scholarly journals Calculated plasma osmolality at hospital admission correlates well with eGFR and D-Dimer, a simple outcome predictor and guiding tool for management of severe COVID-19 patients

2021 ◽  
pp. 102240
Author(s):  
Jayanthy Ramesh ◽  
Moganti Rajesh ◽  
Johann Varghese ◽  
S.L. Sagar Reddy
Keyword(s):  
Hospital Admission ◽  
Plasma Osmolality ◽  
Outcome Predictor ◽  
D Dimer

scholarly journals CLOT STIFFNESS MEASURED BY SEER SONORHEOMETRY AS A MARKER OF POOR PROGNOSIS IN HOSPITALIZED COVID-19 PATIENTS

2021 ◽  
Author(s):  
Francisco Jose Lopez-Jaime ◽  
Sandra Martin-Tellez ◽  
Alberto Doblas-Marquez ◽  
Ignacio Marquez-Gomez ◽  
Jose Maria Reguera-Iglesias ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Disease Severity ◽  
Poor Prognosis ◽  
Point Of Care ◽  
Clot Lysis ◽  
Thrombotic Complication ◽  
Inflammation Markers ◽  
Clinical Value ◽  
Coagulation Tests ◽  
D Dimer

Background: High incidence of life-threatening thrombotic complications is observed in severely ill COVID-19 patients. D-dimer may help evaluate disease severity and predict outcomes at hospital admission. However, its non-specificity and long analysis times strongly constrain its clinical value. Viscoelastic tests (VET) are widely available rapid point-of-care devices that have been shown to detect a hypercoagulable state (increased clot stiffness and fibrinolysis shutdown) as major contributors of the thrombotic complication in COVID-19. Nevertheless, based on the data obtained so far, definitive conclusions have not been drawn. Objectives: We aim to evaluate the association between VET parameters, standard coagulation tests and inflammation markers assessed in COVID-19 patients at hospital admission with disease severity and outcomes. Patients/Methods: A total of 69 COVID-19 patients requiring hospitalization were included in the study. The pro-inflammatory and pro-thrombotic state was analyzed by a panel of inflammation markers (IL-6, CRP, LDH, ferritin), routine coagulation tests (PT, aPTT, platelet count, fibrinogen, D-dimer) and a SEER sonorheometry VET profile (Quantra System). Results: Inflammatory markers IL-6, CRP, LDH and ferritin were elevated in a high percentage of patients (73.6%, 89.2%, 57.1% and 52.4%), as were coagulation-related parameters such as fibrinogen (81.4%) and D-dimer levels (66.2%). Quantra analysis revealed increased clot stiffness (CS) in 34.8%, particularly due to increased fibrinogen contribution (FCS) in 63.7%. Increased clot stability to lysis (CSL) was observed in 32.4%. Age > 65 years, elevated values of fibrinogen, D-dimer, LDH, increased clot stiffness and resistance to clot lysis were significantly associated with worsening disease. The Quantra FCS parameter showed a particularly high prognostic value in distinguishing patients with severe symptomatology. Conclusion: The global study of hemostasis by the whole blood point-of-care Quantra VET system may be a powerful tool for identifying poor prognosis in COVID-19 patients at hospital admission. In particular, FCS measured by Quantra could be established as a plausible prognostic marker to aid the clinical management of COVID-19 patients.

scholarly journals Time and the etiology of Acute Kidney Injury define prognosis in the course of COVID-19

2020 ◽  
Author(s):  
Ahmet Murt ◽  
Mevlut Tamer Dincer ◽  
Cebrail Karaca ◽  
Sinan Trabulus ◽  
Ridvan Karaali ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Admission ◽  
Inflammatory Markers ◽  
Inflammatory Marker ◽  
Kidney Injury ◽  
Final Analysis ◽  
Disease Stage ◽  
Immunologic Response ◽  
Inclusion Criteria ◽  
D Dimer

