scholarly journals Identification of risk factors for the severity of coronavirus disease 2019: a retrospective study of 163 hospitalized patients

2020 ◽  
Author(s):  
Ye Tu ◽  
Ping Yang ◽  
Jingjing Wang ◽  
Xuebi Tian ◽  
Kai Wang ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Curve Analysis ◽  
Severe Illness ◽  
Dynamic Changes ◽  
Factors Associated ◽  
Multivariable Regression ◽  
Operating Characteristic Curve ◽  
D Dimer

Abstract Background: To compare clinical features between moderate and severe cases with COVID-19, and screen factors associated with disease severity.Methods: Demographic and clinical data were compared between moderate and severe cases. Logistic regression was performed for prognostic factors.Results: 163 patients (median age 65.0 (56.8-71.0) years, 78 (47.9%) females) were enrolled, including 87 (53.4%) severe and 76 (46.6%) moderate cases. 79 (90.8%) severe and 59 (77.6%) moderate cases had comorbidities, with hypertension and diabetes commonly presented. The most common symptoms were fever. Severe cases had higher lactate dehydrogenase (LDH), inflammatory cytokines and lymphopenia, eosinopenia on admission, and lower eosinophil and higher neutrophil counts from admission to day 13 and 19. Multivariable regression showed that neutrophilia, eosinopenia, high LDH and D-dimer were associated with severe COVID-19. In receiver operating characteristic curve analysis, LDH, eosinophil and neutrophil + eosinophil + LDH + D-dimer combination, with area under curve of 0.86, 0.76 and 0.93, predicted severe illness with high sensitivity (82.8%, 83.3%, 88.0%) and specificity (68.4%, 84.2%, 81.3%).Conclusions: Eosinopenia, higher LDH and neutrophil + eosinophil + LDH + D-dimer combination on admission were powerful indicators of severe COVID-19. Dynamic changes of neutrophils and eosinophils may be used to evaluate disease progression.

scholarly journals Identification of risk factors for the severity of coronavirus disease 2019: a retrospective study of 163 hospitalized patients

2020 ◽  
Author(s):  
Ye Tu ◽  
Ping Yang ◽  
Jingjing Wang ◽  
Xuebi Tian ◽  
Kai Wang ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Curve Analysis ◽  
Severe Illness ◽  
Dynamic Changes ◽  
Factors Associated ◽  
Multivariable Regression ◽  
Operating Characteristic Curve ◽  
D Dimer

Abstract Background: To compare clinical features between moderate and severe cases with COVID-19, and screen factors associated with disease severity.Methods: Demographic and clinical data were compared between moderate and severe cases. Logistic regression was performed for prognostic factors.Results: 163 patients (median age 65.0 (56.8-71.0) years, 78 (47.9%) females) were enrolled, including 87 (53.4%) severe and 76 (46.6%) moderate cases. 79 (90.8%) severe and 59 (77.6%) moderate cases had comorbidities, with hypertension and diabetes commonly presented. The most common symptoms were fever. Severe cases had higher lactate dehydrogenase (LDH), inflammatory cytokines and lymphopenia, eosinopenia on admission, and lower eosinophil and higher neutrophil counts from admission to day 13 and 19. Multivariable regression showed that neutrophilia, eosinopenia, high LDH and D-dimer were associated with severe COVID-19. In receiver operating characteristic curve analysis, LDH, eosinophil and neutrophil + eosinophil + LDH + D-dimer combination, with area under curve of 0.86, 0.76 and 0.93, predicted severe illness with high sensitivity (82.8%, 83.3%, 88.0%) and specificity (68.4%, 84.2%, 81.3%).Conclusions: Eosinopenia, higher LDH and neutrophil + eosinophil + LDH + D-dimer combination on admission were powerful indicators of severe COVID-19. Dynamic changes of neutrophils and eosinophils may be used to evaluate disease progression.

scholarly journals Abnormal myocardial enzymes are important indicators of poor prognosis in COVID-19 patients

2021 ◽  
Author(s):  
Jingping Cheng ◽  
Wanxin Liu ◽  
Siyang Chen ◽  
Xiafen Hu ◽  
Xiaochen Xiang ◽  
...  
Keyword(s):  
Continuous Monitoring ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Curve Analysis ◽  
Clinical Classification ◽  
Dynamic Changes ◽  
Operating Characteristic Curve ◽  
Patient’S Outcome ◽  
Myocardial Enzymes

