scholarly journals Features of hematological changes in patients with hemorrhagic fever with renal syndrome depending on the severity and period of the disease

2020 ◽  
Vol 19 (5-6) ◽  
pp. 72-80
Author(s):  
Anna V. Lyubushkina
Keyword(s):  
Initial Period ◽  
Hemorrhagic Fever ◽  
Severe Form ◽  
Urea Level ◽  
Reactive Protein ◽  
Comparison Groups ◽  
Depth Study ◽  
Group 2 ◽  
Severity Of The Disease ◽  
Hematological Changes

This article provides a comparative analysis of the features of hematological changes in patients with hemorrhagic fever with renal syndrome (HFRS) in the Samara region, depending on the severity and period of the disease. In-depth study of the metabolic profile was carried out in patients with early hospitalization (until the 5th day of illness). Enzyme studies (ALT, AST, LDH, CPK), indicators of the protein spectrum and electrolytes were performed in patients (n = 73) who were admitted in the initial period of the disease. The patients with proven cases of HFRS were divided into 3 comparison groups: group 1 (n = 22) represents cases of a mild form of the disease (urea level up to 8.3 mmol / l, creatinine up to 130 mmol / l); group 2 (n = 25) includes the cases of a moderate form of the disease (urea level up to 19 mmol / l, creatinine up to 300 mol / l,); group 3 (n = 26) comprises cases of a severe form of the disease (urea level above 19 mmol / l, creatinine above 300 mol / l). The comparison of the groups was performed by using single-factor analysis of variance, between-group comparisons was carried out by means of Dunnetts test. Spearmans correlation analysis was performed to investigate the relationships. Our study demostrates that thrombocytopenia and lymphopenia, as well as a significant increase in ferritin and C-reactive protein (1020-fold) are the early signs of any severity of the disease. Both the level of urea and creatinine and their concentration in the blood as well as aggravated trombo- and lymphocytopenia, determine the severity of the disease. The revealed differences in the key metabolic indicators on the 3rd5th day of the disease will allow to solve the problem of early prediction of the severity of the disease, which will be fully manifested in the oliguric period.

scholarly journals A comparative study of biochemical parameters in mild and severe cases of COVID-19

2021 ◽  
Vol 9 (11) ◽  
pp. 3402
Author(s):  
Gouri A. Gulavani ◽  
Smita V. Wali ◽  
Sanjyoti A. Panchbudhe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Biochemical Parameters ◽  
Clinical Manifestations ◽  
Severe Form ◽  
Nasopharyngeal Swab ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
The Difference ◽  
Severity Of The Disease

Background: COVID-19 has a range of clinical manifestations, including cough, fever, breathlessness, diarrhoea.    Diagnosis of COVID-19 is commonly made through detection of SARS-CoV-2 RNA by PCR testing of a nasopharyngeal swab or other specimens. Evaluation and management of COVID-19 depend on the severity of the disease. This study was done to analyses the difference in the laboratory findings of the mild and severe cases in patients with COVID-19.Methods: In this study biochemical parameters of the patients with mild and those admitted in intensive care unit (ICU) of SKNMCGH, Pune were studied. Total 60 patients were included in this study. Standard deviation and mean were calculated from the values of biochemical parameters of COVID-19 patients in intensive care unit (ICU) and ward patients.Conclusions: We found levels of lactate dehydrogenase (LDH), C-reactive protein (CRP), Aspartate aminotransferase (AST), alanine aminotransferase (ALT), ferritin were significantly elevated in severely ill ICU admitted patients than mild patients. This may be useful for predicting progression towards a more severe form of COVID-19. 

scholarly journals HLA-Associated Hemorrhagic Fever with Renal Syndrome Disease Progression in Slovenian Patients

2011 ◽  
Vol 18 (9) ◽  
pp. 1435-1440 ◽  
Author(s):  
Miša Korva ◽  
Ana Saksida ◽  
Sabina Kunilo ◽  
Blanka Vidan Jeras ◽  
Tatjana Avšič-Županc
Keyword(s):  
Strong Association ◽  
Hemorrhagic Fever ◽  
Class Ii ◽  
Protective Role ◽  
Severe Form ◽  
Slovenian Population ◽  
Dobrava Virus ◽  
Histocompatibility Complex ◽  
Severity Of The Disease ◽  
Hla Molecules

