scholarly journals Utility of C-Reactive Protein Levels for Early Prediction of Dengue Severity in Adults

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Chien-Chih Chen ◽  
Ing-Kit Lee ◽  
Jien-Wei Liu ◽  
Shi-Yu Huang ◽  
Lin Wang
Keyword(s):  
Characteristic Curve ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
World Health ◽  
Severe Dengue ◽  
Early Prediction ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Health Organization

Dengue has broad clinical presentation with unpredictable clinical evolution and outcome. We aimed to evaluate the utility of C-reactive protein (CRP) levels for distinguishing between mild and severe cases in the early phase of the dengue illness. We retrospectively evaluated adults with dengue from 2006 to 2014, according to 1997 and 2009 World Health Organization (WHO) criteria for severity. Of 191 included patients, 32.9% had nonshock dengue hemorrhagic fever (DHF), 3.1% dengue shock syndrome (DSS), and 7.9% severe dengue. The risk of DHF/DSS and severe dengue is significantly related to the increasing levels of CRP. Of 191 patients, 97 had CRP levels measured during the febrile (days 1–3); 85 during the critical (days 4–6); and 9 during the convalescent (days 7–10) illness phases. During the febrile phase, there was significant higher CRP level for DSS versus DF/nonshock DHF and severe dengue versus nonsevere dengue, with CRP cutoff level 30.1 mg/L (area under the receiver operating characteristic curve (AUC), 0.938; 100% sensitivity, 76.3% specificity) and 24.2 mg/L (AUC, 0.717; 70% sensitivity, 71.3% specificity), respectively. Our study highlights the utility of the CRP levels in early prediction of DSS and severe dengue in adult patients.

Role of C- reactive proteins and liver function tests in assessing the severity of dengue fever

2020 ◽  
pp. 1-17
Author(s):  
Akash Khetpal ◽  
Ansab Godil ◽  
Muhammad Tanveer Alam ◽  
Inam ul Haq Muhammad Makhdoom ◽  
Arsalan Majeed Adam ◽  
...  
Keyword(s):  
Liver Function ◽  
Dengue Fever ◽  
Dengue Shock Syndrome ◽  
Liver Function Tests ◽  
Dengue Haemorrhagic Fever ◽  
Severe Dengue ◽  
Haemorrhagic Fever ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Function Tests

Abstract Objective: To determine whether C-reactive protein and liver function tests can serve as severity markers for dengue fever. Methods: The cross-sectional study was conducted in 2015-16 in Karachi and comprised patients with dengue fever visiting a tertiary care hospital. World Health Organisation classifications 1997 and 2009 were used to categorise patients according to clinical signs and symptoms. Receiver Operating Characteristics curve was used to determine discriminative ability and optimum cut-off value of biochemical markers. Comparisons were done through one-way analysis of variance using SPSS 17. Results: Of the 218 patients, 133(61%) were males and 85(39%) were females. The overall mean age was 35.07+15.96 years. Levels of C-reactive protein and total bilirubin were significantly higher for dengue haemorrhagic fever compared to dengue fever; dengue shock syndrome compared to dengue fever; dengue shock syndrome compared to dengue haemorrhagic fever; and dengue shock syndrome compared to dengue fever / dengue haemorrhagic fever (p<0.05 each). Levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were significantly higher for dengue shock syndrome compared to dengue fever; dengue shock syndrome compared to dengue haemorrhagic fever; and dengue shock syndrome compared to dengue fever / dengue haemorrhagic fever (p<0.05 each). Levels of C-reactive protein, total bilirubin, alanine aminotransferase and alkaline phosphatise in patients with severe dengue were significantly higher compared to non-severe dengue. Conclusion: C-reactive protein and liver function tests were found to be effective biochemical markers in assessing dengue fever severity.

scholarly journals A brief-review of the risk factors for covid-19 severity

2020 ◽  
Vol 54 ◽  
pp. 60 ◽  
Author(s):  
J. E. Rod ◽  
Oscar Oviedo-Trespalacios ◽  
Javier Cortes-Ramirez
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
World Health ◽  
Future Research ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
History Of ◽  
Health Organization ◽  
High Consistency ◽  
D Dimer

