1
|
Faghih Dinevari M, Jafarzadeh F, Jabbaripour Sarmadian A, Abbasian S, Nikniaz Z, Riazi A. The effect of melatonin on irritable bowel syndrome patients with and without sleep disorders: a randomized double-blinded placebo-controlled trial study. BMC Gastroenterol 2023; 23:135. [PMID: 37098505 PMCID: PMC10131443 DOI: 10.1186/s12876-023-02760-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/06/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is one of the world's most common gastrointestinal (GI) disorders, and current treatments do not meet patients' demands. This study aimed to investigate melatonin's therapeutic effects on IBS score, GI symptoms, quality of life, and sleep parameters in both groups of IBS patients with and without sleep disorders. METHODS In this randomized double-blinded placebo-controlled trial study, 136 patients with a diagnosis of IBS based on ROME IV criteria were enrolled and then divided into two groups respecting having sleep disorders or not. Patients of each group were randomized in a 1:1 ratio to receive melatonin 6 mg daily (3 mg fasting and 3 mg at bedtime) for 2 months (8 weeks). Blocked randomization was used in this process. All patients were evaluated both at the beginning and the end of the trial regarding IBS score, GI symptoms, quality of life, and sleep parameters through valid questionnaires. RESULTS In both groups of patients with and without sleep disorders, a significant improvement was observed in IBS score and GI symptoms, including the severity and the frequency of abdominal pain, the severity of abdominal bloating, satisfaction with bowel habits, disease's impact on patient's life, and stool consistency; however, there was no significant improvement in the frequency of defecations per week. In patients with sleep disorders, significant improvement in sleep parameters, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction, was observed, while in patients without sleep disorders, there was no significant improvement in sleep parameters. In addition, quality-of-life improvement was observed in a significant number of melatonin recipients compared to placebo in both groups of patients. CONCLUSION Melatonin can be considered an effective treatment for improving IBS score, GI symptoms, and quality of life in IBS patients with and without sleep disorders. It is also effective to improve sleep parameters in IBS patients with sleep disorders. TRIAL REGISTRATION This study has been registered to the Iranian Registry of Clinical Trials (IRCT) with the approval number IRCT20220104053626N2 on the date of 13/02/2022.
Collapse
Affiliation(s)
- Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzaneh Jafarzadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Samaneh Abbasian
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Riazi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
2
|
Somi MH, Faghih Dinevari M, Taghizadieh A, Varshochi M, Sadeghi Majd E, Abbasian S, Nikniaz Z. Effect of vitamin A supplementation on the outcome severity of COVID-19 in hospitalized patients: A pilot randomized clinical trial. Nutr Health 2022:2601060221129144. [PMID: 36205099 PMCID: PMC9548486 DOI: 10.1177/02601060221129144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Vitamin A is one of the vitamins that is suggested as adjuvant therapy in viral infections due to its immune enhancing role. In the present clinical trial, we intended to assess the effect of vitamin A supplementation on Coronavirus disease-2019 (COVID-19) in hospitalized patients. METHODS The present pilot randomized controlled clinical trial was conducted on 30 hospitalized patients with COVID-19. Patients in the intervention group received 50000 IU/day intramuscular vitamin A for a maximum of two weeks. Patients in the control group continued their common treatment protocols. All participants were followed up until discharge from the hospital or death. The primary outcome of the study was time to achieve clinical response based on the six classes of an ordinal scale. Time to clinical response was calculated based on the days needed to improve two scores on the scale or patient's discharge. RESULTS The time to clinical response was not significantly different between the two groups (7.23 ± 2.14 vs. 6.75 ± 1.85 days, respectively, p = 0.48). There was no significant difference between the groups regarding clinical response (hazard ratio: 1.76 [95% CI: 0.73, 4.26]). There were no significant differences between groups regarding the need for mechanical ventilation, duration of hospitalization, or death in the hospital. CONCLUSION The results of this pilot clinical trial showed no benefit of vitamin A compared with the common treatment on outcome severity in hospitalized patients with COVID-19. Although the results are negative, there is still a great need for future clinical studies to provide a higher level of evidence.
