scholarly journals Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0240784 ◽  
Author(s):  
Liam Townsend ◽  
Adam H. Dyer ◽  
Karen Jones ◽  
Jean Dunne ◽  
Aoife Mooney ◽  
...  
Keyword(s):  
Acute Phase ◽  
Acute Infection ◽  
Female Gender ◽  
Supplemental Oxygen ◽  
Common Symptom ◽  
Fatigue Score ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Significant Burden ◽  
Persistent Fatigue

Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.

scholarly journals Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection

2020 ◽  
Author(s):  
Liam Townsend ◽  
Adam H Dyer ◽  
Karen Jones ◽  
Jean Dunne ◽  
Rachel Kiersey ◽  
...  
Keyword(s):  
Acute Phase ◽  
Acute Infection ◽  
Female Gender ◽  
Supplemental Oxygen ◽  
Common Symptom ◽  
Fatigue Score ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Significant Burden ◽  
Persistent Fatigue

Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (52.3%; 45/128) at 10 weeks (median) after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.

Acute-Phase Plasma PCSK9 Levels and Recurrent Cardiovascular Events in a Chinese Acute Myocardial Infarction Cohort

Cardiology ◽  
2018 ◽  
Vol 141 (2) ◽  
pp. 88-97 ◽  
Author(s):  
Yan Gao ◽  
Yan Qiu ◽  
Jihua Wu ◽  
Wei Diao ◽  
Haibo Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Phase ◽  
Recurrent Events ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Female Gender ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular (CV) disease. Whether plasma PCSK9 measured during the acute phase predicts recurrent CV events in patients with acute myocardial infarction (AMI) remains unresolved. Methods and Results: Plasma PCSK9 levels were measured in 1,646 patients with AMI from the China PEACE-Prospective AMI Study at the acute phase. Additionally, 248 patients were resampled and measured at 1 month post-AMI. Associations of acute-phase PCSK9 tertiles with clinical characteristics and recurrent CV events within 1 year were assessed. Female gender (OR 1.94, 95% CI 1.24–3.03), premature coronary heart disease (CHD; OR 2.12, 95% CI 1.37–3.26), higher high-sensitivity C-reactive protein (OR 1.67, 95% CI 1.44–1.95), and higher triglycerides (OR 1.46, 95% CI 1.03–2.09) were associated with higher baseline PCSK9. Plasma PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events in the AMI cohort (HR 0.78, 95% CI 0.52–1.16) or any subgroup. There was also no association between percentage changes in PCSK9 over the first month and 1-year recurrent events, although there was a trend of differences between patients in the upper versus lower tertiles. Conclusion: Plasma PCSK9 levels measured during the acute phase were associated with high-sensitivity C-reactive protein, triglycerides, premature CHD, and gender in patients with AMI but did not predict recurrent CV events within 1 year. Dynamic changes in PCSK9 suggested a trend yet no significance value in predicting recurrent CV events.

scholarly journals Coagulase-NegativeStaphylococcus, Catheter-Related, Bloodstream Infections and their Association with Acute Phase Markers of Inflammation in the Intensive Care Unit: An Observational Study

2012 ◽  
Vol 23 (4) ◽  
pp. 204-208 ◽  
Author(s):  
Oleksa Rewa ◽  
John Muscedere ◽  
Steve Reynolds ◽  
Xuran Jiang ◽  
Daren K Heyland
Keyword(s):  
Intensive Care ◽  
Acute Phase ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Control Group ◽  
C Reactive Protein ◽  
Surgical Intensive Care ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
The Relationship