Abstract Introduction Kidneys are among the affected organs in COVID-19 and there may be different etiologies resulting in acute kidney injury (AKI) in different stages of the disease. This study aimed to analyze AKI among hospitalized COVID-19 patients in relation to the time and etiologies of AKI.Materials & Methods 1056 patients who were hospitalized with COVID-19 diagnosis in our institution were retrospectively evaluated and 383 of them met the inclusion criteria. Eighty-nine patients who developed AKI were involved in the final analysis. As immunologic response is generally accepted to start with the second week of COVID-19 course, patients were classified into three groups, those who had AKI on admission, those who developed AKI in the first week and those who developed AKI starting from 7th day. Initial lymphocyte counts, creatinine levels and inflammatory markers as well as changes in these parameters were compared between the groups.Results AKI was seen in 23% of the patients and 23% of those who developed AKI died. Patients who developed AKI later had higher peak CRP and D-dimer levels with lower nadir lymphocyte counts (p=0,000, 0,004 and 0,003 respectively). Additionally, patients who died had higher initial inflammatory marker levels and lower lymphocyte counts than those who survived. Mortality of patients who had AKI on hospital admission (13%) was similar to the overall COVID-19 mortality for inpatients, however it was as high as 44% for those who developed AKI after 7th day.Conclusion Early AKI was more related to pre-renal causes and had a milder course. However, later AKIs were more related to immunologic response and had significantly higher mortality. Findings of this study suggest that AKI in COVID-19 is not of one kind. When developed, AKI should be evaluated in conjunction with the disease stage and possible etiologies.

scholarly journals Hyperglycemia at hospital admission is associated with severity of the prognosis in patients hospitalized for COVID-19

2020 ◽  
Author(s):  
Alberto Coppelli ◽  
Rosa Giannarelli ◽  
Michele Aragona ◽  
Giuseppe Penno ◽  
Marco Falcone ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Research Design ◽  
Independent Predictor ◽  
Independent Factor ◽  
Glycemic Status ◽  
Glucose Levels ◽  
Inflammatory Profile ◽  
Design And Methods ◽  
D Dimer

OBJECTIVE <p>To explore whether at-admission hyperglycemia is associated with worse outcomes in patients hospitalized for Covid-19.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Hospitalized Covid-19 subjects (N=271) were subdivided based on at-admission glycemic status: 1. glucose levels <7.78 mmol/L (NG; N=149; 55.0%; median glucose 5.99 [5.38-6.72] mmol/L), 2. known diabetes (DM; N=56; 20.7%; 9.18 [7.67-12.71] mmol/L), and 3. no diabetes and glucose levels ≥7.78 mmol/L (HG; N=66, 24.3%; 8.57 [8.18-10.47] mmol/L).</p> <p>RESULTS</p> <p>Neutrophils were higher and lymphocytes and PaO<sub>2</sub>/FiO<sub>2</sub> lower in HG than DM and NG. DM and HG had higher D-Dimer and worse inflammatory profile. Mortality was greater in HG (39.4% vs 16.8%; unadjusted HR 2.20, 95%CI 1.27-3.81, p=0.005) than in NG (16.8%), and marginally so in DM (28.6%; HR 1.73, 0.92-3.25, p=0.086). Upon multiple adjustments, only HG remained an independent predictor (1.80, 1.03-3.15, p=0.04). After stratification by quintile of glucose levels, mortality was higher in Q4 (HR 3.57, 1.46-8.76, p=0.005) and marginally in Q5 (29.6%; HR 2.32, 95% CI 0.91-5.96, p=0.079) vs Q1.</p> <p>CONCLUSIONS</p> <p>Hyperglycemia is an independent factor associated with severe prognosis in people hospitalized for COVID-19.<b><br> </b></p>

scholarly journals Oral anticoagulation with rivaroxaban as thromboprophylaxis in patients recovered from COVID-19 pneumonia in Veracruz, Mexico

