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Krivdić Dupan Z, Periša V, Suver Stević M, Mihalj M, Tolušić Levak M, Guljaš S, Salha T, Loinjak D, Kos M, Šapina M, Canjko I, Šambić Penc M, Štefančić M, Nešković N. The Impact of Pentraxin 3 Serum Levels and Angiotensin-Converting Enzyme Polymorphism on Pulmonary Infiltrates and Mortality in COVID-19 Patients. Biomedicines 2024; 12:1618. [PMID: 39062191 PMCID: PMC11275229 DOI: 10.3390/biomedicines12071618] [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: 07/06/2024] [Revised: 07/14/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVES The aim of this study was to examine the impact of the pentraxin 3 (PTX3) serum level and angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism on the severity of radiographic pulmonary infiltrates and the clinical outcomes of COVID-19. METHODS The severity of COVID-19 pulmonary infiltrates was evaluated within a week of admission by analyzing chest X-rays (CXR) using the modified Brixia (MBrixa) scoring system. The insertion (I)/deletion (D) polymorphism of the ACE gene and the serum levels of PTX3 were determined for all patients included in the study. RESULTS This study included 80 patients. Using a cut-off serum level of PTX3 ≥ 2.765 ng/mL, the ROC analysis (AUC 0.871, 95% CI 0.787-0.954, p < 0.001) showed a sensitivity of 85.7% and specificity of 78.8% in predicting severe MBrixa scores. Compared to ACE I/I polymorphism, D/D polymorphism significantly increased the risk of severe CXR infiltrates, OR 7.7 (95% CI: 1.9-30.1), and p = 0.002. Significant independent predictors of severe CXR infiltrates include hypertension (OR 7.71), PTX3 (OR 1.20), and ACE D/D polymorphism (OR 18.72). Hypertension (OR 6.91), PTX3 (OR 1.47), and ACE I/I polymorphism (OR 0.09) are significant predictors of poor outcomes. CONCLUSION PTX3 and ACE D/D polymorphism are significant predictors of the severity of COVID-19 pneumonia. PTX3 is a significant predictor of death.
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Affiliation(s)
- Zdravka Krivdić Dupan
- Department of Radiology, Osijek University Hospital, 31000 Osijek, Croatia
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vlatka Periša
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Hematology, Osijek University Hospital, 31000 Osijek, Croatia
| | - Mirjana Suver Stević
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Transfusion Medicine, Osijek University Hospital, 31000 Osijek, Croatia
| | - Martina Mihalj
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Dermatology, Osijek University Hospital, 31000 Osijek, Croatia
| | - Maja Tolušić Levak
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Dermatology, Osijek University Hospital, 31000 Osijek, Croatia
| | - Silva Guljaš
- Department of Radiology, Osijek University Hospital, 31000 Osijek, Croatia
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Tamer Salha
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Faculty of Dental Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Domagoj Loinjak
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Internal Medicine, Osijek University Hospital, 31000 Osijek, Croatia
| | - Martina Kos
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Pediatrics, Osijek University Hospital, 31000 Osijek, Croatia
| | - Matej Šapina
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Pediatrics, Osijek University Hospital, 31000 Osijek, Croatia
| | - Ivana Canjko
- Department of Radiotherapy and Oncology, Osijek University Hospital, 31000 Osijek, Croatia
| | - Mirela Šambić Penc
- Department of Radiotherapy and Oncology, Osijek University Hospital, 31000 Osijek, Croatia
| | - Marin Štefančić
- Department of Radiology, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia
| | - Nenad Nešković
- Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- International Medical Center Priora, 31431 Cepin, Croatia
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Rinaldi I, Yulianti M, Yunihastuti E, Rajabto W, Irawan C, Sukrisman L, Rachman A, Mulansari NA, Lubis AM, Prasetyawaty F, Cahyanur R, Priantono D, Ahani AR, Muthalib A, Sudoyo A, Atmakusuma TD, Reksodiputro AH, Djoerban Z, Tambunan K, Winston K, Shufiyani YM, Wiyono L, Pratama S, Edina BC. Factors Associated with All-Cause 30-Day Mortality in Indonesian Inpatient COVID-19 Patients at Cipto Mangunkusumo National General Hospital. J Clin Med 2024; 13:2998. [PMID: 38792539 PMCID: PMC11122025 DOI: 10.3390/jcm13102998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/26/2024] Open
Abstract