Collapse
Affiliation(s)
- Mohammad Hossein Somi
- Gastroenterologist, Liver and
gastrointestinal diseases research center, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Masood Faghih Dinevari
- Gastroenterologist, Liver and
gastrointestinal diseases research center, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Ali Taghizadieh
- Pulmonologist, Tuberculosis and Lung
Disease Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Mojtaba Varshochi
- Infectious disease specialist,
Infectious and Tropical Diseases Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Elham Sadeghi Majd
- Student Research Committee, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Samaneh Abbasian
- Internist, Liver and gastrointestinal
diseases research center, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Gastroenterologist, Liver and
gastrointestinal diseases research center, Tabriz University of Medical
Sciences, Tabriz, Iran
| |
Collapse
|
3
|
Fadaee M, Abbasi H, Maralbashi S, Baradaran B, Shanehbandi D, Dinevari MF, Kazemi T. Docosahexaenoic acid may inhibit immune evasion of colorectal cancer cells through targeting immune checkpoint and immunomodulator genes and their controlling microRNAs. Biofactors 2022; 48:1137-1144. [PMID: 35533068 DOI: 10.1002/biof.1842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/11/2022] [Indexed: 11/10/2022]
Abstract
Colorectal cancer is one of the major concerns in both developed and developing societies. Because of the serious side effects of the current treatments, novel therapy agents have been developed that target immune checkpoint and immunomodulatory molecules in the tumor environment. Therefore, this study investigates the effect of docosahexaenoic acid (DHA) fatty acid on the expression of immune checkpoint molecule, PD-L1, and immunomodulatory molecules, CD47 and CD39, and their controlling miRNAs in the colorectal cancer cell lines. Human colorectal cell lines HT-29 and Caco-2 were treated with 100 μM DHA and 50 μM LA for 24 h under the normoxic and hypoxic conditions. Total RNA was extracted and the qRT-PCR was performed to analyze the expression of the studied genes and miRNAs. The western blotting technique was also used for validation. The qRT-PCR results showed that DHA treatment decreased the expression of the PD-L1, CD47, and CD39 genes, but decreases these genes controlling miRNAs, mir-424, mir-133a, and mir-142, respectively. Western blotting analysis demonstrated that PD-L1 protein expression decreased after DHA treatment. LA administration had no inhibitory effect on the studied genes. This study showed that DHA may have anti-cancer properties by downregulation of proteins involved in the immune evasion of colorectal tumors. DHA could be used as a potential immune checkpoint inhibitor for the treatment of colorectal cancers.
Collapse
Affiliation(s)
- Manouchehr Fadaee
- Immunology Research Center, Tabriz University of Medical Science, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran
| | - Hajar Abbasi
- Department of Immunology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Maralbashi
- Immunology Research Center, Tabriz University of Medical Science, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Science, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Dariush Shanehbandi
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Tohid Kazemi
- Immunology Research Center, Tabriz University of Medical Science, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| |
Collapse
|
4
|
Mohammadi Z, Faghih Dinevari M, Vahed N, Ebrahimi Bakhtavar H, Rahmani F. Clinical and Laboratory Predictors of COVID-19-Related In-hospital Mortality; a Cross-sectional Study of 1000 Cases. Arch Acad Emerg Med 2022; 10:e49. [PMID: 36033996 PMCID: PMC9397590 DOI: 10.22037/aaem.v10i1.1574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Identifying patients at risk for mortality and using appropriate treatment for each patient based on their situation could be an effective strategy in improving their outcome. This study aimed to evaluated the predictors of COVID-19 in-hospital mortality. METHODS This descriptive cross-sectional study was conducted on all adult COVID-19 patients who were managed in Imam-Reza and Sina Hospitals, Tabriz, Iran, from November 2020 until December 2021. The demographic, clinical, and laboratory characteristics of patients were evaluated and predictors of in-hospital mortality were identified using logistic regression model. RESULTS 1000 patients with the mean age of 56.34 ± 18.00 years were studied (65.7% male). There were significant associations between COVID-19 in-hospital mortality and hospitalization above five days (p = 0.001), white blood cell count (WBC) > 4000 Cells*103/mL (p < 0.01), aspartate aminotransferase (AST) above 40 IU/L (p = 0.001), alanine transaminase (ALT) above 40 IU/L (p = 0.001), creatinine above 1.4 mg/dL (p = 0.007), urea above 100 mg/dL (p = 0.024), and SaO2 below 80% (p = 0.001). Hospital stay above five days (OR: 3.473; 95%CI: 1.272 - 9.479; p = 0.15), AST above 40 IU/L (OR: 0.269, 95%CI: 0.179 - 0.402; p = 0.001), creatinine above 1.4 mg/dL (OR: 0.529; 95%CI: 0.344 - 0.813; p = 0.004), urea above 100 mg/dL (OR: 0.327, 95%CI: 0.189 - 0.567; p = 0.001), and SaO2 below 80% (OR: 8.754, 95%CI: 5.413 - 14.156; p = 0.001) were among the independent predictors of COVID-19 in-hospital mortality. CONCLUSION The mortality rate of patients with COVID-19 in our study was 29.9%. Hospitalization of more than five days, AST above 40 IU/L, creatinine above 1.4 mg/dL, urea above 100 mg/dL and SaO2 < 80% were independent risk factors of in-hospital mortality among patients with COVID-19.
