scholarly journals The diagnostic process of covıd-19 in the emergency department: laboratory and ımaging methods

2020 ◽  
Vol 66 (suppl 2) ◽  
pp. 58-64
Author(s):  
Fatih Guneysu ◽  
Yusuf Yurumez ◽  
Ertugrul Guclu ◽  
Mehmet Koroglu ◽  
Alper Karacan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Inflammatory Markers ◽  
Reference Range ◽  
Early Stage ◽  
Diagnostic Process ◽  
Rt Pcr ◽  
Significant Difference ◽  
Laboratory Results ◽  
Novel Coronavirus

SUMMARY OBJECTIVES The 2019 Novel coronavirus disease puts a serious burden on the health system. Therefore, the detection of particularly serious patients at an early stage is extremely important in terms of controlling the outbreak and improving the prognosis. We investigated the role of inflammatory markers studied in patients suspected of COVID-19 at an emergency department in predicting PCR and CT results. METHODS This retrospective study was carried out with 133 patients who were admitted between 13 March and 1st April 2020 with suspicion of COVID-19. The patients were divided into four groups according to CT and RT-PCR results and evaluated. RESULTS Considering all patients, no specific findings were found in the hematological and biochemical values of patients in the laboratory analyses. Although all of the results remained within the reference range, there was a significant difference in white blood cell, neutrophil, platelet, and lymphocyte values when the groups were compared [p = 0.000; p = 0.004; p = 0.022; p = 0.023]. CONCLUSION Laboratory is not specific enough in the pre-diagnosis. In addition, this result does not alter with PCR or CT positivity. However, minimal changes observed in laboratory results may be partially guiding in patients in whom both PCR and CT are positive.

Biochemical parameters and relation to disease severity in COVID-19 patients

2021 ◽  
pp. 93-96
Keyword(s):  
Biochemical Parameters ◽  
Troponin I ◽  
Total Bilirubin ◽  
Early Stage ◽  
Length Of Hospital Stay ◽  
Rt Pcr ◽  
Sodium Potassium ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Severity Of The Disease

Aim: In this study, we aimed to evaluated whether there is an association between the biochemistry parameters obtained from the first blood test after hospitalization of COVID 19 patients and the prognosis and severity of the disease. Thus, we planned to identify patients with a severe course at an early stage and to help physicians determine the appropriate treatment. Material and Method: The study included 106 COVID 19 patients confirmed by RT-PCR. Patients were categorized into two groups: those admitted to the hospital ward and discharged with recovery (mild cases) and those admitted directly or eventually to the intensive care unit (severe cases). Biochemical parameters of the groups were compared with the Mann Whitney-U Test, as none of the compared parameters fit the normal distribution. Results: There was no statistically significant difference between the male-female numbers and ages of the two groups. Statistically significant differences were observed in the length of hospital stay, procalcitonin, hs-troponin I, ferritin, glucose, urea, creatinine, calcium, direct bilirubin, AST, LDH and CRP values (p<0,05). However, no significant difference was found in sodium, potassium, chloride, total bilirubin and ALT tests. Conclusion: The results show that some biochemistry parameters may be used to predict the prognosis of the disease. In particular, procalcitonin, hs troponin I, LDH and CRP values seem to be moderate biomarkers of the prognosis of the disease.

Investigating ADAMTS7 and ADAMTS12 levels in prediabetic and Type 2 diabetic patients

2021 ◽  
Author(s):  
Mercan Taştemur ◽  
Selvihan Beysel ◽  
Sema Hepşen ◽  
Sanem Öztekin ◽  
Erman Çakal ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Diabetic Patients ◽  
Control Groups ◽  
Type 2 Diabetic Patients ◽  
Human Enzyme ◽  
Significant Difference ◽  
And Control ◽  
Type 2 Diabetic

Background: This study aims to investigate the role of ADAMTS7 and ADAMTS12 on atherosclerosis and inflammation in prediabetic and diabetic patients. Patients & methods: Serum ADAMTS7 and ADAMTS12 levels were compared with the atherosclerotic and inflammatory markers in diabetic (n = 65, female 30.9%, mean age = 53 years), prediabetic (n = 55, female 36.6%, mean age = 49 years) and control groups (n = 55, females 32.5%, mean age = 49 years). Serum ADAMTS levels were determined by a human enzyme-liked immunoassay. Results: In terms of ADAMTS7, there was no significant difference between diabetic, prediabetic and control groups (50.93, 44.34, 59.07, respectively; p > 0.05). ADAMTS12 is lower in diabetics (p < 0.05), whereas it is similar in prediabetics and controls (14.53, 20.76, 25.05, respectively; p > 0.05). ADAMTS7 and ADAMTS12 levels did not differ in diabetic nephropathy, retinopathy and neuropathy (p > 0.05). Conclusion: While ADAMTS12 was significantly lower in diabetics and prediabetics, ADAMTS7 and ADAMTS12 were not related to diabetic complications (nephropathy, retinopathy and neuropathy).

