scholarly journals Anaemia is Associated with Severe Illness in COVID-19: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Zheying Tao ◽  
Mingyu Liu ◽  
Jingyi Wu ◽  
Jing Xu ◽  
Wei Chen ◽  
...  

Abstract Background and objective:Anaemia commonly aggravates the severity of respiratory diseases, whereas thus far, no study has elucidated the impact of anaemiaonCorona Virus Disease 2019(COVID-19). The aim of this study was to evaluate the clinical characteristics of patients with anaemia, and to further explore the relationship between anaemiaand the severity of COVID-19.METHODS:In this single-center, retrospective, observational study, a total of 222 patients were recruited, including 79 patients with anaemia and 143 patients without anaemia. Clinical characteristics, laboratory findings, disease progression and prognosis were collected and analyzed. Risk factors associated with the severe illness in COVID-19were established by univariable and multivariable logistic regression models.Result:In our cohort, compared to patients without anaemia, patients with anaemia were more likely to experience one or more comorbidities and severe COVID-19 illness, as well as higher mortality. More patients demonstrated elevated levels of C-reactive protein (CRP), procalcitonin(PCT) and creatinine in anaemia group. Levels of erythrocyte sedimentation rate(ESR), D-dimer, myoglobin, T-pro brain natriuretic peptide(T-pro-BNP) and urea nitrogen(BUN)in patients with anaemia were significantly higher than those without. In addition,the proportion of patients with dyspnoea,elevated CRP and PCT was positively associated with the severity of anaemia. The Odd Ratio (OR) of anaemia related to the severe condition of COVID-19 was 5.07 (95% CI:1.82-14.18, P=0.002) and 3.47 (95% CI:1.02-11.75, P=0.046) after adjustment for baseline date and laboratory indices, respectively.Conclusion:Anaemia is an independent risk factor associated with the severe illness of COVID-19, and healthcare professionals should be more sensitive to the haemoglobin levels of COVID-19 patients on admission. To avoid rapid deterioration, more intensive care should be given to patients with anaemia.Trial registration: Ethics committee of Wuhan University People's Hospital (wdry2020-k064)

2017 ◽  
pp. 81-85
Author(s):  
G. L. IGNATOVA ◽  
V. N. ANTONOV

The article discusses the problem of COPD combined with CAD, determination of inflammatory markers and the prognostic BODE, DOSE and ADO indices. The aim of the study was to evaluate the effect of PCV13 immunization on clinical and functional manifestations of systemic inflammation in patients with COPD and CAD, as well as the relationship with the prognostic markers. Material and methods: The study included 36 male patients with COPD and 36 patients with COPD and CAD, FC II-III stable angina who were treated at Regional Clinical Hospital _4 in Chelyabinsk during the period 2015--2016. Conclusions: 1. Patients with COPD combined with CAD had statistically significant clinical and functional disorders manifested by an increase in the degree of dyspnea and reduction in FEV1. 2. In patients with COPD concomitant with CAD, against the background of the comorbidities, the levels of systemic inflammation markers — C-reactive protein, fibrinogen and procalcitonin — were more overt than in patients only with COPD. 3. Monitoring changes in procalcitonin levels could be used as an additional highly informative method for estimating the probability of the presence of bacterial inflammation and effectiveness of therapy. 4. The prognostic BODE, DOSE and ADO indices tend to decrease unidirectionally under the impact of vaccination with pneumococcal conjugate vaccine. 5. PCV13 can reduce the level of systemic inflammation within 1 year after its application.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not. Methods This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. Results 303 were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p < 0.01), had a higher fatality rate (14.5% vs. 3.8%, p < 0,01), had more hypertension (72.4% vs. 44%, p < 0,01) and diabetes (31.9% vs. 21%, p = 0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p < 0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p = 0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-Reactive-Protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-Reactive-Protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p < 0.01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.