Introduction: Indonesia, as a developing country, has limited data on the factors associated with 30-day mortality in COVID-19 patients in Indonesia. As a matter of fact, study analyzing factors associated with 30-day mortality of COVID-19 infection in Indonesia has never been conducted. This study aims to fill this gap in the literature by conducting a large-scale analysis of factors associated with 30-day mortality in COVID-19 patients in Indonesia. Method: This study employed a single-center retrospective cohort observational design, and was conducted at Cipto Mangunkusumo National General Hospital between the years 2022 and 2023. Sampling was conducted using the consecutive sampling method. The study included patients aged 18 years and above who had been confirmed to have COVID-19 infection. Survival analysis was conducted using Kaplan-Meier and multivariate Cox regression analysis. Result: Our study included a total of 644 patients, with 120 patients (18.6%) expiring within 30 days. In the multivariate analysis using the backward Wald method, severe COVID-19 (HR: 7.024; 95% CI: 3.971-12.744; p value: <0.0001), moderate COVID-19 infection (HR: 1.660; 95% CI: 1.048-2.629; p value: 0.031), liver cirrhosis (HR: 3.422; 95% CI: 1.208-9.691; p value: 0.021), female sex (HR: 1.738; 95% CI: 1.187-2.545; p value: 0.004), old age (HR: 2.139; 95% CI: 1.279-3.577; p value: 0.004), high leukocyte (HR: 11.502; 95% CI: 1.523-86.874; p value: 0.018), high NLR (HR: 1.720; 95% CI: 1.049-2.819; p value: 0.032), high CRP (HR: 1.906; 95% CI: 1.092-3.329; p value: 0.023), high procalcitonin (HR: 3.281; 95% CI: 1.780-6.049; p value: 0.001), and high creatinine (HR: 1.863; 95% CI: 1.240-2.800; p value: 0.003) were associated with 30-day mortality from COVID-19 infection. Subgroup analysis excluding cancer patients showed that age, D-Dimer, CRP, and PCT were associated with 30-day mortality in COVID-19 patients, while steroid therapy is protective. Conclusions: This study finds that COVID-19 severity, liver cirrhosis, sex, age, leukocyte, NLR, CRP, creatinine, and procalcitonin were associated with COVID-19 mortality within 30 days. These findings underscore the multifactorial nature of COVID-19 infection mortality. It is important, therefore, that patients which exhibit these factors should be treated more aggressively to prevent mortality.
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Affiliation(s)
- Ikhwan Rinaldi
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Mira Yulianti
- Respirology and Critical Care, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Evy Yunihastuti
- Allergy and Immunology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Wulyo Rajabto
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Cosphiadi Irawan
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Lugyanti Sukrisman
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Andhika Rachman
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Nadia Ayu Mulansari
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Anna Mira Lubis
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Findy Prasetyawaty
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Rahmat Cahyanur
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Dimas Priantono
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Ardhi Rahman Ahani
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Abdul Muthalib
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Aru Sudoyo
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Tubagus Djumhana Atmakusuma
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Arry Harryanto Reksodiputro
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Zubairi Djoerban
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Karmel Tambunan
- Hematology and Medical Oncology, Internal Medicine Department, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (W.R.); (C.I.); (L.S.); (A.R.); (A.M.L.); (F.P.); (R.C.); (D.P.); (A.R.A.); (A.M.); (A.S.); (T.D.A.); (A.H.R.); (Z.D.); (K.T.)
| | - Kevin Winston
- Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (K.W.); (Y.M.S.); (L.W.); (S.P.); (B.C.E.)
| | - Yuli Maulidiya Shufiyani
- Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (K.W.); (Y.M.S.); (L.W.); (S.P.); (B.C.E.)
| | - Lowilius Wiyono
- Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (K.W.); (Y.M.S.); (L.W.); (S.P.); (B.C.E.)
| | - Samuel Pratama
- Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (K.W.); (Y.M.S.); (L.W.); (S.P.); (B.C.E.)
| | - Brenda Cristie Edina
- Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (K.W.); (Y.M.S.); (L.W.); (S.P.); (B.C.E.)