scholarly journals Role of Plasma Presepsin, Procalcitonin and C-reactive Protein Levels in Determining the Severity and Mortality of Community-Acquired Pneumonia in the Emergency Department

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Pneumonia Severity ◽  
Protein Levels ◽  
Reactive Protein ◽  
Imaging Results ◽  
Severity Scores ◽  
Significant Difference

Objective: In this study, we aimed to explore the role of the plasma presepsin level in patients with community-acquired pneumonia during admission to the emergency department in assessing the diagnosis, severity, and prognosis of the disease. In addition, we wanted to investigate the relationship of presepsinin with procalcitonin, C-reactive protein and pneumonia severity scores. Methods: One hundred twenty-three patients over the age of 18 who presented with a diagnosis of pneumonia to the emergency department were included in the study. The vital signs, symptoms, examination findings, background information, laboratory results, and radiological imaging results of the patients were recorded. The 30-day mortality rates of the patients were determined. Results: A statistically significant difference was found between the presepsin levels of the patients diagnosed with pneumonia and those of healthy subjects (p < 0.05). The plasma presepsin levels of the patients who died (8.63 ± 6.46) were significantly higher than those of the patients who lived (5.82 ± 5.97) (p < 0.05). The plasma procalcitonin and C-reactive protein levels of the dead patients were significantly higher than those living (p < 0.05). A presepsin cut-off value of 3.3 ng/mL for 30-day mortality was established (AUROC, 0.65; specificity, 45%; sensitivity, 82%). Procalcitonin is the most successful biomarker in the determination of mortality (AUROC, 0.70). A significant correlation was available between presepsin and lactate, C-reactive protein and procalcitonin (p < 0.05). There was a significant correlation between the Pneumonia Severity Index values and presepsin levels (p < 0.001, r = 0.311). Conclusion: The plasma presepsin level can be utilized for diagnosing community-acquired pneumonia. Plasma presepsin, procalcitonin and C-reactive protein levels can be used to predict the severity and mortality of community-acquired pneumonia.

scholarly journals Abdominal symptoms as an initial manifestation of COVID-19 infection: Report of two cases

2020 ◽  
Author(s):  
PATRÍCIA YOKOO ◽  
Eduardo Kaiser Ururahy Nunes Fonseca ◽  
Marcelo Oranges Filho ◽  
Rodrigo Caruso Chate ◽  
Gilberto Szarf ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Symptoms ◽  
Early Stage ◽  
The Novel ◽  
Initial Finding ◽  
Initial Manifestation ◽  
Abdominal Symptoms ◽  
Novel Coronavirus ◽  
Lung Base

Abstract The novel coronavirus (COVID-19) pandemic started in December 2019 in Wuhan (Hubei, China) and spread rapidly; therefore, it is essential to detect the disease at an early stage and immediately isolate the infected patients [1]. The most common symptoms of COVID-19 infection include fever, asthenia, cough and dyspnea [2]. However, some patients are asymptomatic from the respiratory symptoms, and may only present abdominal manifestations as an initial finding, what creates a diagnostic challenge.We describe two cases with diagnostic confirmations of COVID-19 who showed up at the Emergency Department with abdominal symptoms before presenting respiratory manifestations, and who had their initial suspicion based on the findings of the thoracoabdominal transition, demonstrating the importance of an adequate assessment of the lung base images.

scholarly journals An atypical case: RT-PCR-negative, sero-positive covid-19 patient

Pneumologia ◽  
2020 ◽  
Vol 69 (2) ◽  
pp. 107-114
Author(s):  
William Suriady ◽  
Andika Chandra Putra ◽  
Wiwien Heru Wiyono ◽  
Mohammad Fahmi Alatas ◽  
Bettia Bermawi ◽  
...  
Keyword(s):  
False Negative ◽  
Severe Pneumonia ◽  
World Health ◽  
Diagnostic Process ◽  
The Novel ◽  
Rt Pcr ◽  
Atypical Case ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Health Organization

Abstract The novel coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a public health emergency of international concern. The first confirmed COVID-19 case in Indonesia was announced on 2 March 2020, and later on, 11,192 confirmed cases were reported as of 3 May. The World Health Organization has stated that performing a real-time reverse transcription–polymerase chain reaction (RT-PCR) specific for SARS-CoV-2 on specimens from the upper and the lower respiratory tracts, especially nasopharyngeal and oropharyngeal swabs, is the standard diagnostic procedure for COVID-19. In Indonesia, we also use other diagnostic tests, such as rapid antibody tests specific for SARS-CoV-2. Herein, we report an atypical case of COVID-19 and describe the diagnostic process, the clinical course, with progression to severe pneumonia on Week 3 of illness and the case management. We also try to highlight the possibility of false-negative RT-PCR tests.