OBJECTIVE: To examine the relationship between the isolation of coagulase-negativeStaphylococcusin blood cultures and acute phase markers of inflammation.METHODS: The present study was a prospective observational analysis conducted at three medical/surgical intensive care units (ICUs) involving adult patients with an expected ICU stay of more than 24 h duration.RESULTS: Of the 598 patients enrolled, 573 developed suspected bloodstream infection and 434 (72.6%) had blood cultures sent 24 h after ICU admission; 142 were excluded due to positive cultures from other sites. Of the remaining 292 patients, 31 (10.7%) grew coagulase-negativeStaphylococcus, 59 (20.2%) grew known pathogenic organisms and 202 (69.2%) did not grow any organisms in their blood cultures. Twenty-five patients without suspicion of infection served as the control group. Interleukin (IL)-6, procalcitonin (PCT) and C-reactive protein (CRP) levels were highest among the known pathogen group (IL-6 271.8 U/L, PCT 4.6 U/L and CRP 164 mg/L), were similar between the coagulase-negativeStaphylococcusand negative culture groups (IL-6 67.0 U/L versus 61.4 U/L [P=1.00]; PCT 1.0 U/L versus 0.9 U/L [P=0.80]; and CRP 110 mg/L versus 103 mg/L [P=0.75]), and were lowest in the control group (IL-6 31.0 U/L, PCT 0.2 U/L and CRP 41.0 mg/L). In the coagulase-negativeStaphylococcusgroup, patients who died by day 28 had increased inflammatory bio-marker levels compared with survivors, although the differences were not statistically significant.CONCLUSIONS: Coagulase-negativeStaphylococcusisolated from blood cultures were associated with lower levels of inflammation compared with bloodstream infections due to known pathogens and were comparable with levels in patients with negative cultures.

scholarly journals Prognostic Roles of C-Reactive Protein and Erythrocyte Sedimentation Rate As Acute Phase Reactants in Mentally Challenged Subjects

2018 ◽  
Vol 13 (4) ◽  
pp. 311
Author(s):  
Adedeji David Atere ◽  
Bashiru S. A. Oseni ◽  
Ifelola Patience Adebua ◽  
Joshua Seun Fapohunda ◽  
Idomeh Festus Aigbokheo
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Acute Phase ◽  
Sedimentation Rate ◽  
Mental Illnesses ◽  
Psychiatric Disease ◽  
Economic Downturn ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Erythrocyte Sedimentation

Background: A mental disorder is a psychiatric disease that presents as mild or severe disturbances in a person’s behavior, mood, or thought. Mental illnesses are very common because of excessive stress. Recent studies show that mental illnesses are on the rise generally because of increasing stress. In Nigeria, medical records suggest an upsurge in mental health cases since the onset of the country’s economic downturn and the consequent trauma following it. The erythrocyte sedimentation rate (ESR) is an indirect marker of serum acute-phase protein concentrations, whereas C-reactive protein (CRP) is a direct protein measurement and it is inherently more well-defined. This study thus evaluated the roles of ESR and CRP as sensitive markers of inflammation and correlated their levels with severity stratification and prognosis in schizophrenic patients. 

Pain Biomarkers in Cancer: An Overview

2020 ◽  
Vol 26 ◽  
Author(s):  
Fabrizio Calapai ◽  
Epifanio Mondello ◽  
Carmen Mannucci ◽  
Emanuela Elisa Sorbara ◽  
Sebastiano Gangemi ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Bone Cancer ◽  
Common Symptom ◽  
Scientific Databases ◽  
Reactive Protein ◽  
Cancer Breast ◽  
Oncologic Patients ◽  
Few Data ◽  
Analgesic Response ◽  
Pro Inflammatory Cytokines

Background: Pain is a common symptom in oncologic patients and its management is generally guided by pain individually perceived by patients and expressed through self-reported scales. However, the utility of these tools is limited because strongly dependent on patients’ opinions. For this reason, more objective instruments are desirable. Objective: In this overview scientific articles indicating potential markers to be used for pain management in cancer were collected and discussed. Methods: research was performed on principal electronic scientific databases by using the words “pain”, “cancer”, “markers” as “biomarkers” as the main keywords, and findings describing potential biomarkers for the management of cancer pain were reported. Results: Studies on pain markers not specific for cancer typology (inflammatory, genetic, markers predicting response to analgesic drugs, neuroimaging markers) and pain markers for specific types of cancer (bone cancer, breast cancer, lung cancer, head and neck cancer, prostate cancer, cancer in pediatrics) are presented and commented. Conclusion: This overview supports the view of the involvement of inflammatory mediators in the mechanisms underlying cancer pain. Up today only a few data from research on markers can help in the management of pain, except for pro-inflammatory cytokines and other inflammatory indexes such as C-reactive protein (CRP). However, biomarkers are a promising strategy useful to predict pain intensity and to purchase objective quantification of analgesic response in guiding decisions on individual-tailored treatments in cancer patients.