Collapse
Affiliation(s)
- Zohreh Mohammadi
- Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | | | - Farzad Rahmani
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. ,Corresponding Author: Farzad Rahmani; Emam Reza Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: 00984133352078, Fax: 00984133352078, , ORCID: 0000-0001-5582-9156
| |
Collapse
|
5
|
Faghih Dinevari M, Somi MH, Sadeghi Majd E, Fattahzadeh A, Nikniaz Z. Elevated Liver Aminotransferases Level and COVID-19 Prognosis in Hospitalized Patients: A Prospective Study from Iran. Middle East J Dig Dis 2022; 14:64-69. [PMID: 36619725 PMCID: PMC9489327 DOI: 10.34172/mejdd.2022.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/29/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: Considering the conflicting results and limited studies on the association between elevated liver enzyme levels and COVID-19 outcomes, in the present study, we aimed to investigate the association between hepatic enzyme changes and the prognosis of COVID-19 during hospital admission. METHODS: In this prospective study, 1017 consecutive patients with COVID-19 participated and were followed up from admission until they were discharged or deceased. The liver enzyme levels were recorded on admission. The patient/disease-related information was recorded by trained nurses using questionnaires. The primary endpoint was the association between elevated liver enzymes and liver injury and mortality from COVID. RESULTS: The mean age of the participants was 62.58±17.45 years; 55.4% of them were male. There was no significant difference between groups regarding the COVID-19 outcomes except for the need for ICU admission (P=0.02). Moreover, all COVID-19 outcomes were significantly higher in patients with liver injury compared with other patients except for the quick sequential organ failure assessment (qSOFA) score. After adjusting for covariates, the patients with Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels of more than 40 (IU/L) and participants with liver injury on admission had significantly greater odds of death, ICU admission, and mechanical ventilation requirements. CONCLUSION: The results of the present study support the hypothesis that poor outcomes of COVID-19 infection were higher in patients with elevated liver enzyme levels and liver injury. Therefore, liver chemicals should be closely monitored during the illness and hospital admission, and patients with COVID-19 and an elevated level of transaminases should be followed up carefully, and necessary interventions should be considered to prevent poor outcomes.
Collapse
Affiliation(s)
- Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Sadeghi Majd
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afshin Fattahzadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding Author: Zeinab Nikniaz, PhD Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Imam Reza hospital, Tabriz, Iran Telefax:+98 4133367473
| |
Collapse
|
6
|
Faghih Dinevari M, Rasoolimanesh M, Tarverdizadeh M, Riazi A, Abbasian S, Zeinolabedini A, Hassannezhad S. Acute pancreatitis in a young woman with COVID-19 infection: A case-report. Caspian J Intern Med 2021; 12:S474-S478. [PMID: 34760109 PMCID: PMC8559625 DOI: 10.22088/cjim.12.0.474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/14/2020] [Accepted: 01/18/2021] [Indexed: 01/13/2023]
Abstract
Background Little is known about the development of acute pancreatitis as a complication of corona virus disease of 2019 (COVID-19) infection. This case report describes the presentation of acute pancreatitis in a young woman who then was diagnosed with COVID-19 infection. Case Presentation An 18-year old previously healthy woman referred to Imam Raza hospital, Tabriz, Iran with a 3-day history of intermittent and crampy abdominal pain. She had serum amylase of 1288 IU/L and serum lipase of 1541 IU/L. She was diagnosed with acute pancreatitis. She was instructed nil per os (NPO) and serum therapy and also was given pantoprazole, and pethidine for her pain management. The laboratory tests for assessing the etiology of acute pancreatitis were normal. Abdominal and pelvic spiral computed tomography (CT) scan revealed edematous pancreas and enhancing loculi fluid accumulation around pancreas along with the small amount of ascites fluid that all suggest acute pancreatitis. Due to the presentation of fever and COVID-19 pandemic and her potential society exposure, we tested SARS CoV-2 by polymerase chain reaction which was positive. The blood C-reactive protein (CRP) level was 3+ but the chest x-ray showed no findings compatible with COVID-19. Eventually after receiving conservative therapy for her pancreatitis, she was discharged from hospital in the good general condition and she has not experienced any episodes of abdominal pain again. Conclusion This case highlights acute pancreatitis as a suspected complication associated with COVID-19 and the need for further research.