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Seifi N, Bahari H, Ghiasi Hafezi S, Ghotbani F, Afzalinia A, Ferns GA, Farkhani EM, Ghayour-Mobarhan M. Dietary mineral intakes predict Coronavirus-disease 2019 (COVID-19) incidence and hospitalization in older adults. BMC Nutr 2024; 10:42. [PMID: 38439106 PMCID: PMC10910775 DOI: 10.1186/s40795-024-00821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 01/03/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The aim of this study was to determine the association between dietary mineral intake and Coronavirus-disease 2019 (COVID-19) infection and its associated hospitalization. METHODS This cohort study utilized the MASHAD study population, which comprised individuals aged 35-65. Upon recruitment in 2007, dietary intake was documented using a validated 65-item food frequency questionnaire (FFQ). Data on COVID-19 PCR test results was collected from all relevant medical centers in Mashhad between February 2020 and June 2022. The regression model included dietary minerals and employed the backward variable selection method, along with advanced data analysis techniques. RESULTS The final analysis involved 1957 participants, including 193 COVID-19-positive patients. The mean age was 49.71 and 50.28 years in the COVID-19-positive and negative groups, respectively (p = 0.12). Dietary intakes of magnesium, iron, and potassium were notably lower in COVID-19-positive patients (P < 0.05). Following adjustments for age and sex, dietary iron remained significantly associated with COVID-19 incidence (OR = 0.94, 95% CI: 0.90-0.98). Furthermore, a statistically significant relationship was observed between dietary zinc and hospitalization due to COVID-19 (OR = 0.69, 95% CI: 0.51-0.93). In dynamical system models, intakes of calcium, zinc, and iron below the cut-offs of 1138, 9.7, and 8.17 mg/day, respectively, were linked to an increased risk of COVID-19 incidence. CONCLUSION Higher dietary iron and zinc intake are associated with decreased risk of COVID-19 infection and hospitalization, respectively.
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Affiliation(s)
- Najmeh Seifi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Bahari
- Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Ghiasi Hafezi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Ghotbani
- Student Research committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - AhmadReza Afzalinia
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | | | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Wu JY, Liu MY, Hsu WH, Tsai YW, Liu TH, Huang PY, Chuang MH, Chin SE, Lai CC. Association between vitamin D deficiency and post-acute outcomes of SARS-CoV-2 infection. Eur J Nutr 2024; 63:613-622. [PMID: 38112761 DOI: 10.1007/s00394-023-03298-3] [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: 08/01/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES This study aimed to investigate the association between vitamin D deficiency (VDD) and post-acute outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS This retrospective study used the TriNetX research network to identify COVID-19 patients between January 1 and November 30, 2022. Patients were matched using propensity score matching (PSM) and divided into VDD (< 20 ng/mL) and control (≥ 20 ng/mL) groups. The primary outcome was a composite of post-COVID-19 condition (identified by ICD-10 code), all-cause emergency department (ED) visits, hospitalization, and death during the follow-up period (90-180 days) after the diagnosis of COVID-19. RESULTS From an initial recruitment of 42,674 non-hospitalized patients with COVID-19 and known 25(OH)D status, a VDD group of 8300 was identified and propensity matched with 8300 controls. During the follow-up period, the VDD group had a higher risk of the primary outcome than did the control group [hazard ratio (HR) = 1.122; 95% confidence interval (CI) = 1.041-1.210]. The VDD group also had a higher risk of all-cause ED visits (HR = 1.114; 95% CI = 1.012-1.226), all-cause hospitalization (HR = 1.230; 95% CI = 1.105-1.369), and all-cause death (HR = 1.748; 95% CI = 1.047-2.290) but not post-COVID-19 condition (HR = 0.980; 95% CI = 0.630-1.523), individually. CONCLUSION Among the COVID-19 patients, VDD might be associated with a higher risk of all-cause ED visits, hospitalization, and death during the post-acute phase.
