scholarly journals COVID-19 anosmia and gustatory symptoms as a prognosis factor: a subanalysis of the HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry

2021 ◽  
Author(s):  
Jesús Porta-Etessam ◽  
Iván Núñez-Gil ◽  
Nuria González García ◽  
Cristina Fernández ◽  
María Viana-LLamas ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Clinical Score ◽  
The Novel ◽  
Prognosis Factor ◽  
Early Symptom ◽  
Reactive Protein ◽  
Knowing That ◽  
Therapeutic Decisions ◽  
Latino American ◽  
Worse Prognosis

Abstract Olfactory and gustatory dysfunctions (OGD) are a frequent symptom of Coronavirus disease 2019 (COVID-19). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19.These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 infection included in the multicenter international HOPE Registry (NCT04334291).There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension, dyslipidemia, diabetes, smoke, renal insufficiency, lung, heart, cancer and neurological disease. We did not find statistical differences in pregnant (p=0.505), patient suffering cognitive (p=0.484), liver (p=0.1) or immune disease (p=0.32). There was inverse relation (protective) between OGD and prone positioning (0.005) and death (<0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression OGD was found to be inversely related to death in COVID-19 patients. The Odds Ratio was 0.26 (0.15-0.44) (p<0.001) and Z was -5.05.The presence of anosmia is fundamental in the diagnosis of SARS.CoV-2 infection, but also could be important when classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, Hypertension, renal insufficiency, or increase of C-reactive protein (CRP) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient.The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment.

Clinical characteristics of inpatients with Coronavirus disease 2019 and acute ischemic stroke: from epidemiology to outcomes

2020 ◽  
Vol 17 ◽  
Author(s):  
Shiling Chen ◽  
Chao Pan ◽  
Ping Zhang ◽  
Yingxin Tang ◽  
Zhouping Tang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Complication ◽  
Pathophysiological Mechanism ◽  
C Reactive Protein ◽  
Vessel Occlusion ◽  
Reactive Protein ◽  
Detailed Search ◽  
Underlying Diseases ◽  
Worse Prognosis

Abstract:: Acute Ischemic Stroke (AIS) is currently the most frequently reported neurological complication of Coronavirus disease 2019 (COVID-19). This article will elaborate on the clinical features of inpatients with COVID-19 and AIS and the pathophysiological mechanism of AIS under the background of COVID-19. Through a detailed search of relevant studies, we found that the incidence of AIS among COVID-19 patients varied from 0.9% to 4.6%, and AIS has been observed in many people without underlying diseases and cardiovascular risk factors as well as young people. The National Institute of Health Stroke Scale (NIHSS) score of COVID-19 patients with AIS was higher than historical AIS patients, and the proportion of large vessel occlusion (LVO) was about 64.2%. COVID-19 patients with AIS have commonly high levels of D-D dimer, fibrinogen, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), suggesting systemic hyperinflammatory and hypercoagulable state. The pooled mortality of COVID-19 patients with AIS was 38% and the mortality of LVO patients is higher (45.9%). Compared with COVID-19-negative AIS patients in the same period in 2020 and 2019, COVID- 19 patients with AIS had a worse prognosis.

Chronic Induction of C-Reactive Protein by Hemodialysis, but Not by Peritoneal Dialysis Therapy

1996 ◽  
Vol 16 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Marion Haubitz ◽  
Reinhard Brunkhorst ◽  
Eike Wrenger ◽  
Peter Froese ◽  
Matthias Schulze ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Inflammatory Activity ◽  
C Reactive Protein ◽  
Dialysis Therapy ◽  
Dialysis Treatment ◽  
Reactive Protein ◽  
Before And After ◽  
Patient Groups

Objective Evaluation of the inflammatory activity in patients on chronic peritoneal dialysis (PD) and patients on chronic hemodialysis (HD) in comparison to patients with chronic renal insufficiency without dialysis treatment and healthy volunteers. Design Open, non randomized prospective study. Setting Nephrology Department, including HD and PD therapy in a university hospital. Patients Twenty -four patients on chronic PD, 21 patients on chronic HD therapy using a cuprophan dialyzer, 16 patients with chronic renal insufficiency without dialysis treatment, and 33 healthy volunteers; 8 additional patients before and after initiation of chronic HD therapy. All patients and controls were without infection or immunosuppressive therapy. Main Outcome Measures As a marker of the inflammatory activity in the different patient groups, C-reactive protein (CAP) was measured serially using a sensitive, enzyme-Iinked, immunosorbent assay in order to detect values below the detection limit of standard assays. Results All patient groups had CAP levels higher than the normal controls (p < 0.01). Patients on HD had CAP levels significantly higher than PD patients (p < 0.01) whose levels were comparable to patients without dialysis therapy. Accordingly, longitudinal measurements before and after initiation of chronic HD showed a significant increase in CAP levels after the beginning of HD treatment (p < 0.04). Conclusions The results suggest that induction of the inflammatory activity is lower during PD compared to HD, since stimulation by the dialyzer membrane, dialysate buffer, or bacterial fragments in the dialysate is avoided. This observation might indicate a possible lower risk of long-term complications in patients with PD.