Objective: Researching the prognostic value of myocardial enzymes in COVID-19 patients. Materials & methods: We collected 113 confirmed COVID-19 patients. The dynamic changes of CK, LDH and α-HBDH in patients were studied retrospectively, the correlation between myocardial enzyme index, clinical classification and outcome of patients and its significance to prognosis. Results: There are significant statistical differences between LDH, α-HBDH, CK and the clinical classification, and patient’s outcome. In the receiver operating characteristic curve analysis, LDH, α-HBDH and CK have a good diagnostic value for the death outcome of patients. Conclusion: LDH, α-HBDH and CK were the components of myocardial enzyme profiles, and our results found that they were significantly positively correlated with clinical classification and prognosis of COVID-19 patients. The values of LDH, α-HBDH and CK increased with the increase of the severity of admission clinical classification and the deterioration of outcome. Therefore, we propose that continuous monitoring of LDH, α-HBDH and CK indicators can warn the deterioration of COVID-19 to a certain extent, regardless of whether patients with cardiovascular diseases are combined or not, and prompt early intervention.

Serum miR-21 and miR-26a Levels Negatively Correlate with Severity of Cirrhosis in Patients with Chronic Hepatitis B

MicroRNA ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Shili Jiang ◽  
Wei Jiang ◽  
Ying Xu ◽  
Xiaoning Wang ◽  
Yongping Mu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Pugh Class ◽  
Operating Characteristic Curve ◽  
Class C ◽  
Circulating Levels

Background and Objective: Accurately evaluating the severity of liver cirrhosis is essential for clinical decision making and disease management. This study aimed to evaluate the value of circulating levels of microRNA (miR)-26a and miR-21 as novel noninvasive biomarkers in detecting severity of cirrhosis in patients with chronic hepatitis B. </P><P> Methods: Thirty patients with clinically diagnosed chronic hepatitis B-related cirrhosis and 30 healthy individuals were selected. The serum levels of miR-26a and miR-21 were quantified by qRT-PCR. Receiver operating characteristic curve analysis was performed to evaluate the sensitivity and specificity of the miRNAs for detecting the severity of cirrhosis. Results: Serum miR-26a and miR-21 levels were found to be significantly downregulated in patients with severe cirrhosis scored at Child-Pugh class C in comparison to healthy controls (miR-26a p<0.01, and miR-21 p<0.001, respectively). The circulating miR-26a and miR-21 levels in patients were positively correlated with serum albumin concentration but negatively correlated with serum total bilirubin concentration and prothrombin time. Receiver operating characteristic curve analysis revealed that both serum miR-26a and miR-21 levels were associated with a high diagnostic accuracy for patients with cirrhosis scored at Child-Pugh class C (miR-26a Cut-off fold change at ≤0.4, Sensitivity: 84.62%, Specificity: 89.36%, P<0.0001; miR-21 Cut-off fold change at ≤0.6, Sensitivity: 84.62%, Specificity: 78.72%, P<0.0001). Our results indicate that the circulating levels of miR-26a and miR-21 are closely related to the extent of liver decompensation, and the decreased levels are capable of discriminating patients with cirrhosis at Child-Pugh class C from the whole cirrhosis cases.

A validated novel preoperative index to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology: A cohort study

2019 ◽  
Vol 30 (7-8) ◽  
pp. 221-228
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh ◽  
Nicholas Hobbs ◽  
Jigar Shah ◽  
Matthew Harris ◽  
...  
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Emergency Laparotomy ◽  
Contamination Index ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Aims To investigate whether an intraperitoneal contamination index (ICI) derived from combined preoperative levels of C-reactive protein, lactate, neutrophils, lymphocytes and albumin could predict the extent of intraperitoneal contamination in patients with acute abdominal pathology. Methods Patients aged over 18 who underwent emergency laparotomy for acute abdominal pathology between January 2014 and October 2018 were randomly divided into primary and validation cohorts. The proposed intraperitoneal contamination index was calculated for each patient in each cohort. Receiver operating characteristic curve analysis was performed to determine discrimination of the index and cut-off values of preoperative intraperitoneal contamination index that could predict the extent of intraperitoneal contamination. Results Overall, 468 patients were included in this study; 234 in the primary cohort and 234 in the validation cohort. The analyses identified intraperitoneal contamination index of 24.77 and 24.32 as cut-off values for purulent contamination in the primary cohort (area under the curve (AUC): 0.73, P < 0.0001; sensitivity: 84%, specificity: 60%) and validation cohort (AUC: 0.83, P < 0.0001; sensitivity: 91%, specificity: 69%), respectively. Receiver operating characteristic curve analysis also identified intraperitoneal contamination index of 33.70 and 33.41 as cut-off values for feculent contamination in the primary cohort (AUC: 0.78, P < 0.0001; sensitivity: 87%, specificity: 64%) and validation cohort (AUC: 0.79, P < 0.0001; sensitivity: 86%, specificity: 73%), respectively. Conclusions As a predictive measure which is derived purely from biomarkers, intraperitoneal contamination index may be accurate enough to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology and to facilitate decision-making together with clinical and radiological findings.

