scholarly journals COVID-19 and Ischemic Stroke

2020 ◽  
Author(s):  
Amira Sidig ◽  
Khabab Abbasher ◽  
Hussien Abbasher ◽  
Radi Tofaha Alhusseini ◽  
Mohamed Elsayed ◽  
...  
Keyword(s):  
Case Report ◽  
Cerebrovascular Accident ◽  
Vascular Wall ◽  
C Reactive Protein ◽  
Brain Infarct ◽  
Reactive Protein ◽  
Increased Risk ◽  
Ct Brain ◽  
The Relationship ◽  
D Dimer

Abstract Background: SARS-CoV-2 causes COVID-19 disease. It was identified in December 2019 and rapidly evolved into a pandemic. During the outbreak of COVID-19, researches demonstrated its effect on many systems, including the nervous system. In our clinic, we have reported an impact of SARS-CoV-2, causing the ischaemic stroke.Case Report: A 62-year-old Sudanese male with some comorbidities brought to the A&E with fever, chest symptoms, and acute evolving left-sided hemiplegia power grade 0/5 MRCS with left upper motor neuron facial palsy. Investigations: CT brain: right middle cerebral artery MCA infarction. CT- chest: bilateral ground-glass appearance. COVID-19 Test was positive. elevated D-dimer and C-reactive protein.Discussion: A retrospective study of data from the COVID-19 outbreak in China showed that the incidence of stroke among hospitalized patients was approximately 5%. The fact that COVID-19 is an acute inflammatory condition associated with an increased incidence of fatty plaques formation, injury of the vascular wall, and hypercoagulability, causing brain infarct can be a reasonable hypothesis.ConclusionPatients with COVID-19 are at increased risk of thrombo-embolization, leading to arterial and venous cerebrovascular accident. This case report enhances the importance of further studies to clarify the relationship between stroke and COVID-19.

scholarly journals Case Report of Multisystem Inflammatory Syndrome in a Child Related to COVID-19

2021 ◽  
Vol 20 (2) ◽  
pp. 89-92
Author(s):  
Faisal Ahmed ◽  
Hasan Zahid ◽  
Moinul Hasan ◽  
Anwar Hossain ◽  
Md Arman Zaid ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Dysfunction ◽  
Digestive System ◽  
Multiple Organ ◽  
C Reactive Protein ◽  
Paediatric Ward ◽  
Reactive Protein ◽  
Ankle Joints ◽  
Inflammatory Syndrome ◽  
D Dimer

Background : Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition that appears to be linked to Coronavirus Disease 2019 (COVID-19). Most children who become infected with the COVID-19 virus have only a mild illness. Aim of this study to evaluate the children who go on to develop MIS-C, some organs and tissues-such as the heart, lungs, blood vessels, kidneys, digestive system, brain, joints, skin or eyes -become severely inflamed. Case Report : 11 years old girl admitted in Paediatric Ward of in Imperial Hospital Chattogram on 12 July 2020 with the complains of fever, loose motion, rash in hands, body and legs, swelling of the wrist and ankle joints which were associated with anorexia, nausea , vomiting and bodyache. For this reason the child was evaluated. Conclusion : Clinical features in children have varied but predominantly include cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-Reactive Protein (CRP) Ferritin, D-dimer and Interleukin-6. MIS-C can lead to shock and multiple organ failure requiring intensive care. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 89-92

scholarly journals High C-reactive protein/albumin ratio increased risk of acute malnutrition during hospitalization in pediatric patients

2020 ◽  
Vol 4 (3) ◽  
pp. 32-38
Author(s):  
I Gusti Lanang Sidiartha ◽  
Dyah Kanya Wati ◽  
Ida Bagus Subanada ◽  
I Gusti Ngurah Made Suwarba
Keyword(s):  
Pediatric Patients ◽  
Child Growth ◽  
Acute Malnutrition ◽  
Adjusted Relative Risk ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Increased Risk ◽  
The Relationship ◽  
Child Growth Standard