2016 ◽  
Vol 9 (3) ◽  
pp. 63 ◽  
Author(s):  
Hassan Naji

<p><strong>OBJECTIVE: </strong>The main objective of the study was to investigate the role of C-reactive protein on the relationship between Bisphenol A &amp; Cardiovascular Disease, where the C-reactive protein has been taken as a moderating variable.</p><p><strong>METHODS: </strong>Quantitative research design has been incorporated for evaluating the role of C-reactive protein. Similarly, non-parametric Spearman correlation test has been conducted to assess the relationship between BPA and CVD. The data was taken out from the National Health and Nutrition Examination Survey (NHANES), which was collected in the year 2009-2010.</p><p><strong>RESULTS: </strong>The impact of urinary Bisphenol A on serum C-reactive protein was found statistically significant according to the Spearman correlation coefficient, <em>r</em>s<em>= </em>.06, <em>p </em>= .015. The scatter plots found that there is no relationship between the two variables; this observation held true after filtering the outliers from the plot.</p><p><strong>CONCLUSION:</strong> The results might have positive change by contributing to the body of knowledge on bisphenol A and by rising scientific examination of substances used by the people in the daily life. Further research to identify other possible causes of CVD and elevation of CRP is recommended.</p>


2020 ◽  
Author(s):  
Wen Luo ◽  
Yihua Lin ◽  
Xiangyang Yao ◽  
Yonghong Shi ◽  
Fang Lu ◽  
...  

Abstract Objective: We sought to investigate the clinical characteristics of patients with novel coronavirus pneumonia in Xiamen, which is a city in Fujian Province, China. Methods: From January 20, 2020, to March 4, 2020, the clinical characteristics of all patients confirmed with novel coronavirus pneumonia admitted to the First Affiliated Hospital of Xiamen University, which was the only designated hospital for cases of novel coronavirus pneumonia in Xiamen, were analyzed. Results: A total of 35 cases of novel coronavirus pneumonia were confirmed. Patients were divided into the general-ward admission group and the intensive-care-unit (ICU) admission group. The most commonly observed symptoms were fever (80%), cough (51%), expectoration (28%), and fatigue (23%). Compared with patients in the general-ward group, patients in the ICU group had a higher maximum body temperature, a longer duration of fever after admission, and more symptoms of systemic pain. Considering the laboratory findings, patients in the ICU group exhibited lower peripheral blood lymphocyte ratios and lymphocyte counts but higher C-reactive protein and lactate dehydrogenase levels. All patients were discharged without death, and no patients required invasive ventilation, continuous renal replacement therapy, or extracorporeal membrane oxygenation. Conclusion: Relative to patients with novel coronavirus pneumonia in Wuhan, the cases in Xiamen were less severe.


2021 ◽  
Author(s):  
Sahar Sobhani ◽  
Reihaneh Aryan ◽  
Elham Kalantari ◽  
Salman Soltani ◽  
Nafise Malek ◽  
...  

AbstractCoronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza hospital, northeast of Iran. Clinical and laboratory features were evaluated among survivors and non-survivors. The correlation between variables and duration of hospitalization and admission to the Intensive Care Unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived (p = 0.017). It was also related to a shorter stay in the hospital (p = 0.032) as opposed to patients who experienced chest pain (p = 0.033). Decreased levels of consciousness and dyspnea were statistically more frequent in non-survivors (p = 0.003 and p = 0.011, respectively). Baseline white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in non-survivors (p < 0.001). Patients with higher WBC and CRP levels were more likely to be admitted to ICU (p = 0.009 and p = 0.001, respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.


2020 ◽  
Vol 16 (1) ◽  
pp. 7-14 ◽  
Author(s):  
David M Nemer ◽  
Bryan R Wilner ◽  
Alicia Burkle ◽  
Jose Aguilera ◽  
Joseph Adewumi ◽  
...  

BACKGROUND: The clinical characteristics and outcomes associated with non–intensive care unit (non-ICU) hospitalizations for coronavirus disease 2019 (COVID-19) outside disease epicenters remain poorly characterized. METHODS: Systematic analysis of all non-ICU patient hospitalizations for COVID-19 completing discharge between March 13 and May 1, 2020, in a large US health care system utilizing off-site central monitoring. Variables of interest were examined in relation to a composite event rate of death, ICU transfer, or increased oxygen requirement to high-flow nasal cannula, noninvasive ventilation, or mechanical ventilation. RESULTS: Among 350 patients (age, 64 ± 16 years; 55% male), most (73%) required 3 L/min or less of supplemental oxygen during admission. Telemetry was widely utilized (79%) yet arrhythmias were uncommon (14%) and were predominantly (90%) among patients with abnormal troponin levels or known cardiovascular disease. Ventricular tachycardia was rare (5%), nonsustained, and not associated with hydroxychloroquine/azithromycin treatment. Adverse events occurred in 62 patients (18%), including 22 deaths (6%), 48 ICU transfers (14%), and 49 patients with increased oxygen requirement (14%) and were independently associated with elevated C-reactive protein (odds ratio, 1.09 per 1 mg/dL; 95% CI, 1.01-1.18; P = .04) and lactate dehydrogenase (OR, 1.006 per 1U/L; 95% CI, 1.001-1.012; P = .03) in multivariable analysis. CONCLUSION: Among non–critically ill patients hospitalized within a nonepicenter health care system, overall survival was 94% with the development of more severe illness or death independently associated with higher levels of C-reactive protein and lactate dehydrogenase on admission. Clinical decompensation was largely respiratory-related, while serious cardiac arrhythmias were rare, which suggests that telemetry can be prioritized for high-risk patients.


