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. 

RECURRENT POLYSEROSITIS ("PERIODIC DISEASE," "FAMILIAL MEDITERRANEAN FEVER") IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (3) ◽  
pp. 443-449
Author(s):  
Tehila R. Shapiro ◽  
Ernest N. Ehrenfeld
Keyword(s):  
Familial Mediterranean Fever ◽  
Acute Rheumatic Fever ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Periodic Disease ◽  
Mediterranean Fever ◽  
The Difference

A series of 19 cases of recurrent polyserositis is presented. All but one child were of Oriental Jewish parentage, and the disease sometimes showed a familial occurrence. The average age of onset was 4 years. The symptoms consisted of fever; abdominal, chest, and joint pains; and skin eruptions. The clinical manifestations often simulated those of acute rheumatic fever, particularly since cardiac murmurs occurred in more than half of the patients. The laboratory findings were those accompanying nonspecific inflammations such as leukocytosis, accelerated enythrocyte sedimentation rate, elevated antistreptolysin titer, and positive C-reactive protein. Though some patients showed transitional albuminunia, no cases of amyloidosis were found. The difference in the clinical manifestations in children as compared with adults, and possible etiological factors are discussed.

scholarly journals Factors Affecting Mortality in 1022 COVID-19 Patients Referred to an Emergency Department in Bergamo during the Peak of the Pandemic

2020 ◽  
Vol 2 (9) ◽  
pp. 1313-1318 ◽  
Author(s):  
Orlando Goletti ◽  
Chiara Nessi ◽  
Amidio Testa ◽  
Giovanni Albano ◽  
Valter Torri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Hospital Admission ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Factors Affecting ◽  
Reactive Protein ◽  
Level Ii ◽  
Severity Of The Disease

Abstract The unexpected outbreak of COVID-19 in the area of Bergamo and the general crisis of personnel and devices has been managed as well as possible during the maximum peak of epidemic; Humanitas Gavazzeni Hospital implemented its facilities and organization in order to optimize the treatment of patients. The number of beds in the Intensive Care Unit (ICU) was doubled (from 16 to 33), and more than 220 beds were dedicated to the COVID-19 patients. This paper analyzes the factors affecting mortality in 1022 COVID-19 patients who referred to Humanitas Gavazzeni between February 25 and March 26, 2020. A total of 274 (34.9%) fatal events were registered: 202 among those admitted to the Intensive Care Unit (ICU) and COVID department and 72 among those treated in Acute Admission Unit Level II (AAUl-2) who died before hospital admission. This paper studies 274 dead cases by analyzing patient’s characteristics, physiological and laboratory parameters, symptoms, and the scores of severity of the disease. Patients who had fatal events in the AAUL-2 showed the worst parameters of risk. The most important differences regarded the Apache II score, Glasgow Coma Score (GCS), CRP (C-reactive protein), pH, creatinine, RR (respiratory rate), and asthenia.

scholarly journals Evidence-based of conjunctival COVID-19 positivity: An Italian experience: Gemelli Against COVID Group

2020 ◽  
pp. 112067212097654
Author(s):  
Maria Cristina Savastano ◽  
Gloria Gambini ◽  
Alfonso Savastano ◽  
Benedetto Falsini ◽  
Umberto De Vico ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Chemistry ◽  
Nasopharyngeal Swab ◽  
Reactive Protein ◽  
Italian Experience ◽  
Impairment Score ◽  
Pulmonary Impairment ◽  
Respiratory Coronavirus ◽  
D Dimer

Background: The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated. Methods: Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C−NF−), (2) NPs positive and Cs negative (NFs+Cs−), (3) NPs negative and Cs positive (NFs−Cs+), and (4) NPs and Cs both positive (NFs−Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP). Results: A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF−C− group (98%) and the lowest (90%) in the group NF+C+ ( p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups ( p = 0.019). Pulmonary impairment score increased from NFs−Cs− group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%). Conclusions: In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity. Trial registration: Clinicaltrials.gov registration. Ethical committee authorization: ID number: 0013008/20

scholarly journals Clinical Characteristics, Comorbidities, Initial Management and Outcome of COVID-19 Infected Patients Admitted to Intensive Care Unit in Somalia: A National Retrospective Study.

