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Ćurčić M, Tarle M, Almahariq H, Hleb S, Havaš J, Pražetina M, Lasić H, Dolenc E, Kukoč A, Mihelčić A, Miko I, Romić A, Tipura D, Drmić Ž, Čučković M, Blagaj V, Lukšić I, Peršec J, Šribar A. Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections-Observations from National COVID-19 Hospital in Croatia. Diagnostics (Basel) 2022; 12:2069. [PMID: 36140471 PMCID: PMC9497731 DOI: 10.3390/diagnostics12092069] [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: 08/04/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Superinfections contribute to mortality and length of stay in critically ill COVID-19 patients. The aim of this study was to determine the incidence and pathogen distribution of bacterial and fungal superinfections of the lower respiratory tract (LRTI), urinary tract (UTI) and bloodstream (BSI) and to determine the predictive value of biomarkers of inflammatory response on their ICU survival rates. METHODS A retrospective observational study that included critically ill COVID-19 patients treated during an 11-month period in a Croatian national COVID-19 hospital was performed. Clinical and diagnostic data were analyzed according to the origin of superinfection, and multivariate regression analysis was performed to determine the predictive values of biomarkers of inflammation on their survival rates. RESULTS 55.3% critically ill COVID-19 patients developed bacterial or fungal superinfections, and LRTI were most common, followed by BSI and UTI. Multidrug-resistant pathogens were the most common causes of LRTI and BSI, while Enterococcus faecalis was the most common pathogen causing UTI. Serum ferritin and neutrophil count were associated with decreased chances of survival in patients with LRTI, and patients with multidrug-resistant isolates had significantly higher mortality rates, coupled with longer ICU stays. CONCLUSION The incidence of superinfections in critically ill COVID-19 patients was 55.3%, and multidrug-resistant pathogens were dominant. Elevated ferritin levels and neutrophilia at ICU admission were associated with increased ICU mortality in patients with positive LRTI.
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Affiliation(s)
- Maja Ćurčić
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Marko Tarle
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Hani Almahariq
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Sonja Hleb
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Juraj Havaš
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Marko Pražetina
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Hrvoje Lasić
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Emil Dolenc
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Andrea Kukoč
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Antonija Mihelčić
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Ivan Miko
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Andrea Romić
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Danijela Tipura
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Željka Drmić
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Marcela Čučković
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Vanja Blagaj
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Ivica Lukšić
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Jasminka Peršec
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Andrej Šribar
- Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Role of natural products towards the SARS-CoV-2: A critical review. Ann Med Surg (Lond) 2022; 80:104062. [PMID: 35814035 PMCID: PMC9249430 DOI: 10.1016/j.amsu.2022.104062] [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: 05/01/2022] [Revised: 06/11/2022] [Accepted: 06/22/2022] [Indexed: 11/23/2022] Open
Abstract
Despite the fact that various therapeutic compounds are being investigated, there is still a scarcity of effective and reliable therapeutic regimens to treat COVID-19. Ever since the COVID-19 pandemic, a diversity of traditional herbal treatments has been investigated to cure infected people, either alone or in conjunction with mainstream pharmaceuticals, with encouraging outcomes. In this article, we look at the latest research on the usage of natural products to alleviate the severity of COVID-19. To determine the activity of the natural products, act against SARS-CoV-2 to various targets like Mpro, ACE-II, papain-like, chymotrypsin-like proteases, and some antiviral targets. The processes underlying this preventative or therapeutic action are also examined. We used PubMed, Scopus, Google Scholar, and the WHO site to perform our review. The anti-SARS-CoV-2 impacts of various herbal extracts and purified compounds may be mediated via direct prevention of viral replication or entrance. Interestingly, certain items might avert SARS-CoV-2 from infecting human cells by blocking the ACE-2 protein or the serine protease TMPRRS2. Natural products have also been stated to suppress proteins intricate in the virus life cycle, like papain-like and chymotrypsin-like proteases. To conclude, natural products can be used alone or in combination as remedies or treatments for COVID-19. In addition, their compositions may provide insight into the development of effective and reliable antiviral drugs. The COVID-19 pandemic caused by a novel coronavirus SARS-CoV-2, resulted in thousands of deaths across the world. Globally, numerous studies and researchers have recently started fighting this virus. In this article, we look at the latest research on the usage of natural products to alleviate the severity of COVID-19. The anti-SARS-CoV-2 impacts of various herbal extracts and purified compounds may be mediated via direct prevention of viral replication or entrance.
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