scholarly journals Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study

2020 ◽  
Author(s):  
Li Tan ◽  
Qi Wang ◽  
Duanyang Zhang ◽  
Jinya Ding ◽  
Qianchuan Huang ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Disease Severity ◽  
Symptom Onset ◽  
Blood Lymphocyte ◽  
Disease Classification ◽  
Dynamic Changes ◽  
Blood Tests ◽  
Death Cases ◽  
Predictive Study ◽  
Independent Criterion

SummaryBackgroundCoronavirus disease-2019 (COVID-19) is a rapidly escalating epidemic caused by SARS-CoV-2. Identification of a simple and effective indicator to assess disease severity and prognosis is urgently needed.MethodsDynamic changes of blood lymphocyte percentage (LYM%) in 15 death cases, 15 severe cases as well as 40 moderate cases of COVID-19 patients were retrospectively analyzed. A Time-LYM% model (TLM) was established according to the descriptive studies and was validated in 92 hospitalized cases.ResultsResults from death and severe cases showed that LYM% in blood tests were inversely associated with the severity and prognosis of COVID-19. LYM% in moderate type of patients with COVID-19 remained higher than 20% 10-12 days after symptom onset. In contrast, LYM% was lower than 20% in severe cases. However, LYM% in severe cases was higher than 5% 17-19 days after the onset of the disease, while it fell below 5% in death cases. Accordingly, we established a Time-LYM% model (TLM), which was validated as an independent criterion of disease classification in another 92 hospitalized patients with COVID-19.ConclusionLymphopenia can be used as an indicator of disease severity and prognosis of COVID-19 patients. TLM is worth of application in the clinical practice.

scholarly journals AB0576 BONE EROSION IN PSORIATIC ARTHRITIS ASSOCIATED WITH PSORIASIS DURATION, SKIN, NAIL AND JOINT DISEASE SEVERITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1325.2-1326
Author(s):  
M. Chamurlieva ◽  
E. Loginova ◽  
T. Korotaeva ◽  
Y. Korsakova ◽  
E. Gubar ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Disease Severity ◽  
Bone Erosion ◽  
Joint Disease ◽  
Practice Research ◽  
Forest Plot ◽  
Clinical Practice Research Datalink ◽  
Increased Risk ◽  
Nail Disease

Background:Psoriatic arthritis (PsA) is heterogeneous in its clinical presentation and disease course, but many patients (pts) develop a destructive form of arthritis. Psoriasis (PsO) precedes arthritis by an average of 7 years. [1]. Theory of transition from PsO to PsA has been proposed recently [2]. But association between skin disease severity and joint disease are still unclear.Objectives:to evaluate association between bone erosion, PsO duration, skin and nail disease severity in PsA pts based on data from clinical practice (RU-PsART cohort).Methods:737 (M/F=350/387) PsA pts fulfilling the CASPAR criteria were included. Mean age 47.4±12.7 years (yrs), PsA duration 55[17;120] mos., PsO duration 165[74.5;292] mos., mean DAPSA 23.3[14;36.9] mos., HAQ-DI - 0.98 [0.5;1.38], CRP - 7.4 [2.1;18] mg/l. All pts underwent standard clinical examination (tender joins count (TJC)/68, swelling joints count (SJC)/66, CRP (mg/l), DAPSA, dactylitis, enthesitis by LEI + Plantar Facia (PF), HAQ-DI. Mild disease was defined as body surface area (BSA)≤10%, moderate to severe as BSA>10%. The presence/absent of nail PsO was evaluated. X-ray of feet and hand were done in 622 out of 737 pts. The one-factor model of logistic regression was used to identify a group of features that are associated with achievement MDA. M±SD, Me [Q25; Q75], Min-Max, %, t-test, Pierson-χ2, Manna-Whitney tests, ORs with 95% CI were performed. All p<0.05 were considered to indicate statistical significance.Results:PsO precedes of PsA by an average of 9.2 years. BSA≤10% was found in 615 out of 672 pts (91.5%), BSA>10% - in 57 out of 672 pts (8.5%). Nail PsO were seen in 230 out of 737 (31.2%). Bone erosion was found in 237 out of 622 of pts (38.1%). Among these pts nail PsO were seen in 67 out of 237 pts (28.3%). Enthesitis found in 236 out of 737 pts (42.1%), dactylitis – in 197 out 731 pts (27%), axial PsA – in 315 out of 731 pts (43.1%). Bone erosion significantly associated with PsO duration more than 5 yrs., skin and nail PsO severity, high PsA activity by DAPSA, axial manifestation and duration of PsA > 36 mos. (Figure 1).Figure 1Forest plot of factors associated with bone erosion in PsA pts.Conclusion:In our cohort the majority of PsA pts had mild PsO preceded PsA on average of 9.2 yrs. Bone erosion was found in 30% of PsA pts which associated with PsO duration, skin and nail disease severity as well as with PsA activity. Early diagnosis and therapeutic intervention within a “window of opportunity” are very important for improving outcomes and prevent structural damage in PsA.References:[1]Tillett W, et al. Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort. Rheumatol. 2017; 56, 2109–2113[2]Scher JU, et al. Preventing psoriatic arthritis: focusing on patients with psoriasis at increased risk of transition. Nat Rev Rheumatol. 2019;15(3):153-166. doi: 10.1038/s41584-019-0175-0. PMID: 30742092.Disclosure of Interests:None declared.