2020 ◽  
Vol 148 ◽  
Author(s):  
Puyu Shi ◽  
Guoxia Ren ◽  
Jun Yang ◽  
Zhiqiang Li ◽  
Shujiao Deng ◽  
...  

Abstract The mortality of coronavirus disease 2019 (COVID-19) differs between countries and regions. This study aimed to clarify the clinical characteristics of imported and second-generation cases in Shaanxi. This study included 134 COVID-19 cases in Shaanxi outside Wuhan. Clinical data were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. In total, 34.3% of the 134 patients were severe cases, 11.2% had complications. As of 7 March 2020, 91.8% patients were discharged and one patient (0.7%) died. Age, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, direct bilirubin, lactate dehydrogenase and hydroxybutyrate dehydrogenase showed difference between severe and no-severe cases (all P < 0.05). Baseline lymphocyte count was higher in survived patients than in non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The interleukin-6 (IL-6) level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest computed tomography images in 51.5% of the pneumonia cases. Imported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account.


2020 ◽  
Vol 5 (3) ◽  
pp. 279-284 ◽  
Author(s):  
Yanan Li ◽  
Man Li ◽  
Mengdie Wang ◽  
Yifan Zhou ◽  
Jiang Chang ◽  
...  

Background and purposeCOVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection.Materials and methodsDemographic and clinical characteristics, laboratory findings, treatments and clinical outcomes were collected and analysed. Clinical characteristics and laboratory findings of patients with COVID-19 with or without new-onset CVD were compared.ResultsOf 219 patients with COVID-19, 10 (4.6%) developed acute ischaemic stroke and 1 (0.5%) had intracerebral haemorrhage. COVID-19 with new onset of CVD were significantly older (75.7±10.8 years vs 52.1±15.3 years, p<0.001), more likely to present with severe COVID-19 (81.8% vs 39.9%, p<0.01) and were more likely to have cardiovascular risk factors, including hypertension, diabetes and medical history of CVD (all p<0.05). In addition, they were more likely to have increased inflammatory response and hypercoagulable state as reflected in C reactive protein (51.1 (1.3–127.9) vs 12.1 (0.1–212.0) mg/L, p<0.05) and D-dimer (6.9 (0.3–20.0) vs 0.5 (0.1–20.0) mg/L, p<0.001). Of 10 patients with ischemic stroke; 6 received antiplatelet treatment with aspirin or clopidogrel; and 3 of them died. The other four patients received anticoagulant treatment with enoxaparin and 2 of them died. As of 24 March 2020, six patients with CVD died (54.5%).ConclusionAcute CVD is not uncommon in COVID-19. Our findings suggest that older patients with risk factors are more likely to develop CVD. The development of CVD is an important negative prognostic factor which requires further study to identify optimal management strategy to combat the COVID-19 outbreak.


2020 ◽  
Vol 161 (50) ◽  
pp. 2117-2123
Author(s):  
András Bikov ◽  
Martina Mészáros ◽  
László Kunos