scholarly journals Development and Validation of a Prognostic Autophagy-Related Gene Pair Index Related to Tumor-Infiltrating Lymphocytes in Early-Stage Lung Adenocarcinoma

2021 ◽  
Vol 9 ◽  
Author(s):  
Zi-Hao Wang ◽  
Yu Li ◽  
Pei Zhang ◽  
Xuan Xiang ◽  
Xiao-Shan Wei ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Gene Pair ◽  
Early Stage ◽  
Tumor Infiltrating Lymphocytes ◽  
Related Gene ◽  
Tumor Immune Escape ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Infiltrating Lymphocytes

The role of autophagy in lung cancer is context-dependent and complex. Recent studies have reported the important role of autophagy in tumor immune escape. However, the association between autophagy and tumor-infiltrating lymphocytes (TILs) in early-stage lung adenocarcinoma (LUAD) remains unclear. In this study, we aimed to develop and validate the autophagy-related gene pair index (ATGPI) and autophagy clinical prognostic index (ACPI) in multiple LUAD cohorts, including The Cancer Genome Atlas (TCGA) cohort, Gene Expression Omnibus cohorts, and one cohort from Union Hospital, Wuhan (UH cohort), using a Cox proportional hazards regression model with the least absolute shrinkage and selection operator. Multivariate Cox regression analysis demonstrated that there was a significant difference in overall survival (OS) between patients with high and low ATGPI in the testing [hazard ratio (HR) = 1.97; P &lt; 0.001] and TCGA validation (HR = 2.25; P &lt; 0.001) cohorts. Time-dependent receiver operating characteristic curve analysis was also performed. We found that high ATGPI could accurately identify patients with early-stage LUAD with shorter OS, with the areas under the curve of 0.703 and 0.676 in the testing and TCGA validation cohorts, respectively. Concordance index (C-index) was used to evaluate the efficiency of ATGPI and ACPI. The C-index of ACPI was higher than that of ATGPI in the testing (0.71 vs. 0.66; P &lt; 0.001), TCGA validation (0.69 vs. 0.65; P = 0.028), and UH (0.80 vs. 0.70; P = 0.015) cohorts. TIL analysis demonstrated that the proportions of tumor-infiltrating CD4+ T cells were lower in the high-ATGPI group than in the low-ATGPI group in both the TCGA validation and UH cohorts. These results indicate the potential clinical use of ATG signatures which are associated with TILs, in identifying patients with early-stage LUAD with different OS.

scholarly journals The Role of the Emergency Department in Protecting the Hospital as a Critical Infrastructure in the Corona Pandemic Strategies and Experiences of a Rural Sole Acute-Care Clinic

2020 ◽  
Author(s):  
Stefan O. Kortuem ◽  
Dirk Becker ◽  
Hans-Juergen Ott ◽  
Hans-Peter Schlaudt
Keyword(s):  
Emergency Department ◽  
Critical Infrastructure ◽  
Early Stage ◽  
Short Term ◽  
Care Clinic ◽  
Appropriate Treatment ◽  
Patient Pathways ◽  
Strategic Element ◽  
First Contact

Background. The Klinikum Hochrhein is responsible as a regional sole provider for the acute and emergency medical treatment of more than 170.000 people. Against the background of the pandemic spread of SARS-CoV-2 with expected high patient inflows and at the same time endangering one's own infrastructure due to intraclinical transmissions, the hospital management defined the maintenance of one's functionality as a priority protection objective in the pandemic. An essential strategic element was a very short-term restructuring of the Emergency Department with the objectives of reducing the number of cases within the clinic, detecting COVID-19 cases as sensitively as possible and separating the patient pathways at an early stage. Methods. The present work is a retrospective analysis of the processes and structures established in the Emergency Department between 27 March 2020 and 20 May 2020. In addition, a retrospective descriptive evaluation of the epidemiological and clinical data of the patients is carried out at the time of first contact during the period mentioned above. Results. After establishing a pre-triage with structured algorithms, all confirmed COVID-19 cases were identified before entering the clinic and assigned to an appropriate treatment pathway. Unprotected entry into hospital structures or nosocomial infections were not observed, although almost 35% of patients with confirmed infection were admitted due to other symptom complexes or injuries. 201 inpatient patients were initially isolated without COVID-19 being confirmed. The number of cases in the Emergency Department was 39% lower than the previous year's period, thus avoiding crowding. Discussion. The reduction in the number of cases was strategically intended and is primarily the result of a restrictive indication of in-clinical treatment but supported by a decline in emergency consultations that can be noticed anyway. The proportion of false positive triage results is probably dependent on epidemiological activity and was accepted for safety reasons as sufficient resources were available for isolation. Conclusion. Short-term organizational, spatial and procedural restructuring of the Emergency Department has enabled the clinic to achieve its goal of managing the pandemic. The algorithms we developed are particularly well suited to guarantee the desired level of safety in the case of a high pre-test probability.