ABSTRACTMajor histocompatibility complex (MHC) class I and class II genes regulate the balance between appropriate aggressive responses and invading pathogens while minimizing the destruction of host tissue. Several studies have shown that in hemorrhagic fever with renal syndrome (HFRS) patients, the disease outcome is determined by a complex interaction between the virus and immunopathologic and human genetic factors. In Slovenia, the severity of the disease caused by Puumala virus (PUUV) is significantly lower than that of HFRS due to Dobrava virus (DOBV). We have determined 23 different HLA-B and 12 different HLA-DRB1 types in Slovenian HFRS patients. Comparison of HLA frequencies between healthy individuals and HFRS patients showed no strong association with the susceptibility for hantaviral infection. Significant associations were recognized when the patient group was separated according to the virus responsible for the infection. DOBV-infected patients have a significantly higher frequency of HLA-B*35 than PUUV-infected patients. For HLA class II genes, the biggest difference between the PUUV- and DOBV-infected groups of patients was in HLA-DRB1*13, where this phenotype was more frequent in PUUV-infected patients, especially in the severe form of the disease. HLA-B*07 could play a protective role in PUUV-caused HFRS in the Slovenian population. Our study shows diverse associations of HLA molecules with DOBV- and PUUV-induced HFRS, and therefore, we presume that different hantaviruses are presented differently through the same HLA molecules and that this might lead to either a more severe or a milder form of the disease. In line with this idea, we have noticed that HLA-B*35 might be a genetic risk factor for DOBV infection in the Slovenian population.

scholarly journals The state of the cytokine system in patients with severe COVID-19

2021 ◽  
Author(s):  
А.А. Гришаева ◽  
Ж.Б. Понежева ◽  
М.Д. Чанышев ◽  
А.А. Плоскирева ◽  
И.А. Маннанова ◽  
...  
Keyword(s):  
Interleukin 1 ◽  
Fatal Outcome ◽  
Severe Form ◽  
Simultaneous Increase ◽  
Shortness Of Breath ◽  
Comparison Groups ◽  
Group 2 ◽  
Made In ◽  
Group 1 ◽  
Number Of Authors

