scholarly journals No Clear Benefit to the Use of Corticosteroid as Treatment in Adult Patients with Coronavirus Disease 2019 : A Retrospective Cohort Study

2020 ◽  
Author(s):  
Dan Wang ◽  
Juan Wang ◽  
Qunqun Jiang ◽  
Juan Yang ◽  
Jun Li ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Fold Increase ◽  
Corticosteroid Treatment ◽  
Adverse Outcomes ◽  
Adult Patients ◽  
C Reactive Protein ◽  
Icu Admission ◽  
Reactive Protein ◽  
Global Health Issue ◽  
Logistic Regressions

AbstractBackgroundCoronavirus disease 2019 (COVID-19) is becoming an increasing global health issue which has spread across the globe. We aimed to study the effect of corticosteroids in the treatment of adult inpatients with COVID-19.MethodsA retrospective cohort of 115 consecutive adult COVID-19 patients admitted to The Third People’s Hospital of Hubei Province between Jan 18, 2020, and Feb 28, 2020 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, clinical features, laboratory indicators and clinical outcomes. The primary endpoint was defined as either mortality or intensive care unit (ICU) admission. Known adverse prognostic factors were used as covariates in multiple logistic regressions to adjust for their confounding effects on outcomes.ResultsAmong 115 patients, 73 patients (63.5%) received corticosteroid. The levels of age, C-reactive protein, D-dimer and albumin were similar in both groups. The corticosteroid group had more adverse outcomes (32.9% vs. 11.9%) and statistically significant differences were observed (p=0.013). In multivariate analysis, corticosteroid treatment was associated with a 2.155-fold increase in risk of either mortality or ICU admission, although not statistically significant.ConclusionNo evidence suggests that adult patients with COVID-19 will benefit from corticosteroids, and they might be more likely to be harmed with such treatment.

scholarly journals Low-Dose Corticosteroid Treatment in Children With Mycoplasma pneumoniae Pneumonia: A Retrospective Cohort Study

2020 ◽  
Vol 8 ◽  
Author(s):  
Liya Zhang ◽  
Lijun Wang ◽  
Shanshan Xu ◽  
Huajun Li ◽  
Caiting Chu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mycoplasma Pneumoniae ◽  
Recovery Time ◽  
Retrospective Cohort ◽  
Low Dose ◽  
Corticosteroid Treatment ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Dose Corticosteroid ◽  
Mycoplasma Pneumoniae Pneumonia

Background: The clinical value of corticosteroid treatment in Mycoplasma pneumoniae pneumonia (MPP) has been controversial. Our study aimed to identify the effects of low-dose corticosteroids on the recovery of children with MPP.Methods: In this retrospective cohort study, pediatric inpatients with MPP were included from the Shanghai Children's Mycoplasma pneumoniae pneumonia cohort study between August 2014 and July 2019. The multivariable logistic regression and propensity-score matching were used to investigate the effects of low-dose corticosteroid treatment on fever duration after admission, total fever duration, length of hospital stay, C-reactive protein recovery time, and imaging recovery time with the stratification of severe pneumonia, refractory pneumonia, inflammatory biomarkers, pulmonary images, and timing of corticosteroids.Results: There were 548 patients in the corticosteroid group and 337 in the no-corticosteroid group. The corticosteroid group showed severe clinical parameters such as more severe and refractory cases, higher laboratory values, and more abnormal imaging manifestations. The corticosteroid group also showed longer fever duration after admission [odds ratio (OR) = 1.9 (95% CI, 1.2–3.1), P = 0.008], longer total fever duration [OR = 1.6 (95% CI, 1.1–2.3), P = 0.011], longer hospital stay [OR = 2.8 (95% CI, 1.9–4.0), P < 0.001], and longer C-reactive protein (CRP) recovery time [OR = 2.1 (95% CI, 1.1–3.9), P = 0.021] in the regression model after the adjustment for severity. Although low-dose corticosteroids were associated with shortened imaging recovery time in patients with high level laboratory values, pulmonary imaging could be completely recovered in both groups. The trend of these results was consistent even after stratifications and a propensity scores matching analysis.Conclusions: Low-dose corticosteroids may not be beneficial in children inpatients with MPP, and further studies on proper treatment modality are needed in the MRMP era.

scholarly journals Fever as a predictor of adverse outcomes in COVID-19

QJM ◽  
2021 ◽  
Author(s):  
N W Chew ◽  
J N Ngiam ◽  
S M Tham ◽  
Z Y Lim ◽  
T Y W Li ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
End Point ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Design And Methods ◽  
Group 1

Summary Background/Introduction There are little data on outcomes of COVID-19 patients with the presence of fever compared to the presence of symptoms. Aim We examined the associations between symptomology, presence of fever and outcomes of a COVID-19 cohort. Design and Methods Between 23 January and 30 April 2020, 554 COVID-19 patients were admitted to a tertiary hospital in Singapore. They were allocated into four groups based on symptomology and fever—Group 1: asymptomatic and afebrile, Group 2: symptomatic but afebrile, Group 3: febrile but asymptomatic and Group 4: symptomatic and febrile. The primary outcomes were intensive care unit (ICU) admissions and mortality. The composite end-point included ICU admissions, mortality or any COVID-19 related end-organ involvement. Results There were differences in ferritin (P=0.003), C-reactive protein (CRP) levels (P<0.001) and lymphopenia (P=0.033) across all groups, with the most favourable biochemical profile in Group 1, and the least in Group 4. Symptomatic groups (Groups 2 and 4) had higher ICU admissions (1.9% and 6.0%, respectively, P=0.003) than asymptomatic groups (Groups 1 and 3). Composite end-point was highest in Group 4 (24.0%), followed by Group 3 (8.6%), Group 2 (4.8%) and Group 1 (2.4%) (P<0.001). The presence of fever (OR 4.096, 95% CI 1.737–9.656, P=0.001) was associated with the composite end-point after adjusting for age, pulse rate, comorbidities, lymphocyte, ferritin and CRP. Presence of symptoms was not associated with the composite end-point. Discussion/Conclusion In this COVID-19 cohort, presence of fever was a predictor of adverse outcomes. This has implications on the management of febrile but asymptomatic COVID-19 patients.