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Affiliation(s)
- Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei-Yuan Liu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
- Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan
- Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
| | - Wan-Hsuan Hsu
- Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ya-Wen Tsai
- Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Min-Hsiang Chuang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Szu-En Chin
- Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
- School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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Baran B, Yetkin NA, Tutar N, Türe Z, Oymak FS, Gülmez İ. The Role of Sequentially Monitored Laboratory Values and Inflammatory Biomarkers in Assessing the Severity of COVID-19. Cureus 2024; 16:e51458. [PMID: 38298278 PMCID: PMC10829529 DOI: 10.7759/cureus.51458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
With the onset of the pandemic in 2020, COVID-19 pneumonia has become a common cause for hospitalization and is associated with high mortality rates. Inflammatory biomarkers play a crucial role in understanding and monitoring the progression of various diseases, including COVID-19. The objective of this study was to assess the significance of sequentially monitored standard laboratory tests, including complete blood cell count, D-dimer, fibrinogen, ferritin, albumin, C-reactive protein (CRP), as well as newly calculated inflammatory biomarkers in predicting the severity and prognosis of COVID-19 pneumonia. This single-center retrospective study included 194 patients hospitalized due to COVID-19 pneumonia. Patients were grouped based on the severity of their clinical symptoms, with 134 categorized as severe disease and 60 as mild-moderate disease. The patients' demographic data and laboratory values at hospital admission and on the third day of hospitalization were comparatively evaluated. In the severe illness group, there were more complaints about shortness of breath and a significant drop in the SPO2 value was observed at the time of application (p =0.005 and p<0.001, respectively). The overall mortality rate in all patients was 9% (18/194), and all deaths occurred within the severe disease group. All laboratory parameters, with the exception of platelet count and ferritin levels, were significantly associated and correlated with the severity of the disease during the hospitalization period. Among the biomarkers, there was no significant difference in neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) on the first day, a significant increase was observed on the third day of hospitalization in the severe disease group (p=0.050 vs. 0.003 and p=0.073 vs. 0.020, respectively). No significant difference was observed only in the PNR (platelet/neutrophil ratio) value among the inflammatory biomarkers (p=0.090 vs. p=0.354). In conclusion, the SPO2 level of COVID-19 patients at admission and the subsequent laboratory parameters examined show a significant relationship with the severity of the disease. In addition, simple inflammation biomarkers derived from laboratory values have shown a very significant relationship and correlation in the diagnosis and follow-up of the disease. In both admission and follow-up evaluation, a more significant association was observed with CRP-related biomarkers such as CRP/albumin ratio and CRP/lymphocyte ratio rather than NLR and PLR, which are widely used in the literature, in showing the severity of COVID-19. In patients with pneumonia, the laboratory assessment made on the third day of hospitalization reflects the severity of the disease more clearly than on the first day.
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Affiliation(s)
- Burcu Baran
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - Nur A Yetkin
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - Nuri Tutar
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - Zeynep Türe
- Infectious Diseases, Erciyes University, Kayseri, TUR
| | - Fatma S Oymak
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - İnci Gülmez
- Respiratory Medicine, Erciyes University, Kayseri, TUR
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MIRJALILI MOHAMMADREZA, RAADABADI MEHDI, DEHGHANI MOHAMMADREZA, ALIABAD MOHAMMADBAKHTIARI, MANSOURI MEHRDAD, MARTINI MARIANO, DEHGHANI ALI. Analysis of death risk factors among COVID-19 patients in Yazd, Iran: A case-cohort study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E304-E310. [PMID: 38125988 PMCID: PMC10730059 DOI: 10.15167/2421-4248/jpmh2023.64.3.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/04/2023] [Indexed: 12/23/2023]
Abstract
Background The COVID-19 epidemic control has become a global challenge and many contributing variables are still unknown to policymakers. This case-cohort study was conducted to investigate the risk factors of mortality in COVID-19 patients. Methods This case-cohort study was conducted on 956 samples in Ardakan and Meybod counties, Yazd Province, between February 20 and May 20, 2020. The data collection tool was a researcher-made questionnaire. Data analysis was done using descriptive statistics and paired t-test, chi-square, and logistic regression analysis. Results Of a total cohort population of 993 in Ardakan and Meybod counties, 435 were assigned to the control group and 521 were assigned to the case group. The results of outcome analysis showed that 14.4% of the patients in the case group and 11.5% of the patients in the control group died. According to the results of logistic regression analysis in COVID-19 patients, each one-year increase in age increased the risk of mortality by 6% (HR = 1.06, p < 0.001), each one-day increase in the hospital stay increased the risk of death by 8% (HR = 1.08, p < 0.001). Moreover, the presence of cardiovascular disease, chronic neurological disease, and chronic pulmonary disease increased the risk of death. The patients who underwent mechanical ventilation had 85% less chance of survival (HR = 0.15, p < 0.001). Conclusions The results showed a higher mortality rate in the elderly patients as well as those with underlying diseases. Attention should be paid to at-risk and elderly patients in terms of ensuring a healthy diet, improving their self-care practices, and providing long-term medical and healthcare facilities.
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Affiliation(s)
- MOHAMMADREZA MIRJALILI
- Internal Medicine Department, Medical College, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - MEHDI RAADABADI
- Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - MOHAMMADREZA DEHGHANI
- Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - MOHAMMAD BAKHTIARI ALIABAD
- Department of health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - MEHRDAD MANSOURI
- Medical College, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - ALI DEHGHANI
- Biostatistics and Epidemiology Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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