2020 ◽  
Author(s):  
Mohamed Farah Yusuf Mohamud ◽  
Abdullahi Said Hashi ◽  
Abdikarim Hussein Mohamed ◽  
Ali Mohamed Yusuf ◽  
Ibrahim Hussein Ali ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Altered Level ◽  
Clinical Presentations ◽  
High Flow Oxygen ◽  
Independent Risk Factors ◽  
Poor Outcomes

Abstract Purpose: To investigate the clinical characteristics, morbidities, management, and outcomes of COVID-19 Infected patients admitted to the intensive care unit (ICU) in Somalia.Material and methods: We conducted a retrospective observational study of laboratory 60 confirmed patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) admitted to an ICU from March 28, to May 28, 2020.The sociodemographic characteristics, comorbidities, exposure history, clinical manifestations (symptoms and signs), laboratory findings, treatment, and outcomes were collected from medical records.Results: Most of the patients admitted to ICU were men over 59 years of age, and nearly half had diabetes followed by hypertension chronic kidney disease and asthma. The most clinical presentations were dyspnea (91.2%), Fever (81.1%), (68.75%), Fatigue and myalgia (25%), and Altered level of conscious (16.6%). Among 48 patients admitted to the ICU, about 24 (50%) patients had required endotracheal intubation and mechanical ventilation, and 11(29.9%) patients needed noninvasive ventilation, while 13(27.08%) patients treated with high-flow oxygen therapy >15 L/min (Table 3). Corticosteroids were administered to most patients (85.4%), while 77.1% of the patients received inhaled bronchodilators and morethan half of the patients administered antibiotics. 58.3% of the patients had received Oseltamivir, while 22.9% received Vasopressors.Conclusion This study represents the first description of critically ill patients infected with SARS-CoV-2 admitted to ICU in Somalia. The study identified that elder age, male gender, and diabetic and hypertensive comorbidities as independent risk factors of poor outcomes for patients admitted to the ICU (p<0.005).

scholarly journals Comparison of APACHE II scores and mortality with CRP/albumin, neutrophil/lymphocyte and thrombocyte/lymphocyte ratios in patients admitted to internal medicine and anesthesia reanimation intensive care unit

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ahmet Usta ◽  
Emin Gemcioglu ◽  
Salih Baser ◽  
Osman Ersoy ◽  
Yunus Halil Polat ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Acute Exacerbation ◽  
Kidney Injury ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
The Relationship

Abstract Objectives This study aimed to evaluate the relationship between C-reactive protein/albumin (CRP/Alb), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR) ratios and the Acute Physiology And Chronic Health Evaluation II (APACHE II) score and 28-day mortality among 400 patients admitted to internal medicine and anesthesia reanimation intensive care unit (ICU). Methods This prospective study included a total of 400 patients who were admitted to hospital internal medicine and anesthesia reanimation ICUs. Results The most common reasons for ICU admission were pneumonia (29.3%), gastrointestinal bleeding (10.3%), acute exacerbation of chronic kidney disease (CKD) (10.3%), and acute kidney injury (7.5%). The comparison of the laboratory findings with survival outcomes revealed that among the patients with acute exacerbation of CKD, the median NLR (p=0.043) and median CRP/Alb (p=0.021) were significantly higher in patients who died. For all of the patients, the APACHE II score was positively correlated with CRP (p<0.001) and CRP/Alb (p<0.001), negatively correlated with Alb (p<0.001), positively correlated with the NLR (p<0.001), and positively correlated with the PLR. Conclusions The APACHE II score was significantly correlated with the CRP/Alb ratio, NLR, and PLR. The NLR and CRP/Alb ratio were statistically associated with mortality in patients hospitalized for acute exacerbation of CKD.

Presepsin - New Marker of Sepsis Romanian Neonatal Intensive Care Unit Experience

2019 ◽  
Vol 70 (8) ◽  
pp. 3008-3013
Author(s):  
Silvia Maria Stoicescu ◽  
Ramona Mohora ◽  
Monica Luminos ◽  
Madalina Maria Merisescu ◽  
Gheorghita Jugulete ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Complete Blood Count ◽  
Clinical Manifestations ◽  
Receiver Operating Curve ◽  
Predictive Values

