scholarly journals The effectiveness of dexmedetomidine in patients with severe COVID-19

2021 ◽  
Author(s):  
Sergei A. Andreichenko ◽  
Mikhail V. Bychinin ◽  
Irina A. Mandel’ ◽  
Tatiana V. Klypa
Keyword(s):  
Inflammatory Markers ◽  
Randomized Trials ◽  
Primary Outcome ◽  
Control Group ◽  
Blood Gas ◽  
C Reactive Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Beneficial Effects ◽  
Reactive Protein ◽  
Secondary Results

Rationale: Mortality in patients with severe COVID-19 remains high. Finding therapies that can improve the outcome in these patients is an urgent function. Objective: To evaluate the clinical efficacy of dexmedetomidine in the results of complex treatment with a severe course of COVID-19. Materials and Methods: The retrospective study included 50 adult patients with severe COVID-19 admitted to the intensive care unit (ICU). The primary outcome of the study was the incidence of delirium. The secondary results of the study were dynamics of gas exchange indicators (PaO2 and PaCO2) and inflammatory markers (C-reactive protein (CRP), procalcitonin, lymphocyte count and neutrophil-lymphocyte ratio (NLR)) for 3 and 5 days of treatment, as well as the duration of mechanical ventilation (MV), length of stay (LOS) in the ICU and hospital and mortality. Results: The incidence of delirium did not differ between the dexmedetomidine group and the control group (41% and 48%, respectively; p = 0,661). The LOS in the ICU and the hospital, as well as the duration of MV, was comparable between the groups. However, hospital mortality in the dexmedetomidine treatment group was lower than in the control group (10,3% and 42,9%, respectively; p = 0,008). The addition of dexmedetomidine to the complex of therapy did not affect the change in blood gas, but contributed to an increase in the number of lymphocytes (p = 0,006) and a decrease in NLS (p = 0,002) by the fifth day of treatment. At the same time, no significant changes in CRP and procalcitonin levels were observed. Conclusion: Therapy with dexmedetomidine was not accompanied by a decrease in the frequency of delirium, LOS in the ICU and the hospital, and the duration of MV in patients with severe COVID-19. Prospective randomized trials are needed to confirm the beneficial effects of dexmedetomidine on the immune system and mortality.

Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

2021 ◽  
pp. 1-9
Author(s):  
Murat Yildirim ◽  
Bulent Koca
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Operation Time ◽  
C Reactive Protein ◽  
Oncologic Surgery ◽  
Protein Ratio ◽  
Colorectal Cancer Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

SAT0379 C-REACTIVE PROTEIN TO ALBUMIN RATIO IS ASSOCIATED WITH DISEASE ACTIVITY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1137.1-1138
Author(s):  
Z. Zhong ◽  
Y. Huang ◽  
Q. Huang ◽  
T. LI
Keyword(s):  
Disease Activity ◽  
Active Group ◽  
Control Group ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Albumin Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Optimal Cutoff Point

Background:C-reactive protein to albumin ratio (CAR) has emerged as a significant biomarker to evaluate and predict systemic inflammation[1]. However, the role of CAR in patients with axial spondyloarthritis (axSpA) remains unknown.Objectives:The aim of this study was to investigate the relationship between CAR and disease activity of axSpA.Methods:A total of 241 patients and 61 healthy controls from Guangdong Second Provincial General Hospital from December 2015 to August 2019 were retrospectively recruited in this study. Patients were divided into two groups, with 176 patients in remission group (BASDAI<4) and 65 patients in active group (BASDAI≥4). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin (ALB), CAR, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) were detected. The correlations between CAR, NLR, PLR, MLR and disease activity were analyzed by the Spearman’s correlations analysis. Receiver operation characteristic (ROC) curves were performed to evaluate the discriminative utility of these parameters for disease activity of axSpA. Furthermore, the evaluation of the risk factors of axSpA was conducted using binary logistic regression analysis.Results:CAR, ESR, CRP, NLR, PLR and MLR in axSpA patients were significantly higher than those in the control group (p<0.05 for each), while ALB was significantly lower (p<0.001). Similarly, CAR in remission group was higher than that in control group (p<0.001) and was lower than that in active group (p<0.001). Besides, there were significantly positive correlations between CAR and ESR (r=0.702, P<0.001), CRP (r=0.996, P<0.001), BASDAI (r=0.329, p<0.001) and BASFI (r=0.328, P<0.001). Furthermore, ROC suggested that the area under the curve (AUC) of CAR was 0.701, which was the highest. The optimal cutoff point of CAR was 0.3644, with sensitivity and specificity of 58.5% and 79.0%. Logistic analysis results revealed that elevated CAR and MLR were independent risk factors for axSpA (EXP (B) =15.546, 95%CI: 5.898-40.979, P<0.001; EXP (B) =2.206, 95%CI: 1.077-4.519, P=0.031, respectively).Conclusion:CAR was increased in axSpA patients especially in active group, and significantly correlated with disease activity. CAR may serve as a novel inflammatory marker of monitoring disease activity in patients with axSpA.References:[1]He, Y., et al., Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritis. Clin Chim Acta, 2020. 500: p. 149-154.Fig 1.ROC curve analysis of the discriminative values of the parameters for disease activity of axSpATable 1.Discriminative values of the parameters for disease activity of axSpAAUC95% CIOptimal cutoff pointSpecificitySensitivityCAR0.7010.623-0.7780.364479.0%58.5%NLR0.4500.365-0.5343.16584.1%18.5%PLR0.5280.448-0.608127.38542.6%69.2%MLR0.4680.384-0.5530.38592.6%16.9%ESR0.6850.612-0.75815.552.3%76.9%CRP0.6910.614-0.76910.8571.6%63.1%CAR, C-reactive protein to albumin ratio; NLR, neutrophil-lymphocyte ratio; PLR, platelet-lymphocyte ratio; MLR, monocyte-lymphocyte ratio; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; AUC, areas under the ROC curveDisclosure of Interests:None declared