scholarly journals C-Reactive Protein and All-Cause Mortality in a Large Hospital-Based Cohort

2008 ◽  
Vol 54 (2) ◽  
pp. 343-349 ◽  
Author(s):  
Claudia Marsik ◽  
Lili Kazemi-Shirazi ◽  
Thomas Schickbauer ◽  
Stefan Winkler ◽  
Christian Joukhadar ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Acute Phase ◽  
Cox Regression ◽  
Disease Risk ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Low Sensitivity

Abstract Background: C-reactive protein (CRP), an acute-phase protein, is a sensitive systemic marker of inflammation and acute-phase reactions. Testing CRP concentrations at hospital admission may provide information about disease risk and overall survival. Methods: All first-ever transmittals to the department of medical and chemical laboratory diagnostics for determination of low-sensitivity CRP (n = 274 515, 44.5% male, median age 51 years) between January 1991 and July 2003 were included [median follow-up time: 4.4 years (interquartile range, 2.3–7.4 years)]. The primary endpoint was all-cause mortality. Multivariate Cox regression adjusted for sex and age was applied for analysis. Results: Compared to individuals within the reference category (CRP <5 mg/L), hazard ratios (HR) for all-cause mortality increased from 1.4 (5–10 mg/L category) to 3.3 in the highest category (>80 mg/L, all P <0.001). CRP was associated with various causes of death. The relation of CRP to cancer death was stronger than to vascular death. Younger patients with increased CRP had relatively far worse outcome than older patients (maximal HR: ≤30 years: 6.7 vs >60 years: 1.7–3.7). Interestingly, both short- and long-term mortality were associated with increasing CRP concentrations (>80 mg/L: HR 22.8 vs 1.4). Conclusion: Measurement of low-sensitivity CRP at hospital admission allowed for the identification of patients at increased risk of unfavorable outcome. Our findings indicate that close attention should be paid to hospitalized patients with high CRP not only because of very substantial short-term risk, but also long-term excess risk, the basis for which needs to be determined.

scholarly journals Low density lipoprotein and very low density lipoprotein are selectively bound by aggregated C-reactive protein.

1982 ◽  
Vol 156 (1) ◽  
pp. 230-242 ◽  
Author(s):  
F C de Beer ◽  
A K Soutar ◽  
M L Baltz ◽  
I M Trayner ◽  
A Feinstein ◽  
...  
Keyword(s):  
Acute Phase ◽  
Solid Phase ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
C Reactive Protein ◽  
Calcium Dependent ◽  
Reactive Protein

C-reactive protein (CRP), the classical acute-phase protein, can bind phospholipids by virtue of its specific, calcium-dependent reactivity with phosphorylcholine residues. However, analysis of acute-phase serum by gel filtration and by density gradient ultracentrifugation showed that the CRP was in a free, uncomplexed form, despite the coexistent presence of the various classes of serum lipoproteins, all of which contain phospholipids. In contrast, when isolated CRP was aggregated by immobilization at a sufficient density on a solid phase and then exposed to normal human serum, it selectively bound low density lipoprotein (LDL) and traces of very low density lipoprotein. The reaction was calcium dependent and reversible by free phosphorylcholine but not by heparin. LDL isolated from normal plasma was also bound by aggregated CRP. CRP reacts in vitro with a wide variety of different ligands both of extrinsic and of autogenous origin, e.g., microbial products and damaged cell membranes, respectively. If CRP aggregated in vivo by complexing with these ligands than acquires the capacity to selectively bind LDL, the phenomenon may have significant implications for the function of CRP and for the metabolism, clearance, and deposition of LDL.

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