Difficulties in establishing the onset of neonatal sepsis has directed the medical research in recent years to the possibility of identifying early biological markers of diagnosis. Overdiagnosing neonatal sepsis leads to a higher rate and duration in the usage of antibiotics in the Neonatal Intensive Care Unit (NICU), which in term leads to a rise in bacterial resistance, antibiotherapy complications, duration of hospitalization and costs.Concomitant analysis of CRP (C Reactive Protein), procalcitonin, complete blood count, presepsin in newborn babies with suspicion of early or late neonatal sepsis. Presepsin sensibility and specificity in diagnosing neonatal sepsis. The study group consists of newborns admitted to Polizu Neonatology Clinic between 15th February- 15th July 2017, with suspected neonatal sepsis. We analyzed: clinical manifestations and biochemical markers values used for diagnosis of sepsis, namely the value of CRP, presepsin and procalcitonin on the onset day of the disease and later, according to evolution. CRP values may be influenced by clinical pathology. Procalcitonin values were mainly influenced by the presence of jaundice. Presepsin is the biochemical marker with the fastest predictive values of positive infection. Presepsin can be a useful tool for early diagnosis of neonatal sepsis and can guide the antibiotic treatment. Presepsin value is significantly higher in neonatal sepsis compared to healthy newborns (939 vs 368 ng/mL, p [ 0.0001); area under receiver operating curve (AUC) for presepsine was 0.931 (95% confidence interval 0.86-1.0). PSP has a greater sensibility and specificity compared to classical sepsis markers, CRP and PCT respectively (AUC 0.931 vs 0.857 vs 0.819, p [ 0.001). The cut off value for presepsin was established at 538 ng/mLwith a sensibility of 79.5% and a specificity of 87.2 %. The positive predictive value (PPV) is 83.8 % and negative predictive value (NPV) is 83.3%.

scholarly journals Beta-Lactams Toxicity in the Intensive Care Unit: An Underestimated Collateral Damage?

2021 ◽  
Vol 9 (7) ◽  
pp. 1505
Author(s):  
Claire Roger ◽  
Benjamin Louart
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Manifestations ◽  
Acute Interstitial Nephritis ◽  
Convulsive Status Epilepticus ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Drug Induced ◽  
Icu Patients

Beta-lactams are the most commonly prescribed antimicrobials in intensive care unit (ICU) settings and remain one of the safest antimicrobials prescribed. However, the misdiagnosis of beta-lactam-related adverse events may alter ICU patient management and impact clinical outcomes. To describe the clinical manifestations, risk factors and beta-lactam-induced neurological and renal adverse effects in the ICU setting, we performed a comprehensive literature review via an electronic search on PubMed up to April 2021 to provide updated clinical data. Beta-lactam neurotoxicity occurs in 10–15% of ICU patients and may be responsible for a large panel of clinical manifestations, ranging from confusion, encephalopathy and hallucinations to myoclonus, convulsions and non-convulsive status epilepticus. Renal impairment, underlying brain abnormalities and advanced age have been recognized as the main risk factors for neurotoxicity. In ICU patients, trough concentrations above 22 mg/L for cefepime, 64 mg/L for meropenem, 125 mg/L for flucloxacillin and 360 mg/L for piperacillin (used without tazobactam) are associated with neurotoxicity in 50% of patients. Even though renal complications (especially severe complications, such as acute interstitial nephritis, renal damage associated with drug induced hemolytic anemia and renal obstruction by crystallization) remain rare, there is compelling evidence of increased nephrotoxicity using well-known nephrotoxic drugs such as vancomycin combined with beta-lactams. Treatment mainly relies on the discontinuation of the offending drug but in the near future, antimicrobial optimal dosing regimens should be defined, not only based on pharmacokinetics/pharmacodynamic (PK/PD) targets associated with clinical and microbiological efficacy, but also on PK/toxicodynamic targets. The use of dosing software may help to achieve these goals.

scholarly journals Comparison of three fixation methods for orotracheal intubation in 95 adults

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ye Sun ◽  
Hua Fan ◽  
Xiao-Xia Song ◽  
Hua Zhang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Older People ◽  
Endotracheal Intubation ◽  
Orotracheal Intubation ◽  
The Other ◽  
Fixation Methods ◽  
The Difference

Abstract Background The present study aimed to compare three fixation methods for orotracheal intubation. Methods Through literature retrieval, the effects of the adhesive/twill tape method, fixator method, and adhesive/twill tape–fixator alternation method on patients with tracheal intubation in the intensive care unit (ICU) were compared. Results The fixator and alternation methods were more effective in protecting the tongue mucosa and teeth. The alternation method was superior to the other two methods in maintaining the position of the endotracheal intubation. However, the difference in facial and lip injuries between the three methods was not statistically significant. Conclusion The fixator method can significantly reduce intraoral injury and is more suitable for older people with weak tongue mucosa and loose teeth. These are worth popularizing among a wider group.

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