The World Health Organization has emphasized that one of the most important questions to address regarding the covid-19 pandemic is to understand risk factors for disease severity. We conducted a brief review that synthesizes the available evidence and provides a judgment on the consistency of the association between risk factors and a composite end-point of severe-fatal covid-19. Additionally, we also conducted a comparability analysis of risk factors across 17 studies. We found evidence supporting a total of 60 predictors for disease severity, of which seven were deemed of high consistency, 40 of medium and 13 of low. Among the factors with high consistency of association, we found age, C-reactive protein, D-dimer, albumin, body temperature, SOFA score and diabetes. The results suggest that diabetes might be the most consistent comorbidity predicting disease severity and that future research should carefully consider the comparability of reporting cases, factors, and outcomes along the different stages of the natural history of covid-19.

scholarly journals SARS-CoV-2 INFECTED PATIENTS: FROM A HEMATOLOGIST PERSPECTIVE

2020 ◽  
Vol 12 (1) ◽  
pp. e2020078
Author(s):  
Firas Kreidieh ◽  
Sally Temraz
Keyword(s):  
Distress Syndrome ◽  
Severity Of Illness ◽  
World Health ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Management Plans ◽  
Careful Revision ◽  
Pharmacologic Thromboprophylaxis ◽  
American Society ◽  
Health Organization

Introduction: According to the World Health Organization (WHO), COVID-19 has become a Public Health Emergency of International Concern (PHEIC). Understanding the hematologic findings of patients with SARS-CoV-2 infection is essential to promote their care and improve outcomes.   Objective:In this review, we aim at summarizing changes in the hematopoietic system and hemostasis that occur in SARS-CoV-2 infected patients.   Findings: COVID-19 infection is often associated with laboratory hematologic findings that can have important clinical implications. Careful revision of baseline hematologic findings at diagnosis can predict severity of illness and help clinicians tailor their management and approach to patients whose condition can be guarded or critical.This can be of therapeutic and prognostic value in severely ill patients and can reduce the mortality rate from COVID-19.  Such markers include D-dimer, procalcitonin, C-reactive protein, viral load, cytokine storm, and lymphopenia.Studies have also shown an association between these markers and severe COVID-19 infection requiring admission to the intensive care unit or complicated by acute respiratory distress syndrome (ARDS). According to the American Society of Hematology (ASH), all hospitalized patients with COVID-19 should receive pharmacologic thromboprophylaxis with LMWH.   Conclusion:Until more data arises, the summary we provide can be used by hematologists to better understand hemostasis in COVID-19 infected patients.We are in need for more studies to define appropriate management plans in the setting of hematologic findings.  

scholarly journals SIADH (Syndrome of Inappropriate ADH Secretion): Perplexing Look of Dengue Fever

2021 ◽  
pp. 1-4
Author(s):  
Richmond Ronald Gomes ◽  
Keyword(s):  
Dengue Virus ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Animal Studies ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
World Health ◽  
Fluid Extravasation ◽  
Health Organization ◽  
Expanded Dengue Syndrome

Dengue is a mosquito-borne disease (female mosquitoes of the Aedes genus, principally Aedes aegypti) caused by any one of four closely related dengue viruses. It is endemic in tropical and subtropical continent. World health organization (WHO) currently estimates there may be 50 -100 million dengue infections worldwide every year with over 2.5 billion people at risk of dengue. Symptomatic dengue virus infection may manifests as undifferentiated fever, classical dengue fever (with or without unusual hemorrhages), and dengue hemorrhagic fever (with or without shock). Isolated organopathy or expanded dengue syndrome (EDS) was coined by WHO in the year 2012 to describe cases, which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. The atypical manifestations noted in expanded dengue are multisystemic and multifaceted with organ involvement, such as liver, brain, heart, kidney, central/peripheral nervous system, gastrointestinal tract, lympho reticular system. Dengue virus has long been considered as a non-neurotropic virus, as animal studies have shown that virus does not cross blood brain barrier. Hyponatremia may be found in association with dengue fever and is thought to be caused by peripheral fluid extravasation and resulting intravascular hypovolaemia. But hyponatremia due to syndrome of inappropriate secretion of anti-diuretic hormone (SIADH) in Dengue fever is rare. We report a 40 years old male who was diagnosed as Dengue fever (Dengue Ns1Ag positive) with thrombocytopenia and hyponatremia. He was admitted and further investigations revealed SIADH. He responded well to cautious sodium replacement and addition of tolvaptan. He recovered completely and was discharged after one week. Thus, all clinicians should keep in mind the possibility of SIADH as a part of expanded dengue syndrome.