Collapse
Affiliation(s)
- Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Rasoolimanesh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Tarverdizadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Riazi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Abbasian
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aysan Zeinolabedini
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Hassannezhad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
7
|
Nikniaz Z, Somi MH, Dinevari MF, Taghizadieh A, Mokhtari L. Diabesity Associates with Poor COVID-19 Outcomes among Hospitalized Patients. J Obes Metab Syndr 2021; 30:149-154. [PMID: 33927066 PMCID: PMC8277582 DOI: 10.7570/jomes20121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/10/2020] [Accepted: 02/07/2021] [Indexed: 12/20/2022] Open
Abstract
Background Although numerous studies have investigated obesity's negative effect on coronavirus disease 2019 (COVID-19) outcomes, only a limited number focused on this association in diabetic patients. In this study, we analyzed the association between obesity and COVID-19 outcome (death, intensive care unit [ICU] admission, mechanical ventilation needs, quick Sequential Organ Failure Assessment [qSOFA] score, and confusion, urea, respiratory rate, blood pressure [CURB-65] scores) for hospitalized diabetic patients. Methods In this prospective hospital-based registry of patients with COVID-19 in East Azerbaijan, Iran, 368 consecutive diabetic patients with COVID-19 were followed from admission until discharge or death. Self-reported weight and height were used to calculate body mass index (kg/m2) upon admission. Our primary endpoint was analyzing obesity and COVID-19 mortality association. Assessing the associations among obesity and disease severity, ICU admission, and mechanical ventilation was our secondary endpoint. Results We analyzed data from 317 patients and found no significant difference between obese and non-obese patients regarding frequency of death, invasive mechanical ventilation, ICU admission, CURB-65, or qSOFA scores (P>0.05). After adjusting for confounding factors, obese diabetic COVID-19 patients were 2.72 times more likely to die than non-obese patients. Moreover, ventilator dependence (adjusted odds ratio [aOR], 1.87; 95% confidence interval [CI], 1.03-4.76) and ICU admission (aOR, 2.41; 95% CI, 1.11-5.68) odds were significantly higher for obese patients than non-obese patients. Conclusion The results of the present study indicated that obesity worsens health outcomes for diabetic COVID-19 patients.
Collapse
Affiliation(s)
- Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz, Iran
| | | | - Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz, Iran.,Imam Reza Hospital, Tabriz, Iran
| | - Ali Taghizadieh
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
8
|
Faghih Dinevari M, Somi MH, Sadeghi Majd E, Abbasalizad Farhangi M, Nikniaz Z. Anemia predicts poor outcomes of COVID-19 in hospitalized patients: a prospective study in Iran. BMC Infect Dis 2021; 21:170. [PMID: 33568084 PMCID: PMC7875447 DOI: 10.1186/s12879-021-05868-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 02/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There are limited number of studies with controversial findings regarding the association between anemia at admission and coronavirus disease 2019 (COVID-19) outcomes. Therefore, in this research, we aimed to investigate the prospective association between anemia and COVID-19 outcomes in hospitalized patients in Iran. METHODS In this prospective study, the data of 1274 consecutive patients hospitalized due to COVID-19 were statistically analyzed. All biomarkers, including hemoglobin and high-sensitivity C-reactive protein (hs-CRP) levels were measured using standard methods. Anemia was defined as a hemoglobin (Hb) concentration of less than 13 g/dL and 12 g/dL in males and females, respectively. Assessing the association between anemia and COVID-19 survival in hospitalized patients was our primary endpoint. RESULTS The mean age of the participants was 64.43 ± 17.16 years, out of whom 615 (48.27%) were anemic subjects. Patients with anemia were significantly older (P = 0.02) and had a higher frequency of cardiovascular diseases, hypertension, kidney disease, diabetes, and cancer (P < 0.05). The frequency of death (anemic: 23.9% vs. nonanemic: 13.8%), ICU admission (anemic: 27.8% vs. nonanemic:14.71%), and ventilator requirement (anemic: 35.93% vs. nonanemic: 20.63%) were significantly higher in anemic patients than in nonanemic patients (P < 0.001). According to the results of regression analysis, after adjusting for significant covariate in the univariable model, anemia was independently associated with mortality (OR: 1.68, 95% CI: 1.10, 2.57, P = 0.01), ventilator requirement (OR: 1.74, 95% CI: 1.19, 2.54, P = 0.004), and the risk of ICU admission (OR: 2.06, 95% CI: 1.46, 2.90, P < 0.001). CONCLUSION The prevalence of anemia in hospitalized patients with COVID-19 was high and was associated with poor outcomes of COVID-19.