Inflammatory markers in early-stage breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11537-e11537
Author(s):  
Hilbrahim Petekkaya ◽  
Sercan Aksoy ◽  
Gizem Gecmez ◽  
Emre Kulahcioglu ◽  
Alexis K. Okoh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Markers ◽  
Early Stage ◽  
Disease Free Survival ◽  
Serum Markers ◽  
Early Stage Breast Cancer ◽  
Chemotherapy Response ◽  
Significant Difference ◽  
Stage Ia

e11537 Background: In a few number of studies a possible relationship between inflammatory markers and the prognosis, chemotherapy response and survival in breast cancer has been reported. The aim of this study is to point out the place of serum markers as a prognostic factor in early stage breast cancer. Methods: This study was conducted in Hacettepe University Cancer Institute. Patients operated and stage IA to III C for breast cancer between December 2009 and June 2012 were included the study. Before the any adjuvant therapy inflammation markers were studied. Results: A total of 704 patients were included in the study. The median age of the patients was 50 (25-92). 42,8% of the patients were premenopausal and 48,2% postmenopausal. The median follow up period for the whole study group was 22 months (3-287). We studied the CRP, erythrocyte sedimentation rate, B2 microglobulin, LDH, albumin, and ferritin studied and values for each marker were grouped as high and normal. There was no statistically significant difference in disease free survival and overall survival for each marker who had high and normal levels. Conclusions: We did not found any inflammatory markers as a prognostic value. However our follow up time is short and we should be wait for more mature data.

Evaluation of ADAMTS13 Activity and Inflammatory Markers in Deep Venous Thrombosis Patients

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5246-5246
Author(s):  
Bruna de Moraes Mazetto ◽  
Fernanda A. Orsi ◽  
Aline Barnabé ◽  
Erich V de Paula ◽  
Joyce M Annichino-Bizzacchi
Keyword(s):  
Inflammatory Markers ◽  
Conflicts Of Interest ◽  
Adamts13 Activity ◽  
Vein Thrombosis ◽  
Outpatient Unit ◽  
Inflammatory Conditions ◽  
Significant Difference ◽  
Von Willebrand ◽  
D Dimer

Abstract Abstract 5246 BACKGROUND: The role of inflammation on the pathophysiology of arterial thrombosis has been extensively studied. However, the relationship between inflammation and deep vein thrombosis (DVT) is not completely understood. Conflicting reports have been published about the levels of proteins involved in the inflammatory response in the context of DVT. Changes in ADAMTS13 levels have been reported in other inflammatory conditions such as sepsis, and this protease could be involved in the interplay between hemostasis and inflammation. OBJECTIVE: To evaluate ADAMTS13 activity in DVT patients and its association with inflammatory markers (IL-6, IL-8, CRP, TNF-α), D-dimer and von Willebrand Factor (VWF) levels. METHODOLOGY: Thirty-eight DVT patients, from 6 months to five years after the diagnosis of DVT, followed at the outpatient unit of thrombotic diseases from University of Campinas and 38 healthy volunteers selected as controls were included in the study. ADAMTS13 activity was determined by the residual binding of VWF to collagen. VWF, IL-6, IL-8 and TNF-alpha levels were determined by ELISA, and D-dimer levels was determined by a turbidimetric method. RESULTS: In this study population DVT was triggered by transient risk factors, particularly the use of oral contraceptives. No patient presented renal, hepatic or malignant disease. Median ADAMTS13 activity was not statistically different between patients (median: 98.2%; range: 70–146) and controls (median: 96.1%; range: 66–117; p=0.35). IL-6 and TNF-alfa levels were also higher in patients (median: 1.0pg/mL and 2.3pg/mL) compared to controls (median: 0.64pg/mL and 1.7pg/mL, p=0,01 and p=0,009). In addition, VWF and D-dimer levels were also significantly higher in patients (all P<0.01). No significant difference could be demonstrated between IL-8 and CRP levels from patients and controls. No significant correlation between ADAMTS13 levels and other inflammatory markers could be demonstrated. VWF levels correlated significantly with IL-8 (r=-0.4635, p< 0.0001). CONCLUSIONS: This study reinforces the role of inflammation in the pathogenesis of DVT. The correlation of VWF and IL-8 supports the notion that IL-8 stimulates the secretion of VWF. The role of ADAMTS13 in the context of DVT is yet to be determined. Disclosures: No relevant conflicts of interest to declare.

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