scholarly journals Diabetes predicts severity of COVID‐19 infection in a retrospective cohort: A mediatory role of the inflammatory biomarker C‐reactive protein

2021 ◽  
Vol 93 (5) ◽  
pp. 3023-3032
Author(s):  
Huilin Koh ◽  
Angela Mei Chung Moh ◽  
Ester Yeoh ◽  
Yi Lin ◽  
Serena Kiat Mun Low ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
C Reactive Protein ◽  
Inflammatory Biomarker ◽  
Reactive Protein

The role of coinfection with influenza viruses in the pathogenesis of severe infection in patients with COVID-19

2021 ◽  
Vol 21 (3) ◽  
pp. 159-164
Author(s):  
Tamara N. Shvedova ◽  
Olga S. Kopteva ◽  
Polina A. Kudar ◽  
Anna A. Lerner ◽  
Yuliya A. Desheva
Keyword(s):  
Influenza A ◽  
Fold Increase ◽  
Igg Antibodies ◽  
C Reactive Protein ◽  
S Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Coronavirus Infection

BACKGROUND: Despite the continuing global spread of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus, the mechanisms of the pathogenesis of severe infections remain poorly understood. The role of comorbidity with other seasonal viral infections, including influenza, in the pathogenesis of the severe course of COVID-19 remains unclear. MATERIALS AND METHODS: The present study used sera left over from ongoing laboratory studies of patients with varying degrees of severity of COVID-19. The study was approved by the Local Ethics Committee of the Federal State Budgetary Scientific Institution IEM (protocol 3/20 from 06/05/2020). We studied 28 paired samples obtained upon admission of patients to the hospital and after 57 days of hospital stay. Paired sera of patients with COVID-19 were tested for antibodies to influenza A and B viruses. The presence of IgG antibodies specific to the SARS-CoV-2 spike (S) protein was studied using an enzyme-linked immunosorbent assay (ELISA). The serum concentration of C-reactive protein and the neutrophil-lymphocyte ratio on the day of hospitalization were also assessed. RESULTS: At least a 4-fold increase in serum IgG antibodies to SARS-CoV-2 S protein was found both in patients with PCR-confirmed SARS-CoV-2 infection and without PCR confirmation. It was shown that out of 18 patients with moderate and severe forms of COVID-19 infection, six of them showed at least a 4-fold increase in antibodies to influenza A/H1N1, in one to influenza A/H3N2 and in two cases to the influenza B. Laboratory data in these two groups were characterized by significant increases in serum C-reactive protein and neutrophil-lymphocyte ratio concentrations compared with the moderate COVID-19 group. CONCLUSIONS: Serological diagnostics can additionally detect cases of coronavirus infection when the virus was not detected by PCR. In moderate and severe cases of COVID-19, coinfections with influenza A and B viruses have been identified. The results obtained confirm the need for anti-influenza immunization during the SARS-CoV-2 pandemic. Influenza virus screening can significantly improve patient management because recommended antiviral drugs (neuraminidase inhibitors) are available.

C-reactive protein at ICU admission as a marker of early graft dysfunction after liver transplant. A prospective, single-center cohort study

2020 ◽  
Vol 44 (5) ◽  
pp. 275-282
Author(s):  
G. Seller-Pérez ◽  
J.E. Barrueco-Francioni ◽  
R. Lozano-Sáez ◽  
M.M. Arrebola-Ramírez ◽  
M.J. Diez-de-los-Ríos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Transplant ◽  
Single Center ◽  
Graft Dysfunction ◽  
C Reactive Protein ◽  
Icu Admission ◽  
Reactive Protein ◽  
Early Graft ◽  
Early Graft Dysfunction

scholarly journals Low Albumin Levels Are Associated with Poorer Outcomes in a Case Series of COVID-19 Patients in Spain: A Retrospective Cohort Study

2020 ◽  
Vol 8 (8) ◽  
pp. 1106 ◽  
Author(s):  
Roberto de la Rica ◽  
Marcio Borges ◽  
Maria Aranda ◽  
Alberto del Castillo ◽  
Antonia Socias ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Case Series ◽  
Hospital Length ◽  
Limited Information ◽  
C Reactive Protein ◽  
Icu Patients ◽  
Reactive Protein ◽  
Epidemiological Features ◽  
Initial Symptoms

There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for coronavirus disease 2019 (COVID-19). In this observational study, we aimed to describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior to hospitalization. Forty-eight patients (27 non-ICU and 21 ICU) with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were analyzed (mean age, 66 years, [range, 33–88 years]; 67% males). There were no differences in age or sex among groups. Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs. 61%, p = 0.022). ICU-patients had lymphopenia as well as hypoalbuminemia. Lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < 0.001). Lower albumin levels were associated with poor prognosis measured as longer hospital length (r = −0.472, p < 0.001) and mortality (r = −0.424, p = 0.003). As of 28 April 2020, 10 patients (8 ICU and 2 non-ICU) have died (21% mortality), and while 100% of the non-ICU patients have been discharged, 33% of the ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward). Critically ill patients with COVID-19 present lymphopenia, hypoalbuminemia and high levels of inflammation.

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