Pediatric patients with malnutrition commonly have poor prognosis related to the inflammation and catabolism state. This study investigated the relationship between high C-Reactive Protein/Albumin ratio on admission with the risk of acute malnutrition during hospitalization in pediatric patients. A cohort study in patients aged 1 month to 18 years old who met the study criteria was done. On admission, the level of serum C-Reactive Protein and Albumin were measured and calculated the C-Reactive protein/Albumin ratio which was divided into the high and low ratio. Acute malnutrition was determined according to the weight-for-height or body mass index-for-age z-score less than 2 SD below the WHO Child Growth Standard median.  A total of 110 patients were analyzed, 50% male and the mean aged was 77.7 months. Patients with acute malnutrition on admission and discharge were 24.5% and 32.7%, respectively. Acute malnutrition on discharge in patients with high and low ratio were 51.6% and 25.3%, respectively (adjusted Relative Risk, 9.1; 95% CI: 1. 9 to 42.7; p = 0.005). High C-Reactive Protein/Albumin ratio on admission increased the risk of acute malnutrition during hospitalization in pediatric patients.

scholarly journals Case Report: A Severe SARS-CoV-2 Infection in a Teenager With Angelman Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Alessandra G. D. Lopes ◽  
Camila S. H. Celestino ◽  
Tiago T. A. Barros ◽  
Aline G. Fevereiro ◽  
Debora H. Gejer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Angelman Syndrome ◽  
Neutralizing Antibodies ◽  
Present Report ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
D Dimer

Teenagers generally present mild to no symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In the present report, we present the case of a 14-year-old boy with Angelman syndrome (AS) who presented with severe COVID-19 symptoms. He spent 20 days in the ICU with elevated inflammatory biomarkers (C-reactive protein and D-dimer) and increased peaks of neutrophil-to-lymphocyte ratio, which is uncommon for teenagers diagnosed with COVID-19. Although he showed physiological instability, he was able to produce neutralizing antibodies, suggesting a functional immune response. The literature concerning the immune response to infections in patients with AS is still poor, and to our knowledge, this was the first report of a patient with AS diagnosed with COVID-19. As such, the present study may alert other patients with AS or other rare diseases that they lack a competent immune response and could suffer severe consequences of SARS-CoV-2 infection.

scholarly journals Coronary tortuosity is associated with an elevated high-sensitivity C-reactive protein concentration and increased risk of ischemic stroke in hypertensive patients

2018 ◽  
Vol 46 (4) ◽  
pp. 1579-1584 ◽  
Author(s):  
Yang Li ◽  
Abdul Qadir Nawabi ◽  
Yi Feng ◽  
Genshan Ma ◽  
Jiayi Tong ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
High Sensitivity ◽  
Lacunar Infarction ◽  
C Reactive Protein ◽  
Hypertensive Patients ◽  
Reactive Protein ◽  
Increased Risk ◽  
Hs Crp ◽  
Coronary Tortuosity ◽  
N 93

Objective The clinical implication of coronary tortuosity is unclear. The present study was conducted to determine the relationships between coronary tortuosity and the high-sensitivity C-reactive protein (hs-CRP) concentration and between coronary tortuosity and cerebrovascular accident in hypertensive patients without coronary artery disease. Methods In total, 236 patients with normal coronary angiography findings were categorized into 3 different groups: control participants (n = 58), who had neither hypertension nor coronary tortuosity; patients with hypertension but no coronary tortuosity (H-NCT group, n = 93); and patients with both hypertension and coronary tortuosity (H-CT group, n = 85). The hs-CRP concentration was measured in every patient, and 168 hypertensive patients were followed up for at least 2 years to check for the development of cerebrovascular accident. Results The hs-CRP concentration was significantly higher in the H-CT group than in the control and H-NCT groups (4.33 ± 3.15 vs. 1.52 ± 1.31 and 2.31 ± 2.09 mg/L, respectively). The incidence of lacunar infarction was higher in the H-CT than H-NCT group during the follow-up. Conclusions Hypertensive patients with coronary tortuosity have a higher serum hs-CRP level concentration and have a higher incidence of lacunar infarction than hypertensive patients without coronary tortuosity.