Инфекция COVID-19 является одной из самых актуальных проблем современного здравоохранения. Несмотря на прогресс, достигнутый в понимании патогенеза данной инфекции, в настоящее время отсутствуют прогностические критерии утяжеления и летального исхода. Рядом авторов предложено рассматривать некоторые интерлейкины (ИЛ) в качестве маркеров прогноза тяжелого течения. Нами была проанализирована клинико-лабораторная характеристика больных с тяжелым течением COVID-19, включая исследование уровней ИЛ-1, ИЛ-6, ИЛ-10. Под наблюдением находились 49 пациентов с тяжелой формой COVID-19 в возрасте от 18 до 90 лет, госпитализированных в отделение реанимации и интенсивной терапии инфекционного стационара. У всех пациентов диагноз был подтвержден выявлением РНК SARS-CoV-2 методом ПЦР в мазках из носоглотки и ротоглотки. У 47 пациентов наблюдался отягощенный преморбидный фон. При поступлении самыми частыми жалобами являлись лихорадка, одышка и сухой кашель. У всех больных была диагностирована двусторонняя полисегментарная пневмония, тяжелая форма (КТ-3/4) наблюдалась у 32,7% больных. Анализ исследуемых цитокинов (ИЛ-1, ИЛ-6, ИЛ-10) в сыворотке крови больных с тяжелым течением COVID-19 выявил, что ИЛ-6 был повышен у 75%, в то время как повышение уровня ИЛ-10 отмечено менее чем у половины больных (46,9%), а показатель ИЛ-1 выше нормы регистрировали менее чем у трети пациентов (12,2%.) Проанализированы клинико-лабораторные особенности у пациентов с COVID-19 тяжелого течения в зависимости от исхода болезни в группах сравнения: группа 1 – выжившие; умершие – группа 2. В группе 1 повышение концентрации ИЛ-6 регистрировали у 73,9% исследуемых, ИЛ-1 – только в 4,3% случаев, а ИЛ-10 – у 21,7% больных. При этом в группе 2 (с летальным исходом) выявлены повышенные концентрации ИЛ-6 у 96,2% больных, ИЛ-10 и ИЛ-1 – в 69,2% и 21,7% случаев соответственно. Одновременное повышение трех исследуемых цитокинов наблюдалось только у 12,2% пациентов – все они относились к группе 2. Таким образом, исследуемые цитокины могут рассматриваться как потенциальные прогностические маркеры летального исхода у больных с тяжелой формой COVID-19. COVID-19 infection is one of the most actual problems of modern healthcare. Despite the progress made in understanding of the pathogenesis of this infection, there are currently no prognostic criteria for aggravation and death. A number of authors propose to consider interleukins 1, 6, 10 (IL-1, IL-6, IL-10) as markers of the prognosis of a severe course. We analyzed the clinical and laboratory characteristics of patients with severe COVID-19, including the interleukin 1, 6, 10 levels. We observed 49 patients with a severe form of COVID-19 aged 18 to 90 years, hospitalized in the intensive care unit of the Infectious Hospital. The diagnosis of Covid-19 was confirmed by the detection of SARS-CoV-2 RNA by PCR in nasopharyngeal and oropharyngeal smears. 47 patients had a burdened premorbid background. The most frequent complaints on admission were fever, shortness of breath, and dry cough. Bilateral polysegmental pneumonia was diagnosed at admission in all patients, but severe form (CT-3/4) was observed only in 32,7% of patients. Analysis of the studied cytokines (IL-1, IL-6, IL-10) in the blood serum of patients with severe Covid-19 revealed that IL-6 was elevated in more than 75% cases, while an increase in the level of IL-10 was noted in less than half of the patients (46,9%), and the IL-1 index above the baseline was recorded in less than a third of patients (12,2%).) We analyzed the clinical and laboratory characteristics of patients with severe COVID-19, depending on the outcome of the disease by the comparison groups: group 1 – survivors and group 2 – lethal. An increase of the concentration of IL-6 in group 1 was observed in 73,9% of the subjects, IL-1 – only in 4,3% of cases, and IL-10 – in 21,7% of patients. Elevated concentrations of IL-6 were detected in group 2 (with a fatal outcome) in 96,2% of patients, IL-10 in 69,2% of cases and IL-1 in 21,7% of patients. A simultaneous increase in the three cytokines studied was observed only in 12,2% of patients – all of them belonged to group 2. Thus, the cytokines studied can be considered as potential lethal markers for patients with severe COVID-19.

scholarly journals Thrombocytopenia and endothelial dysfunction in hemorrhagic fever with renal syndrome

2018 ◽  
Vol 10 (4) ◽  
pp. 48-52
Author(s):  
G. A. Mukhetdinova ◽  
R. M. Fazlyeva ◽  
D. A. Valishin ◽  
G. M. Khasanova ◽  
R. G. Yapparov
Keyword(s):  
Platelet Count ◽  
Initial Period ◽  
Hemorrhagic Fever ◽  
Control Group ◽  
Laboratory Examination ◽  
Mild Form ◽  
Average Value ◽  
Quantitative Content ◽  
The Difference ◽  
Severity Of The Disease

Purpose: to estimate the content of platelets and sP-selectin in patients with different severity of Hemorrhagic Feverwith Renal Syndrome. Materials and methods: we have conducted the clinical and laboratory examination of 220 patients with Hemorrhagic Fever with Renal Syndrome, including mild (52), moderate (112) and severe (56) forms. The quantitative content of sPselectin in blood serum was determined by enzyme immunoassay in 90 patients (30 people from each group). Results: during first days of admission to the hospital thrombocytopenia in patients with mild form of HFRS was moderate. For moderate and severe forms of HFRS during the initial period the average value of the platelet was less than 100u109/l; correlation analysis between platelet countand creatinine level revealed an inverse relationship between the platelet count during the initial period and the level of creatinine during the oliguric period (r=-0,526; p=0,029). The difference in the content of sP-selectin are statistically significant not only with the control group, but also between groups of patients depending on the severity of the disease, a correlation between the content of platelets and sP-selectin was revealed in all groups of patients. Conclusion: the activity of sP-selectin and the degree of thrombocytopenia are closely interrelated and characterize the severity of the disease.