scholarly journals Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian national referral hospital

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110599
Author(s):  
Lugyanti Sukrisman ◽  
Robert Sinto
Keyword(s):  
Inflammatory Markers ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Ferritin Concentration ◽  
Reactive Protein ◽  
Health Organization ◽  
National Referral Hospital ◽  
D Dimer

Background Coagulopathy and inflammation are associated with coronavirus disease 2019 (COVID-19) severity. This study assessed D-dimer concentration and its correlation with inflammatory markers and COVID-19 severity. Methods This was a retrospective cross-sectional study involving 194 COVID-19 cases, with the severity of infection graded in accordance with the World Health Organization (WHO) guidelines. We measured D-dimer, C-reactive protein (CRP), and ferritin on admission and determined the cutoff values for D-dimer and CRP and evaluated the correlation between D-dimer and CRP and ferritin. Results Median D-dimer, CRP, and ferritin concentrations were 2240 µg/L, 73.2 mg/L, and 1173.8 µg/mL, respectively. The highest median D-dimer value was seen in mild and moderate acute respiratory distress syndrome (ARDS). The highest ferritin concentration was seen in severe ARDS. There was a significant correlation between D-dimer value and CRP (r = 0.327), but no significant correlation between D-dimer and ferritin (r = 0.101). The area under the receiver operating characteristic curve (AUC) for the combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L as a marker of COVID-19 severity was 0.722 (95% confidence interval (CI): 0.615–0.781). Conclusion The combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L can be used as marker of COVID-19 severity, with moderate accuracy.

scholarly journals Perbedaan Kadar C-Reactive Protein pada Demam Akut karena Infeksi Dengue dan Demam Tifoid

2017 ◽  
Vol 3 (3) ◽  
pp. 138
Author(s):  
Adeputri Tanesha Idhayu ◽  
Lie Khie Chen ◽  
Suhendro Suhendro ◽  
Murdani Abdullah
Keyword(s):  
Typhoid Fever ◽  
Medical Center ◽  
Demographic Data ◽  
Dengue Infection ◽  
Hemorrhagic Fever ◽  
Cross Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Protein Levels ◽  
Reactive Protein