Dynamic Changes in Serum Cortisol and Acth Levels and Lymphocyte Subset Counts in Children With Septic Shock

2020 ◽  
Author(s):  
Min Lin ◽  
Bo-Qiu Zhang ◽  
Hai Lin ◽  
Peng-Ming Sun ◽  
Shi-Biao Wang ◽  
...  
Keyword(s):  
Peripheral Blood Lymphocyte ◽  
Peripheral Blood ◽  
Blood Lymphocyte ◽  
Early Stage ◽  
Serum Cortisol ◽  
Lymphocyte Subset ◽  
Advanced Stage ◽  
Dynamic Changes ◽  
Significant Difference ◽  
Peripheral Blood Lymphocyte Subset

Abstract Backgroud: To study the dynamic changes in serum cortisol, adrenocorticotropic hormone (ACTH) levels and peripheral blood lymphocyte subset counts in children with septic shock (SS) and to explore their association with the severity and prognosis of the disease. Methods: The levels of serum cortisol, ACTH and peripheral blood lymphocyte subsets were analyzed in 25 patients in the advanced-stage group with decreased blood pressure and 24 patients in the early-stage group with normal blood pressure. Twenty-five healthy children who underwent physical examination were selected as the control group. Children in the advanced-stage group were further divided into the death subgroup (n = 5) and the survival subgroup (n = 20).Results: At admission, the levels of serum cortisol and ACTH in the advanced-stage group were apparently higher than those in the early-stage group (P < 0.05). The advanced-stage group had significantly lower lymphocyte subset counts than the early-stage group (P < 0.05). On the 3rd day after admission, the levels of serum cortisol and ACTH in both groups decreased, and the counts of total lymphocytes, T cells and Th cells in the early-stage group were significantly higher than those at admission. On the 8th day after admission, there was no statistically significant difference in the levels of serum cortisol or ACTH between the groups. At admission, there was no statistically significant difference in serum cortisol and ACTH levels between the death subgroup and the survival subgroup. On the third day after admission, the levels of cortisol and ACTH were decreased in both groups, but the differences between the two subgroups were not statistically significant. All the lymphocyte subset counts in the death subgroup on the third day after admission were significantly lower than those in the survival subgroup (P < 0.05).Conclusions: The hypothalamic-pituitary-adrenal axis is excessively activated in children with SS. Higher serum cortisol and ACTH levels and lower peripheral blood lymphocyte subset counts indicate increased severity of the disease. After treatment, the first signs that indicate the effective control of the disease are decreased serum cortisol and ACTH levels and increased T cell, Th cell and total lymphocyte counts.

scholarly journals Association between incubation period and clinical characteristics of patients with COVID-19

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095683
Author(s):  
Yeyu Cai ◽  
Jiayi Liu ◽  
Haitao Yang ◽  
Mian Wang ◽  
Qingping Guo ◽  
...  
Keyword(s):  
Incubation Period ◽  
Disease Severity ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Receiver Operator Characteristic Curve ◽  
Hunan Province ◽  
Laboratory Findings ◽  
Incubation Periods

Purpose To investigate associations between the clinical characteristics and incubation periods of patients infected with coronavirus disease 2019 (COVID-19) in Wuhan, China. Methods Complete clinical and epidemiological data from 149 patients with COVID-19 at a hospital in Hunan Province, China, were collected and retrospectively analyzed. Results Analysis of the distribution and receiver operator characteristic curve of incubation periods showed that 7 days was the optimal cut-off value to assess differences in disease severity between groups. Patients with shorter (≤7 days) incubation periods (n = 79) had more severe disease, longer durations of hospitalization, longer times from symptom onset to discharge, more abnormal laboratory findings, and more severe radiological findings than patients with longer (>7 days) incubation periods. Regression and correlation analyses also showed that a shorter incubation period was associated with longer times from symptom onset to discharge. Conclusion The associations between the incubation periods and clinical characteristics of COVID-19 patients suggest that the incubation period may be a useful marker of disease severity and prognosis.

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