CLINICAL AND LABORATORY PECULIARITIES OF WHOOPING COUGH IN CHILDREN OF DIFFERENT AGE GROUPS

2020 ◽  
Vol 99 (6) ◽  
pp. 98-104
Author(s):  
I.V. Babachenko ◽  
◽  
Y.V. Nesterova ◽  
N.V. Skripchenko ◽  
◽  
...  
Keyword(s):  
Whooping Cough ◽  
Severe Disease ◽  
Respiratory Rhythm ◽  
Age Groups ◽  
Low Frequency ◽  
Pertussis Infection ◽  
Group 2 ◽  
Sick Children ◽  
Hematological Changes ◽  
Group 1

Objective of the research: to present the clinical and laboratory peculiarities of modern whooping cough in hospitalized children of different ages. Materials and methods: сlinical and laboratory characteristics of whooping cough were analyzed in 88 hospitalized sick children aged 1 month to 18 years in groups of children: group 1 – children under 1 year old; group 2 – children 1–6 years old; group 3 – children 7–17 years old. DNA of causative agents of pertussis infection was isolated by PCR in nasopharyngeal swabs using a commercial kit AmpliSens®Bordetella multi-FL (Moscow). Results: children of group 1 in 90% (n=43) of cases were not vaccinated against whooping cough, severe forms were recorded in 17% (n=8) of children of the 1st year of life, and in 15% (n=7) – due to respiratory rhythm disturbances. The diagnosis was confirmed by PCR in 94% (n=45) of children, leukocytosis with lymphocytosis was detected in 81,5% (n=101). Along with hematological changes typical for whooping cough, 79% (n=38) of patients in the first year of life had thrombocytosis (>400×109/l), which was most pronounced in severe disease course 511,5 [425; 568,5]×109/l vs 421 [347; 505,5]×109/l; p<0,05, which has no tendency to decrease throughout the entire observation period and correlates with the level of leukocytes (rs=0,69; p<0,001). Patients over 7 years old in 88% (n=21) of cases were vaccinated against whooping cough, but 79% (n=27) hemograms had no characteristic changes, which, along with a low frequency of confirmation of the diagnosis by PCR 22% (n=4), made it difficult to diagnose whooping cough. Conclusion: children over 7 years of age may not have characteristic hematological changes and PCR diagnostics are insufficiently effective, which contributes to the spread of whooping cough in family foci.

Patients Who Attend Alone at a First Memory Consultation: Are They a Specific Population,or Is It an Instance of Confounding Bias?

2019 ◽  
Vol 81 (1-2) ◽  
pp. 81-86
Author(s):  
Pierre Koskas ◽  
Mouna Romdhani ◽  
Olivier Drunat
Keyword(s):  
Selection Bias ◽  
Confounding Bias ◽  
Significant Difference ◽  
Comparison Groups ◽  
Methodological Problems ◽  
Group 2 ◽  
The Impact ◽  
First Time ◽  
State Examination ◽  
Group 1

As commonly happens in epidemiological research, none of the reported studies were totally free of methodological problems. Studies have considered the influence of social relationships on dementia, but the mechanisms underlying these associations are not perfectly understood. We look at the possible impact of selection bias. For their first memory consultation, patients may come alone or accompanied by a relative. Our objective is to better understand the impact of this factor by retrospective follow-up of geriatric memory outpatients over several years. All patients over 70 who were referred to Bretonneau Memory Clinic for the first time, between January 2006 and 2018, were included in the study. The patients who came alone formed group 1, the others, whatever type of relative accompanied them, formed group 2. We compared the Mini-Mental State Examination (MMSE) scores of patients; and for all patients who came twice for consultation with at least a 60-day interval, we compared their first MMSE with the MMSE performed at the second consultation. In total, 2,935 patients were included, aged 79.7 ± 8.4 years. Six hundred and twenty-five formed group 1 and 2,310 group 2. We found a significant difference in MMSE scores between the 2 groups of patients; and upon second consultation in group 2, but that difference was minor in group 1. Our finding of a possible confounding factor underlines the complexity of choosing comparison groups in order to minimize selection bias while maintaining clinical relevance.

scholarly journals Serum Neopterin Levels and the Clinical Presentation of COVID-19