scholarly journals AB0644 EVALUATION OF MONOCYTE TO HIGH-DENSITY LIPOPROTEIN RATIO AND CAROTID INTIMA MEDIA THICKNESS IN GOUT PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1355.1-1355
Author(s):  
C. Kadiyoran ◽  
A. Kucuk ◽  
H. Aydemir ◽  
A. U. Uslu
Keyword(s):  
High Density Lipoprotein ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Curve Analysis ◽  
High Density ◽  
Media Thickness ◽  
Operating Characteristic Curve

Background:The aim of this study is to investigate, evaluation of monocyte to high density liporotein ratio and carotid intima media thickness in gout patients.Objectives:Gout disease is an autoinflammatory disease caused by the accumulation of monosodium urate crystals (MSU) in tissues and organs due to hyperuricemia (1). It is a common cause of arthritis due to the changes in lifestyle and eating habits. The effects of the inflammatory process and hyperuricemia in gout are not limited to the joints, but are associated with increased atherosclerosis and cardiovascular disease (1,2) Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a systemic inflammatory marker and has recently been used quite widely for the evaluation of inflammation in cardiovascular disorders (3,4).Methods:Fourty eight patients who were evaluated in the rheumatology clinic with an arthritis attack and diagnosed with Gout, and 48 healthy individuals whose age, gender and body mass index were matched were included in our study. Basic laboratory and biochemical parameters of the period when gout patients were asymptomatic were examined. Carotid intima-media thickness (CIMT), which is a non-invasive procedure due to its widespread use, was used as a marker.Results:MHR and CIMT values were 18.22 ± 9.01 and 0.76 ± 0.11 mm in patients with gout. In the control group, it was 13.62 ± 4.48 and 0.65 ± 0.13 (p = 0.002, p <0.0001, respectively). When evaluated within the study group, it was found that there was a positive correlation between MHR and CIMT (r = 0.253, p = 0.013), and according to linear regression analysis, there was an independent relationship between MHR and CIMT (beta [β] = 0.293, p = 0.049). When assessing Gout patients in the study population, a cutoff value of 13.85 with sensitivity of 66 %, specificity of 53 %, and p = 0.011 (area under curve: 0.650, 95% confidence interval 0.540-0.760), was observed according to receiver-operating characteristic curve analysis (Figure 1).Figure 1.Receiver-operating characteristic curve analysis.Conclusion:This study showed us that MHR can be an inexpensive and easily accessible marker that can be used in the evaluation of atherosclerotic lesions. We think that studies with larger number of patients are needed on this subject.References:[1]Çukurova S, Pamuk ON, Unlu Ercument, Pamuk GE, Cakir NE. Subclinical atherosclerosis in gouty arthritis patients: a comparative study. Rheumatol Int. 2012 Jun; 3 2(6): 1769-73.[2]Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation 2007 Aug 21; 116 (8): 894-900.[3]McAdams-DeMarco MA, Maynard JW, Coresh J, Baer AN.Anemia and the onset of gout in a population-based cohort of adults: Atherosclerosis Risk in Communities study. Arthritis Res Ther. 2012 Aug 20; 14(4): R193.[4]Enhos A, Cosansu K, Huyut MA, Turna F, Karacop E, Bakshaliyev N, Nadir A, Ozdemir R, Uluganyan M. Assessment of the Relationship between Monocyte to High-Density Lipoprotein Ratio and Myocardial Bridge. Arq Bras Cardiol. 2019 Jan;112(1):12-17.Disclosure of Interests:None declared.

Diagnostic Value of CD4/CD8 in Scrub Typhus

2021 ◽  
Author(s):  
Kangkang Hong ◽  
Ziping Shu ◽  
Laodong Li ◽  
Yu Zhong ◽  
Weiqian Chen ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Bloodstream Infection ◽  
Operating Characteristic ◽  
Scrub Typhus ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Curve Analysis ◽  
Control Groups ◽  
Infection Group ◽  
Operating Characteristic Curve