Összefoglaló. Bevezetés és célkitűzés: Az obstruktív alvási apnoe (OSA) a felnőtt lakosság jelentős részét érintő betegség, mely ismert rizikófaktora a cardiovascularis és metabolicus betegségeknek és a korai halálozásnak. Mindazonáltal kevés magyarországi adat áll rendelkezésre az OSA-ban szenvedő betegek demográfiai és klinikai jellemzőiről, így vizsgálatunk célja ennek bemutatása volt. Módszer: Retrospektív vizsgálatunkban a Semmelweis Egyetem Pulmonológiai Klinikájának Alváslaboratóriumában kivizsgált 394 személy (58 [46–66] év, 73% férfi, testtömegindex [BMI] = 32,5 [29,2–37,5]) adatait elemeztük, akik kitöltötték az Epworth Álmosság Skálát, poliszomnográfiás vizsgálaton estek át; felvettük az anamnézist, és 255 esetben reggeli éhomi vérvétel történt. Eredmények: 282 esetben igazolódott OSA. Ebben a csoportban magasabb volt a férfiak aránya (66 vs. 35%), magasabb volt az életkor (59 [48–66] vs. 47 [39–60] év) és a BMI (32,11 [27,78–37,18] vs. 25,29 [22,04–29,03] kg/m2), magasabbak voltak a C-reaktív protein értékek (3,0 [1,71–5,34] mg/l vs. 1,71 [0,91–3,31] mg/l), illetve a betegek gyakrabban szenvedtek társbetegségekben a kontrollcsoporthoz képest (magas vérnyomás 74% vs. 39%, cukorbetegség 24% vs. 11%, dyslipidaemia 46% vs. 30%, szív- és érrendszeri betegség 22% vs. 5%, szívritmuszavar 27% vs. 16%; minden p<0,05). Bár az OSA valószínűsége progresszívan nőtt az életkorral és az Epworth Álmosság Skála emelkedésével, a trendekben szignifikáns különbségeket észleltünk a férfiak és a nők között (mindkettő p<0,05). Ezzel szemben az OSA valószínűségének BMI-függése nemektől független volt (p = 0,94). Következtetés: Az OSA valószínűsége progresszívan emelkedik a kor, a BMI és a nappali aluszékonyság függvényében, ugyanakkor ezt befolyásolja a nem is. Közleményünk rámutat a társbetegségek szűrésének fontosságára is az OSA különböző súlyossági fokaiban. Orv Hetil. 2020; 161(50): 2117–2123. Summary. Introduction and objective: Obstructive sleep apnoea (OSA) is a common disease which is a known risk factor for cardiovascular and metabolic disease and mortality as well. However, the demographic and clinical characteristics of Hungarian patients with OSA are less known. The aim of this study was to describe them. Method: We analysed the data of 394 subjects (58 [46–66] years, 73% male, body mass index [BMI] = 32.5 [29.2–37.5]) who attended the Sleep Laboratory of the Department of Pulmonology at Semmelweis University. The volunteers filled out the Epworth Sleepiness Scale, we performed a polysomnography and took medical history. In 255 subjects, fasting blood samples were collected. Results: OSA was diagnosed in 282 cases. This group had higher proportion of males (66 vs. 35%) and comorbidities (hypertension 74% vs. 39%, diabetes 24% vs. 11%, dyslipidaemia 46% vs. 30%, cardiovascular diseases 22% vs. 5%, arrhythmia 27% vs. 16%), the patients were older (59 [48–66] vs. 47 [39–60] years) and had higher BMI (32.11 [27.78–37.18] vs. 25.29 [22.04–29.03] kg/m2) and C-reactive protein levels (3.0 [1.71–5.34] mg/l vs. 1.71 [0.91–3.31] mg/l, all p<0.05). There was a significant relationship between the propensity of OSA along increasing age, BMI and Epworth Sleepiness Scale; however, the relationship depended on gender for age and Epworth Sleepiness Scale (both p<0.05). Conclusion: The propensity of OSA increases with age, BMI and symptoms burden and it is affected by the gender. Our study highlights the importance of screening comorbidities in different severity grades of OSA. Orv Hetil. 2020; 161(50): 2117–2123.


2020 ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study aims to offer a comparative description of the COVID-19 patients, admitted to a general ward for a non-critical clinical picture, who required or not to be transferred to the intensive (ICU) and/or sub-intensive care (SICU) units. Methods This observational retrospective study included all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined Group 1; patients who were transferred to the ICU and/or SICU are defined Group 2. Demographic and clinical characteristics were compared between the two groups. Results 303 patients were included. Median age was 62 years. 69 patients (22,8%) met the primary outcome and were defined Group 2. The overall mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5% vs. 3,8%, p<0,01), had more hypertension (72,4% vs. 44%, p<0,01) and diabetes (31,9% vs. 21%, p=0,04) and were more likely to present dry cough (49,3% vs. 25,2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63,2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs. 17,2%, p<0,01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0,01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.


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