2021 ◽  
Vol 13 (1) ◽  
pp. 12-15
Author(s):  
Luis Del Carpio Orantes ◽  
Jesús Salvador Sánchez- Díaz ◽  
Karla Gabriela Peniche- Moguel ◽  
Elisa Estefanía Aparicio- Sánchez ◽  
Orlando Israel Segura- Rodríguez ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Analytical Study ◽  
Thrombotic Event ◽  
Severe Pneumonia ◽  
Hemorrhagic Event ◽  
Hemorrhagic Events ◽  
History Of ◽  
June July ◽  
D Dimer

Background: Patients affected by COVID-19 are at risk of various venous and arterial thrombotic events, as well as embolic risks, the risk can vary from 17% to 78% according to the different published series. Therefore, thromboprophylaxis must be imperative. Methods: Descriptive and analytical study in patients who presented pneumonia due to COVID-19 in April and May 2020, who received LMWH during their hospital stay and at discharge with rivaroxaban 10 mg / day for 2 months. D-dimer was measured at the beginning of the study and 1 month after discharge. Thrombotic or hemorrhagic episodes are controlled after 1 and 2 months of treatment (June – July 2020). Results: 50 patients are included, twenty women (40%) and thirty (60%) men, with a median age of 42.9 years. 32 (64%) patients had mild pneumonia and 18 (36%) patients had severe pneumonia, mean initial d-dimer 556.5 (375.2 - 1233.7) ng / ml, 56% of patients had d-dimer ≥ 500 ng / ml at the time of hospital admission. Baseline D-dimer values were significantly higher among patients with severe pneumonia. In the follow-up at one and two months after hospital discharge, we found that D-dimer values were significantly higher among patients with severe pneumonia and also, in this group of patients, the percentage of patients with D-dimer levels ≥ 500 ng / mL in the first month of follow-up, was significantly higher in the group of patients who were hospitalized for severe pneumonia. During the first month of follow-up, there was a thrombotic event and a hemorrhagic event in the group of patients with a history of severe pneumonia; by the second month of follow-up, there was a hemorrhagic event in the group of patients with mild pneumonia, but this difference in frequencies was not statistically significant. Conclusion: In this group of patients, the incidence of thrombotic and hemorrhagic events was low, so the thromboprophylaxis scheme used in patients with recovered pneumonia due to COVID-19 is recommended. Rivaroxaban is safe to use like thromboprophylaxis.

scholarly journals Primary Analysis of the Risk Factors for Severity and Mortality in COVID-19 Patients in Uzbekistan

2021 ◽  
Vol 53 (03) ◽  
pp. 104-111
Author(s):  
Azamat Alimov ◽  
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Retrospective Analysis ◽  
Old Age ◽  
Severe Disease ◽  
Fatal Outcome ◽  
Male Gender ◽  
Primary Analysis ◽  
Moderate Disease ◽  
D Dimer

A retrospective analysis of 561 patients with confirmed COVID-19 was performed to determine the risk factors for severity and mortality which could predict the disease outcome in early stages. Patients were divided into 4 groups in accordance with disease severity: mild, moderate, severe and critical. And initial clinical and laboratory parameters of patients at admission were studied. The age of severe and deceased patients was significantly higher than patients with mild and moderate course (р=0.003). Patiens with severe disease and fatal outcome had higher incidence of concomitant diseases compared to patients with mild and moderate course (p=0.01). The time passed from onset of first symptoms and hospital admission was shorter in patients with mild and moderate disease than patients with severe and critical disease (р=0.0001). The leukocytosis, significant lymphopenia (р=0.0001), high D-dimer and ferritin levels were associated with severe disease. Male gender, old age, presence of concomitant diseases should be considered as risk factors for severe course and death at COVID-19.

scholarly journals Predicting pulmonary embolism in patients infected with COVID-19 based on D-dimer levels and days between diagnosis of the infection and D-dimer determination