Pendahuluan. Infeksi dengue dan demam tifoid merupakan penyakit endemik di Indonesia. Namun pada awal awitan demam terdapat kesulitan dalam membedakan keduanya. Oleh karena itu dibutuhkan modalitas pemeriksaan penunjang yang sederhana untuk membantu diagnosis infeksi dengue dan demam tifoid. C-Reactive Protein (CRP) merupakan alat bantu diagnostik yang terjangkau, cepat dan murah untuk diagnosis penyebab demam akut. Penelitian ini bertujuan mengetahui perbedaan kadar CRP pada demam akut karena infeksi dengue dengan demam tifoid.Metode. Penelitian ini merupakan studi potong lintang pada pasien demam akut dengan diagnosis demam dengue/ demam berdarah dengue atau demam tifoid yang dirawat di IGD atau ruang rawat RSCM, RS Pluit dan RS Metropolitan Medical Center Jakarta dalam kurun waktu Januari 2010 sampai dengan Desember 2013. Kadar CRP yg diteliti adalah CRP yang diperiksa 2-5 hari setelah awitan demam. Data penyerta yang dikumpulkan adalah data demografis, data klinis, pemberian antibiotik selama perawatan, leukosit, trombosit, neutrofil, LED dan lama perawatan.Hasil. Sebanyak 188 subjek diikutsertakan pada penelitian ini, terdiri dari 102 pasien dengue dan 86 pasien demam tifoid. Median (RIK) CRP pada infeksi dengue 11,65 (16) mg/L dan pada demam tifoid 53 (75) mg/L. Terdapat perbedaan median CRP yang bermakna antara infeksi dengue dan demam tifoid (p <0,001). Pada titik potong persentil 99%, didapatkan hasil kadar CRP infeksi dengue sebesar 45,91 mg/L dan kadar CRP demam tifoid pada level persentil 1% sebesar 8 mg/L.Simpulan. Terdapat perbedaan kadar CRP pada demam akut karena infeksi dengue dengan demam tifoid. Pada titik potong persentil 99%, kadar CRP >45,91 mg/L merupakan diagnostik CRP untuk demam tifoid, kadar CRP <8 mg/L merupakan diagnostik CRP untuk infeksi dengue. kadar CRP 8-45,91 mg/L merupakan area abu-abu dalam membedakan diagnosis keduanya.Kata Kunci: dengue, demam tifoid, protein C-reaktif The Difference of C-Reactive Protein Levels in Acute Fever caused by Dengue and Typhoid InfectionsIntroduction. Dengue infection and typhoid fever are endemic disease in Indonesia. But in the early days of onset sometimes it is difficult to distinguish them. A simple modality test is needed to support the diagnosis. C-Reactive Protein (CRP) is an affordable, fast and relatively less expensive diagnostic tool to diagnose the causes of acute fever. This study was aimed to determine the differences of CRP level in the acute febrile caused by dengue infection or typhoid fever. Methods. A cross sectional study has been conducted among acute febrile patients with diagnosis of dengue fever/ dengue hemorrhagic fever or typhoid fever who admitted to the emergency room or hospitalized in Cipto Mangunkusumo Hospital, Pluit Hospital, and Metropolitan Medical Center Hospital Jakarta between January 2010 and December 2013. Data obtained from medical records. CRP used in this study was examined at 2-5 days after onset of fever. The other collected data were demographic data, clinical data, use of antibiotics, leukocytes, platelets, neutrophils, ESR, and length of stay in hospital. Results. 188 subjects met the inclusion criteria; 102 patients with dengue and 86 patients with typhoid fever. Median CRP levels in dengue infection was 11.65 (16) mg/L and in typhoid fever was 53 (75) mg/L. There were significant differences in median CRP levels between dengue infection and typhoid fever (p < 0.001). At the 99% percentile cut-off point, CRP levels for dengue infection was 45.91 mg/L and CRP levels for typhoid fever at 1% percentile was 8 mg / L. Conclusions. There was significantly different levels of CRP in acute fever due to dengue infection and typhoid fever. At the 99% percentile cut-off point, CRP level >45.91 mg/L was diagnostic for typhoid fever, CRP level <8 mg/L was diagnostic for dengue infection. CRP level between 8 to 45.91 mg/L was a gray area for determining diagnosis of dengue infection and typhoid fever. Keywords: C-reactive protein, dengue, typhoid fever  

scholarly journals Blood routine test in mild and common 2019 coronavirus (COVID-19) patients

2020 ◽  
Vol 40 (8) ◽  
Author(s):  
Dodji Kossi Djakpo ◽  
Zhiquan Wang ◽  
Rong Zhang ◽  
Xin Chen ◽  
Peng Chen ◽  
...  
Keyword(s):  
Social Sciences ◽  
Complete Blood Count ◽  
World Health ◽  
C Reactive Protein ◽  
Routine Test ◽  
Reactive Protein ◽  
The Social ◽  
Blood Routine Test ◽  
Health Organization ◽  
The City

Abstract The new 2019 coronavirus disease (COVID-19), according to the World Health Organization (WHO), has been characterized as a pandemic. As more is being discovered about this virus, we aim to report findings of the complete blood count (CBC) of COVID-19 patients. This would serve in providing physicians with important knowledge on the changes that can be expected from the CBC of mild and normal COVID-19 patients. A total of 208 mild and common patients were admitted at the Dongnan Hospital located in the city of Xiaogan, Hubei, China. The CBCs of these patients, following a confirmed diagnosis of COVID-19, were retrospectively analyzed and a significant P&lt;0.05 was found after a full statistical analysis was conducted using the Statistical Package for the Social Sciences (IBM SPSS). CBC analysis revealed changes in the levels of red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and C-reactive protein (CRP). Clinicians should expect similar findings when dealing with the new COVID-19.