scholarly journals P-226 Analysis of Hispanic Latino American patients with colorectal cancer, clinical features and laterality as a prognosis factor of overall survival

2020 ◽  
Vol 31 ◽  
pp. S164
Author(s):  
G. Calderillo-Ruiz ◽  
C. Diaz ◽  
D. Heredia ◽  
B. Carbajal-López ◽  
H. Lopez Basave ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Clinical Features ◽  
Prognosis Factor ◽  
Latino American

scholarly journals Retrospective analysis of the clinical features of outpatients with novel coronavirus in areas outside Wuhan, China

2020 ◽  
Author(s):  
Yong-Tao Li ◽  
Mei-Lian Peng ◽  
Jia-dan Fu ◽  
Li Liu ◽  
Yong-zheng Guo ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Clinical Performance ◽  
The Novel ◽  
C Reactive Protein ◽  
Early Screening ◽  
Reactive Protein ◽  
Ct Findings ◽  
Epidemic Area ◽  
Novel Coronavirus ◽  
Lung Ct

Abstract Objective: The novel coronavirus pneumonia (COVID-19) has spread rapidly across the globe with the movement of people. How to diagnose COVID-19 quickly and accurately is a concern for all. We retrospectively assessed the clinical characteristics of patients with COVID-19 detected by outpatient screening in areas outside Wuhan, China, to guide early screening outside the epidemic area, to isolate and treat COVID-19-positive patients, and to control the spread of this virus in the region.Results: Among the 213 patients treated in the fever clinic of our hospital, 41 tested positive for novel coronavirus (2019-nCoV) and 172 were negative. Among the positive patients, 13 (31.7%) of the patients had been to Wuhan, while 28 (68.3%) had not been to Wuhan. There were 4 cases of clustering occurrence. The main symptoms exhibited by COVID-19-positive patients were fever (87.8%), cough (68.3%), and expectoration (34.1%). The C-reactive protein (CRP) levels were increased in 35 (85.3%) positive patients; the hydroxybutyrate dehydrogenase in the myocardial zymogram was increased in 22 positive patients (53.6%) and 38 negative patients (22.1%); computed tomography (CT) findings revealed lung lesions in all 41 positive patients (100%).Conclusion: We classified the patient population and analyzed the data to understand the early clinical performance of COVID-19. Our research illustrate that screening for COVID-19 outside Wuhan should focus on early symptoms such as fever and cough, in combination with lung CT findings, epidemiological history, and sputum pathogen detection to determine whether patients need further isolation.

scholarly journals Clinical and Laboratory Profiles of 75 Hospitalized Patients with Novel Coronavirus Disease 2019 in Hefei, China

2020 ◽  
Author(s):  
Zonghao Zhao ◽  
Jiajia Xie ◽  
Ming Yin ◽  
Yun Yang ◽  
Hongliang He ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Effectiveness ◽  
Antiviral Treatment ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Nasopharyngeal Swab ◽  
The Novel ◽  
Reactive Protein ◽  
Cell Counts ◽  
Novel Coronavirus

AbstractThe outbreak of the novel coronavirus disease 2019 (COVID-19) infection began in December 2019 in Wuhan, and rapidly spread to many provinces in China. The number of cases has increased markedly in Anhui, but information on the clinical characteristics of patients is limited. We reported 75 patients with COVID-19 in the First Affiliated Hospital of USTC from Jan 21 to Feb 16, 2020, Hefei, Anhui Province, China. COVID-19 infection was confirmed by real-time RT-PCR of respiratory nasopharyngeal swab samples. Epidemiological, clinical and laboratory data were collected and analyzed. Of the 75 patients with COVID-19, 61 (81.33%) had a direct or indirect exposure history to Wuhan. Common symptoms at onset included fever (66 [88.0%] of 75 patients) and dry cough (62 [82.67%]). Of the patients without fever, cough could be the only or primary symptom. The most prominent laboratory abnormalities were lymphopenia, decreased percentage of lymphocytes (LYM%), decreased CD4+ and CD8+ T cell counts, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients with elevated interleukin 6 (IL-6) showed significant decreases in the LYM%, CD4+ and CD8+ T cell counts. Besides, the percentage of neutrophils, CRP, LDH and Procalcitonin levels increased significantly. We concluded that COVID-19 could cause different degrees of hematological abnormalities and damage of internal organs. Hematological profiles including LYM, LDH, CRP and IL-6 could be indicators of diseases severity and evaluation of treatment effectiveness. Antiviral treatment requires a comprehensive and supportive approach. Further targeted therapy should be determined based on individual clinical manifestations and laboratory indicators.

