|
1
|
Giani M, Pozzi M, Rona R. Lessons from the COVID-19 Pandemic. J Clin Med 2023; 12:5791. [PMID: 37762732 PMCID: PMC10531926 DOI: 10.3390/jcm12185791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic was an unprecedented global crisis that significantly impacted around the world [...].
Collapse
Affiliation(s)
- Marco Giani
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Department of Emergency and Intensive Care, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Matteo Pozzi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Department of Emergency and Intensive Care, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Roberto Rona
- Department of Emergency and Intensive Care, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| |
Collapse
|
|
2
|
Radonjić T, Milićević O, Jovanović I, Zdravković M, Dukić M, Mandić OM, Bjekić-Macut J, Marković OB, Todorović Z, Brajković M, Nikolić N, Klašnja S, Popadić V, Divac A, Marinković M, Alhayek N, Branković MS. Elevated Transaminases as Predictors of COVID-19 Pneumonia Severity. Medicina (B Aires) 2022; 58:medicina58070842. [PMID: 35888561 PMCID: PMC9319887 DOI: 10.3390/medicina58070842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/17/2022] [Accepted: 06/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background: This study aimed to calculate the frequency of elevated liver enzymes in hospitalized patients with coronavirus disease 2019 (COVID-19) infection and to test if liver enzyme biochemistry levels on admission could predict the computed tomography (CT) scan severity score of bilateral interstitial pneumonia. Methods: This single-center study comprised of 323 patients including their demographic data, laboratory analyses, and radiological findings. All the information was taken from electronic health records, followed by statistical analysis. Results: Out of 323 patients, 115 of them (35.60%) had aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) over 40 U/L on admission. AST was the best predictor of CT scan severity score of bilateral interstitial pneumonia (R2 = 0.313, Adjusted R2 = 0.299). CT scan severity score in the peak of the infection could be predicted with the value of AST, neutrophils, platelets, and monocytes count (R2 = 0.535, Adjusted R2 = 0.495). Conclusion: AST, neutrophils, platelets, and monocytes count on admission can account for almost half (49.5%) of the variability in CT scan severity score at peak of the disease, predicting the extensiveness of interstitial pneumonia related to COVID-19 infection. Liver enzymes should be closely monitored in order to stratify COVID-19 patients with a higher risk of developing severe forms of the disease and to plan the beforehand step-up treatment.
Collapse
Affiliation(s)
- Tijana Radonjić
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
- Correspondence:
| | - Ognjen Milićević
- Faculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, Serbia;
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Igor Jovanović
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Marija Zdravković
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Marija Dukić
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Olga Milorad Mandić
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Jelica Bjekić-Macut
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Olivera Borko Marković
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Zoran Todorović
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Milica Brajković
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Novica Nikolić
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Slobodan Klašnja
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Višeslav Popadić
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Anica Divac
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
| | - Milica Marinković
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Nabil Alhayek
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| | - Marija Svetislav Branković
- University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia; (I.J.); (M.Z.); (M.D.); (O.M.M.); (J.B.-M.); (O.B.M.); (Z.T.); (M.B.); (N.N.); (S.K.); (V.P.); (A.D.); (M.S.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (N.A.)
| |
Collapse
|
|
3
|
Severe COVID-19 ARDS Treated by Bronchoalveolar Lavage with Diluted Exogenous Pulmonary Surfactant as Salvage Therapy: In Pursuit of the Holy Grail? J Clin Med 2022; 11:jcm11133577. [PMID: 35806862 PMCID: PMC9267619 DOI: 10.3390/jcm11133577] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Severe pneumonia caused by coronavirus disease 2019 (COVID-19) is characterized by inflammatory lung injury, progressive parenchymal stiffening and consolidation, alveolar and airway collapse, altered vascular permeability, diffuse alveolar damage, and surfactant deficiency. COVID-19 causes both pneumonia and acute respiratory distress syndrome (COVID-19 ARDS). COVID-19 ARDS is characterized by severe refractory hypoxemia and high mortality. Despite extensive research, the treatment of COVID-19 ARDS is far from satisfactory. Some treatments are recommended for exhibiting some clinically positive impacts on COVID-19 patients although there are already several drugs in clinical trials, some of which are already demonstrating promising results in addressing COVID-19. Few studies have demonstrated beneficial effects in non-COVID-19 ARDS treatment of exogenous surfactant, and there is no evidence-based, proven method for the procedure of surfactant administration. Aim: The aim of this work is to underline the key role of ATII cells and reduced surfactant levels in COVID-19 ARDS and to emphasize the rational basis for exogenous surfactant therapy in COVID-19 ARDS, providing insights for future research. Methods: In this article, we describe and support via the literature the decision to administer large volumes of surfactant to two patients via bronchoalveolar lavage to maximize its distribution in the respiratory tract. Results: In this study, we report on two cases of COVID-19 ARDS in patients who have been successfully treated with diluted surfactants by bronchoalveolar lavage, followed by a low-dose bolus of surfactant. Conclusion: Combining the administration of diluted, exogenous pulmonary surfactant via bronchoalveolar lavage along with the standard therapy for SARS-CoV-2-induced ARDS may be a promising way of improving the management of ARDS.
Collapse
|