scholarly journals Early Prediction of Disease Progression in Patients with Severe COVID-19 Using C-Reactive Protein to Albumin Ratio

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Yi Li ◽  
Haitao Li ◽  
Chao Song ◽  
Rongli Lu ◽  
Yuhao Zhao ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Hospital Stay ◽  
Disease Progression ◽  
Invasive Mechanical Ventilation ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Increased Risk ◽  
Risk Of Progression ◽  
D Dimer

Background. Early identification of patients with severe coronavirus disease (COVID-19) at an increased risk of progression may promote more individualized treatment schemes and optimize the use of medical resources. This study is aimed at investigating the utility of the C-reactive protein to albumin (CRP/Alb) ratio for early risk stratification of patients. Methods. We retrospectively reviewed 557 patients with COVID-19 with confirmed outcomes (discharged or deceased) admitted to the West Court of Union Hospital, Wuhan, China, between January 29, 2020 and April 8, 2020. Patients with severe COVID-19 ( n = 465 ) were divided into stable ( n = 409 ) and progressive ( n = 56 ) groups according to whether they progressed to critical illness or death during hospitalization. To predict disease progression, the CRP/Alb ratio was evaluated on admission. Results. The levels of new biomarkers, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, CRP/Alb ratio, and systemic immune-inflammation index, were higher in patients with progressive disease than in those with stable disease. Correlation analysis showed that the CRP/Alb ratio had the strongest positive correlation with the sequential organ failure assessment score and length of hospital stay in survivors. Multivariate logistic regression analysis showed that percutaneous oxygen saturation (SpO2), D-dimer levels, and the CRP/Alb ratio were risk factors for disease progression. To predict clinical progression, the areas under the receiver operating characteristic curves of Alb, CRP, CRP/Alb ratio, SpO2, and D-dimer were 0.769, 0.838, 0.866, 0.107, and 0.748, respectively. Moreover, patients with a high CRP/Alb ratio (≥1.843) had a markedly higher rate of clinical deterioration ( log − rank   p < 0.001 ). A higher CRP/Alb ratio (≥1.843) was also closely associated with higher rates of hospital mortality, ICU admission, invasive mechanical ventilation, and a longer hospital stay. Conclusion. The CRP/Alb ratio can predict the risk of progression to critical disease or death early, providing a promising prognostic biomarker for risk stratification and clinical management of patients with severe COVID-19.

scholarly journals Cerebrovascular comorbidity, high blood levels of C - reactive protein and D-dimer are associated with disease outcomes in COVID-19 patients

2020 ◽  
pp. 1-12
Author(s):  
Foad Alzoughool ◽  
Lo’ai Alanagreh ◽  
Suhad Abumweis ◽  
Manar Atoum
Keyword(s):  
Case Reports ◽  
Meta Analysis ◽  
Serum Levels ◽  
Blood Levels ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cerebrovascular Complications ◽  
Increased Risk ◽  
Risk Of Disease ◽  
D Dimer

The emerging coronavirus disease (COVID-19) swept the world, affecting more than 200 countries and territories. As of August 22, 2020, the pandemic infected more than 23,329,752 including 807,054 patients who have died. Although the main clinical features of the pandemic disease are respiratory, cerebrovascular comorbidities emerged as one of the leading causes of death associated with COVID-19. Different case reports have indicated that C-reactive protein (CRP) and D-dimer (pro-inflammatory biomarkers) were elevated in COVID-19 patients, which can significantly increase the risk of ischemic stroke. Available data on cerebrovascular complications in COVID-19 patients were collected and a meta-analysis was designed and carried out to evaluate the risk of severity and mortality associated with high levels of CRP and D-dimer levels in COVID-19 patients. In addition, we aimed to describe the overall event rate of pre-existing cerebrovascular disease in COVID-19 patients. In our analysis, 5,614 cases have been studied, out of these patients 164 cases have developed cerebrovascular comorbities. Cerebrovascular comorbidity increased the risk of disease severity (odd ratio = 4.4; 95% CI: 1.48 to 12.84) and mortality (odd ratio = 7.0; 95% CI: 2.56 to 18.99). Statistical analyses showed that CRP and D-dimer serum levels were elevated by six-folds in the severe cases of COVID-19 patients. This significant increase in these two proteins levels can serve as a vital indicator for COVID-19 patients who are at increased risk of severe COVID-19 cerebrovascular complications, such as stroke.