Pteridines ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 185-192
Author(s):  
Deniz Öğütmen Koç ◽  
Hande Sipahi ◽  
Cemile Dilşah Sürmeli ◽  
Mustafa Çalık ◽  
Nilgün Bireroğlu ◽  
...  
Keyword(s):  
Disease Activity ◽  
Clinical Presentation ◽  
Serum Levels ◽  
Neutrophil Lymphocyte Ratio ◽  
Serum Neopterin ◽  
Protein Levels ◽  
Reactive Protein ◽  
Group 2 ◽  
Immune Activation Marker ◽  
Group 1

AbstractIn Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investigate possible biomarkers. Therefore, in this study, we investigated the relationship between disease activity and serum levels of possible immune activation marker neopterin in patients with COVID-19. The study enrolled 45 patients (23 females, 51.1%) treated for COVID-19. The patients were divided into two groups according to their clinical presentation: those who recovered quickly (Group 1) and those who worsened progressively (Group 2). The neopterin and C-reactive protein levels were high in all patients on admission. In Group 1, neopterin concentrations and serum neopterin/creatinine ratios were significantly higher on admission compared to Day 14 of the disease, whereas in Group 2, levels were significantly higher at Day 14 of the disease than on admission. Neopterin levels at admission were significantly higher in Group 1. The serum neopterin concentrations at admission were markedly higher in patients with a derived neutrophil–lymphocyte ratio (dNLR) > 2.8 compared to those with a dNLR ≤ 2.8 (p < 0.05). Serum neopterin levels can be used as a prognostic biomarker in predicting disease activity in COVID-19.

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&lt;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&lt;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.

The state of acid-base balance and electrolyte metabolism in patients with hemorrhagic fever with renal syndrome

1982 ◽  
Vol 63 (2) ◽  
pp. 8-10
Author(s):  
A. I. Chukavina ◽  
A. I. Motyreva ◽  
V. T. Gorlov
Keyword(s):  
Hemorrhagic Fever ◽  
The State ◽  
Acid Base Balance ◽  
Acid Base ◽  
Electrolyte Metabolism ◽  
Base Balance ◽  
Severity Of The Disease

Examination of 167 patients with hemorrhagic fever with renal syndrome revealed regular changes in acid-base balance and electrolyte metabolism. They were mutually correlated and corresponded to the severity of the disease.

Role of antioxidant therapy in patients with moderate and severe COVID-19

2021 ◽  
Vol 19 (1) ◽  
pp. 159-164
Author(s):  
E.K. Shavarova ◽  
◽  
E.R. Cazakhmedov ◽  
M.V. Alekseeva ◽  
L.G. Ezhova ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intervention Group ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Control Group ◽  
Reactive Protein ◽  
Virus Rna ◽  
Active Intervention Group ◽  
Group 2 ◽  
Novel Coronavirus

The coronavirus disease COVID-19 is characterized by high mortality and the lack of effective etiotropic therapy. Activation of oxidative stress may be one of the links in the pathogenesis of organ damage of this infection. Objective. To assess the ability of Mexidol® to influence the rate of clinical improvement in pneumonia caused by the SARSCoV-2 virus in hospitalized patients with the novel coronavirus disease COVID-19 and concomitant discirculatory encephalopathy. 62 patients over the age of 18 years with confirmed new coronavirus disease COVID-19 according to computed tomography (CT) of the lungs (stages CT1, CT2, CT3) and PCR of a swab from the nasopharynx and oropharynx for SARS-CoV-2 virus RNA were included. After randomization patients of group 1 received an infusion of Mexidol® at a dose of 1000 mg/day, patients of group 2 – an infusion of isotonic sodium chloride solution for 7 days. Compared with the control group, the patients receiving Mexidol® therapy showed a significantly more pronounced decrease in body temperature, a tendency towards a decrease in the severity of shortness of breath. In the Mexidol® group, the concentration of superoxidedismutase did not change, while in the control group there was a tendency to its decrease, C-reactive protein decreased 2.2 times more than in the control group (p = 0.09). There was a tendency for a more rapid decrease in ferritin in the active intervention group. Mexidol® therapy can have a positive effect on the clinical manifestations and severity of laboratory-inflammatory syndrome in patients with the new coronavirus disease COVID-19. Key words: coronavirus disease COVID-19, oxidative stress, Mexidol

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