scholarly journals Plasma C-Reactive Protein Is Not Related to Sinus Non-Conversion by Maze Procedure Adjunct to Mitral Valve Surgery

2012 ◽  
Vol 33 (3) ◽  
pp. 119-126
Author(s):  
Chien-Jen Chen ◽  
Wen-Hao Liu ◽  
Jen-Ping Chang ◽  
Wan-Chun Ho ◽  
Yung-Lung Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Inflammatory Markers ◽  
Left Atrial ◽  
Significant Risk ◽  
Valve Surgery ◽  
Maze Procedure ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein

In Framingham cohort study, C-reactive protein was not associated with incident atrial fibrillation (AF) after adjustment for left atrial size. This study examined whether levels of plasma inflammatory markers would be significant risk factors for failed maze procedure for AF. This study enrolled 88 patients with mitral valve disease undergoing valve surgery (n= 32, sinus control group) or concomitant maze procedure for persistent atrial fibrillation (AF) (n= 56, AF group). The mean follow-up in the AF group was 55.0 ± 17.5 months. The AF and sinus control groups did not differ in preoperative levels of C-reactive protein (p= 0.636). In the AF group receiving maze procedure, the sinus conversion (n= 37) and non-conversion (n= 19) groups did not significantly differ in preoperative levels of interleukin-6 (p= 0.607) and tumor necrosis factor-α(p= 0.379). In multivariate analysis after adjustment for preoperative plasma inflammatory markers, independent factors associated with sinus conversion were AF duration (p=0.003), and left atrial area (p= 0.014). In conclusion, plasma inflammatory markers are not associated with sinus non-conversion by radiofrequency maze procedure.

scholarly journals Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer

2017 ◽  
Vol 51 (3) ◽  
pp. 131-136 ◽  
Author(s):  
S Ozmen ◽  
O Timur ◽  
I Calik ◽  
K Altinkaynak ◽  
E Simsek ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Control Group ◽  
Tumor Diameter ◽  
C Reactive Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Platelet Lymphocyte Ratio ◽  
Differentiated Thyroid Cancers

AbstractObjectives.NLR (neutrophil-lymphocyte ratio) and PLR (platelet-lymphocyte ratio) are prognostic markers of differentiated thyroid cancers. In our study, we evaluated NLR, PLR and C-reactive protein (CRP) for predicting the occurence of differentiated thyroid cancer. This is the first study that compares NLR and PLR to C-reactive protein indifferantiated thyroid cancer not only papillary cancer but also folliculer cancer.Methods.This study includes 51 papillary carcinoma, 42 papillary microcarcinoma and 31 folliculer carcinoma patients attending to our outpatient Endocrinology Clinic at Erzurum Region Training and Research Hospital between 2009 and 2014. The control group include 50 age, sex and body mass index matched healty subjects. Blood counts and CRP were measured at the day before surgery. Thyroglobulin was measured after 6 months of operation.Results.There were positive correlations between tumor diameter, age, white blood cell (WBC) and thyroglobulin levels. There were also positive correlation between NLR, PLR and CRP levels.Conclusion.In our study, we found out that higher NLR and PLR was associated with higher levels of thyroglobulin which indicates worse survival. CRP levels were also associated with poorer tumor profile but the determining rate was lower according to ROC analysis

scholarly journals Two new inflammatory markers related to the CURB-65 score for disease severity in patients with community-acquired pneumonia: The hypersensitive C-reactive protein to albumin ratio and fibrinogen to albumin ratio

2021 ◽  
Vol 16 (1) ◽  
pp. 84-91
Author(s):  
Bing Luo ◽  
Minjie Sun ◽  
Xingxing Huo ◽  
Yun Wang
Keyword(s):  
Inflammatory Markers ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Low Risk ◽  
Control Group ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
The Relationship

