed a lower mean of WBC count (7.8 × 103/μL), D-dimer (2.4 μg/mL), and C-reactive protein (103 mg/L) among statin users. They also had lower mortality rates (17.1%), a lesser requirement for mechanical ventilation (20%), and hemodialysis (5.4%). CONCLUSION This observation study elaborates on the beneficial effects of statins in COVID-19 patients. However, the inferences from this study should be viewed with caution due to the impending effect of confounding factors on its statistical results.
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Affiliation(s)
- Srikanth Umakanthan
- Department of Para-clinical sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad Trinidad and Tobago
| | - Sanjum Senthil
- International Research Association Unit, New Delhi, India
- Department of Medicine, RRN Multispecialty Hospital, Tamil Nadu, India
| | - Stanley John
- International Research Association Unit, New Delhi, India
- Department of Medicine, Holy Cross Hospital, Tamil Nadu, India
| | - Mahesh K. Madhavan
- Department of Medicine, Holy Cross Hospital, Tamil Nadu, India
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
| | - Jessica Das
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
| | - Sonal Patil
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
| | - Ragunath Rameshwaram
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Department of Biostatistics, Epidemiology, and Informatics, Piramal Research Centre, Gujarat, India
| | - Ananya Cintham
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Venkatesh Subramaniam
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Madhusudan Yogi
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Abhishek Bansal
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Sumesh Achutham
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Chandini Shekar
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Vijay Murthy
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Robbin Selvaraj
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
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