2021 ◽  
Author(s):  
Ignasi Garcia-Olivé ◽  
Helena Sintes ◽  
Joaquim Radua ◽  
Jordi Deportos ◽  
Isabel Nogueira ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Retrospective Study ◽  
Hospital Admission ◽  
Cross Validation ◽  
Area Under The Curve ◽  
Subsequent Development ◽  
Tertiary Hospital ◽  
The Subject ◽  
D Dimer ◽  
Over Time

This was an observational, retrospective study, conducted at a tertiary hospital. All subjects with PCR-confirmed COVID-19 infection requiring hospital admission at our institution between the months of March and April 2020 were included in the study. We compared D-dimer levels in subjects who went on to develop a PE and those who did not. We then created a model to predict the subsequent development of a PE with the current D-dimer levels of the subject. D-dimer levels changed over time from COVID-19 diagnosis, but were always higher in subjects who went on to develop a PE. Regarding the predictive model created, the area under the curve of the ROC analyses of the cross-validation predictions was 0.72. The risk of pulmonary embolism for the same D-dimer levels varied depending on the number of days elapsed since COVID-19 diagnosis and D-dimer determination. To conclude, D-dimer levels were elevated in subjects with a COVID-19 infection, especially in those with PE. D-dimer levels increased during the first 10 days after the diagnosis of the infection and can be used to predict the risk of PE in COVID-19 subjects.

scholarly journals Hyperglycemia at hospital admission is associated with severity of the prognosis in patients hospitalized for COVID-19

2020 ◽  
Author(s):  
Alberto Coppelli ◽  
Rosa Giannarelli ◽  
Michele Aragona ◽  
Giuseppe Penno ◽  
Marco Falcone ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Research Design ◽  
Independent Predictor ◽  
Independent Factor ◽  
Glycemic Status ◽  
Glucose Levels ◽  
Inflammatory Profile ◽  
Design And Methods ◽  
D Dimer

OBJECTIVE <p>To explore whether at-admission hyperglycemia is associated with worse outcomes in patients hospitalized for Covid-19.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Hospitalized Covid-19 subjects (N=271) were subdivided based on at-admission glycemic status: 1. glucose levels <7.78 mmol/L (NG; N=149; 55.0%; median glucose 5.99 [5.38-6.72] mmol/L), 2. known diabetes (DM; N=56; 20.7%; 9.18 [7.67-12.71] mmol/L), and 3. no diabetes and glucose levels ≥7.78 mmol/L (HG; N=66, 24.3%; 8.57 [8.18-10.47] mmol/L).</p> <p>RESULTS</p> <p>Neutrophils were higher and lymphocytes and PaO<sub>2</sub>/FiO<sub>2</sub> lower in HG than DM and NG. DM and HG had higher D-Dimer and worse inflammatory profile. Mortality was greater in HG (39.4% vs 16.8%; unadjusted HR 2.20, 95%CI 1.27-3.81, p=0.005) than in NG (16.8%), and marginally so in DM (28.6%; HR 1.73, 0.92-3.25, p=0.086). Upon multiple adjustments, only HG remained an independent predictor (1.80, 1.03-3.15, p=0.04). After stratification by quintile of glucose levels, mortality was higher in Q4 (HR 3.57, 1.46-8.76, p=0.005) and marginally in Q5 (29.6%; HR 2.32, 95% CI 0.91-5.96, p=0.079) vs Q1.</p> <p>CONCLUSIONS</p> <p>Hyperglycemia is an independent factor associated with severe prognosis in people hospitalized for COVID-19.<b><br> </b></p>

D-Dimer Tests Not Predictive of VTE in Elderly

2008 ◽  
Vol 41 (10) ◽  
pp. 12-13
Author(s):  
JANE SALODOF MACNEIL
Keyword(s):  
D Dimer
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