Abstract Background The objective of this study was to investigate the relationship among hypersensitive C-reactive protein to albumin ratio (CAR), fibrinogen to albumin ratio (FAR), and the CURB-65 score for community-acquired pneumonia (CAP) severity. Methods Clinical data and laboratory indicators of 82 patients with CAP and 40 healthy subjects were retrospectively analysed. The relationship among CAR, FAR, and the severity of CAP was then analysed. Results CAR and FAR in patients with low-risk CAP were significantly higher than those in the normal control group (P < 0.05). CAR and FAR in patients with medium–high-risk CAP were further increased compared with those in patients with low-risk CAP (P < 0.05). CAR and FAR were positively correlated with hypersensitive C-reactive protein, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and CURB-65 scores (P < 0.05). In the receiver operating characteristic curve for predicting severe CAP, the area under the curve of combining four biomarkers (CAR + FAR + NLR + PLR) was the largest. CAR was also an independent risk factor for severe CAP (OR = 8.789, 95% CI: 1.543–50.064, P = 0.014). Conclusions CAR and FAR may be used as the inflammatory markers for CAP severity evaluation.

scholarly journals C-REACTIVE PROTEIN/ALBUMIN RATIO AND NEUTROPHIL-LYMPHOCYTE RATIO AS PREDICTORS OF COVID-19 SEVERITY

2021 ◽  
Vol 9 (12) ◽  
pp. 374-378
Author(s):  
M.V. Madhav ◽  
◽  
Y. Sirisha ◽  
V. Anjaneya Prasad ◽  
◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
World Health ◽  
Common Finding ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
First Case ◽  
Severity Prediction

Coronavirus disease 2019 (COVID-19) was announced in early December 2019. By genome sequencing, the virus was recognised. From Wuhan City, the virus spread globally. The pandemic situation was declared by the World Health Organization.The first case of COVID-19 in Indiawas reported in Kerala on January 27, 2020.The clinical features varied with disease severity. Most COVID-19 patients have non-severe manifestations and show a good prognosis. However, patients with severe disease may progress to pulmonary dysfunction, multiple organ dysfunction, and death. COVID-19 related to a considerable mortality rate in older patients and cases had other morbidities. Studies suggested that the inflammatory storm is a common finding in other coronaviruses.Similarly, increases in the inflammatory markers like C-reactive protein (CRP),ferritin,interleukin-6 (IL-6) and were described in COVID-19 (1). Albumin levels decreased in the inflammatory conditions reduced levels were confirmed in severe COVID-19 patients. Hypoalbuminemia and high CRP/albumin ratio were previously linked to the mortality of various clinical conditions as critically ill patients.To avoid the unnecessary or inappropriate utilisation of the healthcare resources, early prediction of the severity of COVID-19 will be helpful. Severity prediction will also improve the prognosis by reducing the mortality rate.Thus, this study aimed to evaluate the role of inflammatory markers in estimating the severity and predicting the prognosis of COVID-19. This study hypothesised that elevated values of CRP/ albumin ratio and the neutrophil-lymphocyte ratio at the time of COVID-19 diagnosis are associated with COVID-19 severity and mortality.

scholarly journals Neutrophil-Lymphocyte Ratio (NLR) Reflects Myocardial Inhomogeneities in Hemodialyzed Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Kamila Bołtuć ◽  
Arkadiusz Bociek ◽  
Robert Dziugieł ◽  
Martyna Bociek ◽  
Tomasz Zapolski ◽  
...  
Keyword(s):  
Strong Predictor ◽  
Curve Analysis ◽  
Control Group ◽  
Inflammation Marker ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Echocardiographic Parameters

Introduction. Cardiovascular diseases (CVDs) are a leading cause of death in chronically hemodialyzed (HD) patients. In this group, inflammation exerts significant impact on the prevalence of CVD morbidity and mortality. Spatial QRS-T angle is an independent and strong predictor of CV events, including sudden cardiac death (SCD), both in general population and HD patients. Pathogenesis of widened QRS-T angle is complicated and is not well established. Objectives. The study is aimed at evaluating whether inflammation process can contribute to the wide QRS-T angle. Patients and Methods. The retrospective study was performed on 183 HD patients. The control group consisted of 38 patients. Demographic, biochemical, vectorcardiographic, and echocardiographic data were evaluated in all patients. Inflammation process was expressed as neutrophil-lymphocyte ratio (NLR), as well as C-reactive protein (CRP). Results. Both NLR (3.40 vs. 1.95 (p<0.0001)) and spatial QRS-T angle (50.76 vs. 93.56 (p<0.001)) were higher in the examined group, compared to the control group. Similarly, CRP was higher in the examined group than in the control group (8.35 vs. 4.06 (p<0.001), respectively). The QRS-T angle correlated with NLR, CRP, some structural echocardiographic parameters, parathormone (PTH), and calcium (Ca) concentrations. Multiple regression analysis showed that NLR is an independent QRS-T angle predictor (r=0.498, p=0.0027). The ROC curve analysis indicated the cut-off point of NLR equaled 4.59, where the sensitivity and specificity were the highest for predicting myocardial inhomogeneities expressed as widened QRS-T angle. Conclusion. The NLR, as an inflammation marker, may indicate myocardial inhomogeneities in HD patients.

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

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