scholarly journals The impact of COVID-19 pandemic on the treatment of acute appendicitis in China

2021 ◽  
Author(s):  
ZhiXue Zheng ◽  
Jing Tao Bi ◽  
Ya Qi Liu ◽  
Xuan Cai
Keyword(s):  
Acute Appendicitis ◽  
White Blood Cells ◽  
Onset Time ◽  
The Novel ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Number Of Patients ◽  
Hospital Visits ◽  
Novel Coronavirus ◽  
The Impact

Abstract Objective This research aims to analyze the impact of the novel coronavirus pandemic on the hospital visits of patients with acute appendicitis. Methods The retrospective analysis was designed to look at the treatment of acute appendicitis in the Department of General Surgery in Beijing Jishuitan Hospital before and during the COVID-19 pandemic (2019–2020). Data was analyzed by the numbers of patients, sex, age, onset time, fever or not, laboratory examination, imaging test, and treatment. And we analyzed the differences between the “pre-COVID group” and “during-COVID group”. Results Compared with the year 2019, the number of acute appendicitis patients has diminished substantially during the COVID-19 pandemic (2020), but the number elevated with the control of the pandemic. Even if we did not find the differences of the treatment before and during the pandemic (P = 0.932), the onset time to emergency was significantly longer (P < 0.001), and more patients had showed fever (P < 0.001) during the COVID-19 pandemic. And the total number of white blood cells and C reactive protein level were significantly higher in 2020 than those in 2019 (P = 0.006, 0.003). And the same result was found in patients with appendiceal fecalith (P = 0.047). Conclusion During the pandemic of the new coronavirus pneumonia, the number of patients with acute appendix treatment dropped significantly, mainly because it took longer than before, and the condition was more severe. It can be seen that the new coronary pneumonia has a great impact on the patients’ medical treatment behavior, and the active prevention and treatment of the new coronavirus pneumonia is currently an important and urgent issue.

Clinical cases of eculizumab use as a part of complex therapy in patients with severe COVID-19.

2021 ◽  
Author(s):  
Р.А. Майер ◽  
Б.А. Бакиров ◽  
А.А. Набиева ◽  
Д.А. Кудлай
Keyword(s):  
Virus Disease ◽  
Membrane Attack Complex ◽  
Lung Ventilation ◽  
Blood Analysis ◽  
The Novel ◽  
Reactive Protein ◽  
Corona Virus ◽  
Complex Therapy ◽  
Novel Coronavirus ◽  
Clinical Cases

Введение. В последние 2 года серьезной проблемой для всего мирового сообщества стало распространение новой коронавирусной (CoV) инфекции COVID-19 (COrona VIrus Disease-2019). Ввиду сложившихся событий в лечении COVID-19 активно стали применяться новые молекулы и уже зарегистрированные лекарственные препараты, доказавшие свою эффективность при других заболеваниях. Цель исследования: оценить эффективность применения препарата экулизумаб у пациентов с тяжелой формой течения COVID-19. Материалы и методы. Проанализированы 3 клинических случая применения препарата экулизумаб в составе комплексной терапии у пациентов с тяжелой формой течения COVID-19. Для оценки эффективности лечения проводился мониторинг основных клинико-лабораторных показателей, а также показателей, характеризующих воспалительный процесс при коронавирусной инфекции: общий анализ крови, биохимический анализ крови, проанализированы уровни таких показателей как ферритин, С-реактивный белок, интерлейкин-6, лактатдегидрогеназа и мембраноатакующий комплекс. Результаты. На фоне проводимой терапии выявлено снижение концентрации основных маркеров воспаления относительно исходных значений. Заключение. Комплексная терапия, включающая экулизумаб, облегчает течение заболевания, позволяет сократить длительность пребывания пациентов в отделении реанимации и интенсивной терапии, укорачивает срок их пребывания на искусственной вентиляции легких, тем самым снижая процент летальности. Background. In the past two years, the incidence of the novel coronavirus (CoV) infection COVID-19 (COrona Virus Disease-2019) has been a serious problem for the global community. Considering these circumstances, new molecules and already registered drugs that have proven their effectiveness in other diseases, began to be actively used in COVID-19 treatment. Objectives: to assess the effi cacy of eculizumab in patients with severe COVID-19. Patients/Methods. Three clinical cases of eculizumab use as a part of complex therapy in patients with severe COVID-19 have been analyzed. To assess the treatment efficacy, the main clinical and laboratory parameters and indicators of inflammatory process in coronavirus infection were monitored (clinical blood analysis, biochemical blood test, levels of ferritin, C-reactive protein, interleukin-6, lactate dehydrogenase and membrane attack complex). Results. Under the therapy we found the reduction of concentration of the main inflammation markers relative to the initial values. Conclusions. Complex therapy with eculizumab facilitates the course of the disease, reduces the stay duration of patients in the intensive care unit, shortens the period of artificial lung ventilation, thereby reducing the mortality rate.