scholarly journals Association of D-dimer and fibrinogen magnitude with hypercoagulability by thromboelastography in severe COVID-19

2020 ◽  
Author(s):  
Abhimanyu Chandel ◽  
Saloni Patolia ◽  
Mary Looby ◽  
Heidi Dalton ◽  
Najeebah Bade ◽  
...  
Keyword(s):  
Thrombotic Event ◽  
Maximum Amplitude ◽  
Fibrinogen Concentration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Venous Thromboembolism Prevention ◽  
Thrombotic Complications ◽  
Correlation Tests ◽  
The Relationship ◽  
D Dimer

Introduction: D-dimer concentration has been used to identify candidates for intensified anticoagulant treatment for both venous thromboembolism prevention and mitigation of the microthrombotic complications associated with COVID-19. Thromboelastography (TEG) maximum amplitude (MA) has been validated as an indicator of hypercoagulability and MA ≥ 68 mm has been utilized as a marker of hypercoagulability in other conditions. We evaluated the relationship between coagulation, inflammatory, and TEG parameters in patients with COVID-19 on extracorporeal membrane oxygenation (ECMO). Methods: We performed a single center retrospective analysis of consecutive patients that received ECMO for the treatment of COVID-19. TEG, inflammatory, and coagulation markers were compared in patients with and without thrombotic complications. Correlation tests were performed to identify the coagulation and inflammatory markers that best predict hypercoagulability as defined by an elevated TEG MA. Results: 168 TEGs were available in 24 patients. C-reactive protein and fibrinogen were significantly higher in patients that developed a thrombotic event versus those that did not (p=0.038 and p=0.043 respectively). D-dimer was negatively correlated with TEG MA (p<0.001) while fibrinogen was positively correlated (p<0.001). A fibrinogen > 441 mg/dL had a sensitivity of 91.2% and specificity of 85.7% for the detection of MA ≥ 68 mm. Conclusions: In critically ill patients with COVID-19, D-dimer concentration had an inverse relationship with hypercoagulability as measured by TEG MA. D-dimer elevation may reflect severity of COVID-19 related sepsis rather than designate patients likely to benefit from anticoagulation. Fibrinogen concentration may represent a more useful marker of hypercoagulability in this population.

scholarly journals Leveraging genetic data to elucidate the relationship between Covid-19 and ischemic stroke

2021 ◽  
Author(s):  
Verena Zuber ◽  
Alan Cameron ◽  
Evangelos P. Myserlis ◽  
Leonardo Bottolo ◽  
Israel Fernandez-Cadenas ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Mendelian Randomization ◽  
Genetic Data ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk ◽  
The Relationship ◽  
Randomization Analysis