Collapse
Affiliation(s)
- Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Sadeghi Majd
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
9
|
Somi MH, Faghih Dinevari M, Alizadeh L, Riazi A, Abbasian S, Nikniaz Z. Comparison of the serum fibrinogen level and International Normalized Ratio in the assessment of the risk of gastrointestinal bleeding in decompensated cirrhosis. J Res Clin Med 2020. [DOI: 10.34172/jrcm.2020.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Gastrointestinal (GI) bleeding is the most life-threatening complication of cirrhosis and it's predicting is crucial for the management of cirrhotic patients. The present study aimed to assess the relationship between INR and plasma fibrinogen level and the risk of GI bleeding using in cirrhotic patients. Methods: In the present cross-sectional study, seventy-eight cirrhotic patients were enrolled. We assessed demographic, biochemical, hematologic parameters in all patients. Underlying diseases and the etiology of cirrhosis were documented. The Child-Pugh and the Model for End-stage Liver Disease (MELD) scores were used to assess the severity of liver cirrhosis. The history of bleeding episodes within 6 months before inclusion were recorded. A blood sample was drowned and fibrinogen and prothrombin time (PT) were measured and INR was calculated. Results: The patients' mean age was 51.23±15.08 years and 40 (51.3%) were male. About 17 patients (%21.7) had a history of GI bleeding within 6 months before the study. The significant difference was observed between the two groups who experienced bleeding and who did not regarding the fibrinogen level (P < 0.05). The fibrinogen level was a better predictive marker of bleeding in cirrhotic patients (AUC: 0.87). According to the results of predictive tests, the fibrinogen level had a sensitivity of (77%) and specificity of (%94) in the prediction of bleeding with the cut-off value of 182.5. Conclusion: The results of the present study showed that the fibrinogen level is a better predictor of bleeding in cirrhotic patients compared with INR.
Collapse
Affiliation(s)
- Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Alizadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Riazi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Abbasian
- Student research committee, Tabriz University of medical sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
10
|
Faghih Dinevari M, Somi MH, Tarzamni MK, Alizadeh L, Abbasian S, Riazi A, Nikniaz Z. The diagnostic value of non-invasive serum liver fibrosis indices in the prediction of portal hypertension in cirrhotic patients: a cross-sectional study. J Res Clin Med 2020. [DOI: 10.34172/jrcm.2020.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Considering that portal hypertension is principally caused by hepatic fibrosis, some studies postulated the predictive value of serum liver fibrosis indices in the diagnosis of portal hypertension. In this study we assessed the prognostic value of serum indices in the diagnosis of portal hypertension in cirrhotic patients. Methods: One hundred two cirrhotic patients were selected according to inclusion/exclusion criteria. Cirrhosis and the Child-Pugh score was determined by the gastroenterologist. Portal hypertension was diagnosed by the radiologist using the color Doppler method. The fasting blood sample was drawn and different serum indices were determined. The following indices were calculated: FIB4, Fibroindex, APRI, FORNS, LOK. Results: The patients mean age was 54.39±6.60 years. About 52.94% of the patients were women. The mean liver enzymes level was higher in patients with portal hypertension. In 50.98% of patients, the etiology of cirrhosis was viral hepatitis. Significant differences was observed between the two groups regarding the studied indices (P<0.05). According to the results of the ROC curve, the FORNS index was a better predictive marker of portal hypertension in cirrhotic patients. The maximum AUC (area under the curve) was for the FORNS index. According to the results of diagnostic tests, the FORNS index had adequate sensitivity and specificity in the diagnosis of portal hypertension with the cut-off value of 8.51. Conclusion: The results of the present study showed that the FORNS index is a better predictor of portal hypertension in cirrhotic patients.
Collapse
Affiliation(s)
- Masood Faghih Dinevari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Leila Alizadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Abbasian
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Riazi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|