Management of non-conventional risk factors

2020 ◽  
pp. 111-116
Author(s):  
Roberto Pedretti
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Chronic Kidney Disease ◽  
High Sensitivity ◽  
Controlled Trials ◽  
Reactive Protein ◽  
Prognostic Implications ◽  
Hs Crp ◽  
Worse Prognosis ◽  
Conventional Risk Factors

Evidence supports the association of some non-conventional or yet to be established risk factors (RFs), such as serum uric acid (UA) or high-sensitivity C-reactive protein (hs-CRP), with the risk of arterial hypertension (HTN), metabolic syndrome, and chronic kidney disease and a worse prognosis in patients with known coronary vascular disease (CVD). However, there is no evidence from randomized controlled trials to support their use in guiding therapy. In the secondary prevention setting, detection of peripheral vascular damage and kidney dysfunction may provide significant additional prognostic implications.

Narrative Dynamics, Perspective-Taking, and Engagement

2017 ◽  
Author(s):  
Hanna Meretoja
Keyword(s):  
Perspective Taking ◽  
Ethical Issues ◽  
Critical Distance ◽  
Narrative Form ◽  
The Novel ◽  
Life World ◽  
Knowing That ◽  
The Holocaust ◽  
Conditions Of Possibility ◽  
Ethical Significance

Chapter 6 addresses the ethical issues involved in engaging with the perpetrator’s perspective by analyzing Jonathan Littell’s Les Bienveillantes (2006, The Kindly Ones). It discusses imaginative resistance, difficult empathy, and identification in relation to readerly engagement and perspective-taking. The chapter shows how the interplay between immersiveness and critical distance can produce a narrative dynamic that allows the reader to engage emotionally—but without uncritically adopting the protagonist’s perspective—with an ethically problematic life-world. It analyzes how the novel performatively shows, through the breakdown of narrative mastery, that no exhaustive comprehension is possible. In relation to different logics of narrative, the chapter articulates the ethical significance of self-reflexive narrative form and relates the hermeneutic notion of docta ignorantia—knowing that one does not know—to the novel’s way of dealing with the conditions of possibility of the Holocaust and with the limits of understanding, representing, and narrating it.

Rational Anemia Diagnostics and Therapy Control of Pediatric Patients Employing the Novel Hemaplot and Thomasplot

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5384-5384
Author(s):  
Andreas Weimann ◽  
Andreas Lun ◽  
Gerhard Gaedicke
Keyword(s):  
Pediatric Patients ◽  
Binding Capacity ◽  
Correct Diagnosis ◽  
The Novel ◽  
Graphical Data ◽  
Therapeutic Decisions ◽  
General Practioner ◽  
The Right ◽  
A Prospective Study ◽  
Iron Binding Capacity

Abstract “Anemia” is one of the most frequent diagnoses during childhood. For the choice of the right therapy an exact diagnosis is a prerequisite. Due to numerous and rather diverse pathophysiological etiologies of anemia and different mechanisms of compensation of the organism, establishing the correct diagnosis might turn out to be rather difficult for the general practioner as well as for the hospital doctor. Within a prospective study the routine blood counts of 100 anemic pediatric patients were measured at ten time points per patient with SYSMEX XE-2100 blood analyzer including the parameters Hb, MCV, MCH, Ret-Hb, delta-Hb and RPI. Plasma samples were checked for transferrin, iron binding capacity, sTfR, Ferritin and CRP levels. The EXPERTviewer was used for transmitting the numerical and graphical data to the clinician. The “Hemaplot” (Ret-Hb versus delta-Hb) as well as the “Thomasplot” (Ret-Hb versus Ferritin-Index) and all regular scatterplots and histograms were conveyed. Preliminary data show that the Thomasplot and Hemaplot help to distinguish hyperregenerative anemias and nutritive or deficiency types. The plots also proved to be helpful in identifiying hyporegenerative as well as congenital and aquired forms of anemia. Thomasplot and Hemaplot might help to better understand pathophysiology of anemias and thus to make rational therapeutic decisions easier and more efficient.

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