Scrub typhus is often misdiagnosed in febrile patients, leading to antibiotic abuse and multiple complications. We conducted a retrospective record review at the Fourth Affiliated Hospital of Guangxi Medical University in China. Data were collected on 52 patients with a confirmed diagnosis of scrub typhus and complete clinical data. In addition, data were collected on 52 patients with bloodstream infection, 25 patients with HIV infection, 112 patients with common community-acquired pneumonia (CCAP), and 36 patients with severe community-acquired pneumonia (SCAP) to serve as control groups. The peripheral blood CD4 and CD8 counts, CD4/CD8 ratio, C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, creatinine, and β2 microglobulin levels; and the white blood cell count and neutrophil percentage were compared between the scrub typhus and the control groups. The value of these biomarkers in the diagnosis of scrub typhus was assessed using receiver–operating characteristic curve analysis. The scrub typhus group had a significantly lower CD4 count and CD4/CD8 ratio than the bloodstream infection, CCAP, and SCAP groups, and a significantly greater CD4 count and CD4/CD8 ratio than the HIV infection group. In contrast, the scrub typhus group had a significantly greater CD8 count than the bloodstream infection and CCAP and SCAP groups, and it had a lower level of CD8 than the HIV infection group. The areas under the curve of CD4/CD8 were more than 0.93 in the receiver–operating characteristic curve analysis. These findings suggest that the CD4/CD8 ratio is a useful ancillary test for diagnosing scrub typhus.

Predictors of thermal increase in magnetic resonance–guided focused ultrasound treatment for essential tremor: histogram analysis of skull density ratio values for 1024 elements

2021 ◽  
pp. 1-6
Author(s):  
Ken Iijima ◽  
Hajime Yokota ◽  
Toshio Yamaguchi ◽  
Masayuki Nakano ◽  
Takahiro Ouchi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Operating Characteristic ◽  
Focused Ultrasound ◽  
Characteristic Curve ◽  
Density Ratio ◽  
Predictive Ability ◽  
Curve Analysis ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Operating Characteristic Curve

OBJECTIVE Sufficient thermal increase capable of generating thermocoagulation is indispensable for an effective clinical outcome in patients undergoing magnetic resonance–guided focused ultrasound (MRgFUS). The skull density ratio (SDR) is one of the most dominant predictors of thermal increase prior to treatment. However, users currently rely only on the average SDR value (SDRmean) as a screening criterion, although some patients with low SDRmean values can achieve sufficient thermal increase. The present study aimed to examine the numerical distribution of SDR values across 1024 elements to identify more precise predictors of thermal increase during MRgFUS. METHODS The authors retrospectively analyzed the correlations between the skull parameters and the maximum temperature achieved during unilateral ventral intermediate nucleus thalamotomy with MRgFUS in a cohort of 55 patients. In addition, the numerical distribution of SDR values was quantified across 1024 elements by using the skewness, kurtosis, entropy, and uniformity of the SDR histogram. Next, the authors evaluated the correlation between the aforementioned indices and a peak temperature > 55°C by using univariate and multivariate logistic regression analyses. Receiver operating characteristic curve analysis was performed to compare the predictive ability of the indices. The diagnostic performance of significant factors was also assessed. RESULTS The SDR skewness (SDRskewness) was identified as a significant predictor of thermal increase in the univariate and multivariate logistic regression analyses (p < 0.001, p = 0.013). Moreover, the receiver operating characteristic curve analysis indicated that the SDRskewness exhibited a better predictive ability than the SDRmean, with area under the curve values of 0.847 and 0.784, respectively. CONCLUSIONS The SDRskewness is a more accurate predictor of thermal increase than the conventional SDRmean. The authors suggest setting the SDRskewness cutoff value to 0.68. SDRskewness may allow for the inclusion of treatable patients with essential tremor who would have been screened out based on the SDRmean exclusion criterion.

scholarly journals The Optimal Cutoff Value of D-dimer Levels to Predict in Hospital Mortality in Severe Cases of Coronavirus Disease 2019

2021 ◽  
Vol 9 (B) ◽  
pp. 1561-1564
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Hospital Mortality ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Operating Characteristic Curve ◽  
D Dimer

Introduction: Coronavirus disease 2019 (Covid-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. The purpose of this study is to determine the differences of D-dimer levels in severe cases of Covid-19 who survived and non-survived and determine the optimal cut-off value of D-dimer levels to predict in-hospital mortality. Method: Data were obtained from confirmed Covid-19 patients who were treated from June to September 2020. The Mann-Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cut-off value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve (ROC) method. Results: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 mg/ml; minimum – maximum: 0.939 – 50.000 mg/ml) compared to surviving patients (median 1.201 mg/ml; minimum – maximum: 0.302 – 29.425 mg/ml), p = 0.012. D-dimer levels higher than 1.500 mg/ml are the optimal cut-off value for predicting mortality in severe cases of Covid-19 with a sensitivity of 80.0%; specificity of 64.3%; and area under the curve of 0.754 (95% CI 0.586 - 0.921; p = 0.010). Conclusions: D-dimer levels can be used as a predictor of mortality in severe cases of Covid-19.

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