AbstractBackgroundThe relationship between coronavirus disease 2019 (Covid-19) and ischemic stroke is poorly defined. We aimed to leverage genetic data to investigate reported associations.MethodsGenetic association estimates for liability to Covid-19 and cardiovascular traits were obtained from large-scale consortia. Analyses primarily focused on critical Covid-19, defined as hospitalization with Covid-19 requiring respiratory support or resulting in death. Cross-trait linkage disequilibrium score regression was used to estimate genetic correlations of critical Covid-19 with ischemic stroke, other related cardiovascular outcomes, and risk factors common to both Covid-19 and cardiovascular disease (body mass index, smoking and chronic inflammation, estimated using C-reactive protein). Mendelian randomization analysis was performed to investigate whether liability to critical Covid-19 was associated with increased risk of any of the cardiovascular outcomes for which genetic correlation was identified.ResultsThere was evidence of genetic correlation between critical Covid-19 and ischemic stroke (rg=0.29, FDR p-value=4.65×10−3), body mass index (rg=0.21, FDR-p-value=6.26×10−6) and C-reactive protein (rg=0.20, FDR-p-value=1.35×10−4), but none of the other considered traits. In Mendelian randomization analysis, liability to critical Covid-19 was associated with increased risk of ischemic stroke (odds ratio [OR] per logOR increase in genetically predicted critical Covid-19 liability 1.03, 95% confidence interval 1.00-1.06, p-value=0.03). Similar estimates were obtained when considering ischemic stroke subtypes. Consistent estimates were also obtained when performing statistical sensitivity analyses more robust to the inclusion of pleiotropic variants, including multivariable Mendelian randomization analyses adjusting for potential genetic confounding through body mass index, smoking and chronic inflammation. There was no evidence to suggest that genetic liability to ischemic stroke increased the risk of critical Covid-19.ConclusionsThese data support that liability to critical Covid-19 is associated with an increased risk of ischemic stroke. The host response predisposing to severe Covid-19 is likely to increase the risk of ischemic stroke, independent of other potentially mitigating risk factors.

Features of the immune response and vascular wall stiffness in workers exposed to industrial aerosols

2019 ◽  
Vol 1 (10) ◽  
pp. 850-854
Author(s):  
Ju. V. Ivanova ◽  
M. Y. Milyutina ◽  
E. V. Makarova
Keyword(s):  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Vascular Wall ◽  
Interleukin 10 ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Factor Α ◽  
The Relationship ◽  
Necrosis Factor

Introduction. In recent years, in occupational pathology, much attention is paid to professionally caused diseases, a special place among which is occupied by cardiovascular pathology. Vascular wall stiff ness is considered as an independent cardiovascular risk factor. This makes it important to study the mechanism of development of arterial stiffness, a key component of which is inflammation.The aim of the study was to identify the relationship between immune parameters and vascular wall stiff ness according to volumetric sphygmography in workers exposed to industrial aerosols.Materials and methods. A survey was conducted of 55 men working in conditions of exposure to industrial aerosols, and 32 men who do not have professional contact with industrial pollutants. Serum concentrations of class A and G immunoglobulins, cytokines, tumor necrosis factor α, and C-reactive protein were determined by solid-phase enzyme immunoassay. Assessment of elastic properties of the vascular wall was carried out by volumetric sphygmography.Results. Increased production of anti-inflammatory interleukin–8, immunoglobulin G and C-reactive protein, as well as increased cardiovascular and ankle vascular index on the right and left in the group working under the influence of industrial aerosols was found. Median concentrations of immunoglobulins, interleukins and C-reactive protein were independent of changes in the value of the cardiovascular ankle vascular index. Increased rigidity of the vascular wall was accompanied by an increase in the production of tumor necrosis factor α. Thus, in the group of persons with increased stiff ness, the level of this cytokine was 3 times higher than in the group of persons with normal values of the cardiovascular-ankle vascular index. The relationship between the cardiovascular ankle vascular index and the concentration of tumor necrosis factor α (r=0.61; p=0.009), C-reactive protein (r=0.54; p=0.02) and feedback with the level of anti-infl ammatory interleukin–10 (r=0.36; p=0.04) was revealed.Conclusions. The established significant correlations between cytokines (tumor necrosis factor α, interleukin–10), C-reactive protein and individual indicators of volumetric sphygmography (cardio-ankle vascular index) indicate the pathogenetic role of cytokines and acute phase proteins in the violation of elastic properties of the vascular bed in workers under the influence of industrial aerosols.

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