scholarly journals An evaluation of the World Health Organization’s 1997 and 2009 dengue classifications in hospitalized dengue patients in Malaysia

2014 ◽  
Vol 8 (07) ◽  
pp. 869-875 ◽  
Author(s):  
Zuraihan Zakaria ◽  
Nur A Zainordin ◽  
Benedict LH Sim ◽  
Masliza Zaid ◽  
Umi S Haridan ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Dengue Shock Syndrome ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
Peninsular Malaysia ◽  
Warning Signs ◽  
World Health ◽  
Severe Dengue ◽  
The World ◽  
Dengue With Warning Signs

Introduction: The latest revised version of the World Health Organization’s dengue classification was released in 2009. A handful of studies have taken initiatives to evaluate the old and revised guidelines to determine early signs and symptoms of severe dengue. This retrospective study aimed to compare the classification of dengue using both the 1997 and 2009 guidelines in a selected cohort of dengue patients from Peninsular Malaysia between 2008 and 2012. Methodology: Adult dengue patients were recruited from tertiary hospitals in two different states, Selangor and Kelantan, in Peninsular Malaysia. Their clinical manifestations were assessed. Results: A total of 281 confirmed dengue patients were enrolled; the mean duration of illness at admission was five days. Of these, 88.6%, 10.7%, and 0.7% were classified according to the 1997 guidelines as having dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS), respectively. When the WHO 2009 guidelines were applied, 17.1%, 78.3%, and 4.6% were classified as dengue without warning signs, dengue with warning signs, and severe dengue, respectively. Conclusions: Our data suggests that the revised WHO 2009 guidelines stratify a much larger proportion of patients into a category that requires a higher level of medical and nursing care.

scholarly journals Correlation Analysis between Ratio of C-Reactive Protein/Albumin and Severity of Dengue Hemorrhagic Fever in Children

2021 ◽  
Vol 9 (3) ◽  
pp. 136
Author(s):  
Agustin Iskandar ◽  
Yuyun Norwahyuni ◽  
Aryati Aryati ◽  
Andrea Aprilia
Keyword(s):  
Dengue Hemorrhagic Fever ◽  
Pearson Correlation ◽  
Dengue Infection ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Bromocresol Green ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Albumin Ratio ◽  
Reactive Protein

Dengue Hemorrhagic Fever (DHF) is a dengue infection which can cause shock and leads to mortality. Hypoalbuminemia is a marker of plasma leakage in DHF and correlated with severity of in fl ammatory response triggered by infection, including DHF. C-Reactive Protein (CRP) is a proin fl ammatory marker that also increases in DHF. This study aims to determine a correlation of CRP/albumin ratio with severity of DHF. Cross sectional study on pediatric patients diagnosed as DHF at Saiful Anwar Malang Hospital was done in July-December 2016. CRP levels were examined using immunoturbidimetry method, while albumin was examined by using Bromocresol Green (BCG) method. Correlation of CRP/albumin ratio with DHF severity was analyzed by using Pearson correlation test.The result showed that there were signi fi cant diff erences in CRP levels and CRP/albumin ratios in the Dengue Shock Syndrome (DSS) and non-DSS group (p = 0.002, p = 0.001, α<0.05). There was no signi fi cant diff erence in albumin level in the same group (p = 0.207, α <0.05). Positive correlation found in CRP and CRP/albumin ratio (r = 0.46, r = 0.49, α <0.01). On the contrary the negative correlation was found in albumin (r = -0.21, α <0.01). This is presumably because albumin is an acute phase protein which will decrease along with the severity of infection. In contrast, CRP will increase during the critical phase of infection. It can be concluded that the CRP/albumin ratio was positively correlated with DHF severity, as well as CRP levels, but not positively correlatedwith albumin. 

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