Clinical and laboratory findings of COVID-19 in children younger than six months old; Neutropenia is more common not lymphopenia

Background: Studies on age-related differences in clinical and laboratory features on coronavirus disease 2019 (COVID-19) are limited. We aimed to evaluate the demographic, clinical, and laboratory findings of COVID-19 in children younger than six months old and compare them with older children. Methods: A single-center retrospective study, including 209 confirmed COVID-19 cases, was conducted between March 11, 2020, and September 1, 2021. The case group consisted of 47 patients younger than six months old, and the control group consisted of 162 patients older than six months old. Results: The mean age of the case group was 2.77±1.52 months, and the control group was 101.89±65.77 months. Cough was statistically higher in the control group, poor feeding was higher in the case group (P=.043, .010). The underlying disease ratio was statistically higher in the case group; however, the hospitalization rate was higher in the case group (P=.001, .036). The case group had significantly lower median values of the absolute neutrophil count, hemoglobin, and higher median values of white blood cell, absolute lymphocyte count, platelet than the control group (P<.05). C-reactive protein, fibrinogen values were significantly lower, and procalcitonin, D-dimer, troponin T, N‑terminal pro-B-type natriuretic peptide significantly higher in the case group (P<.05). Lymphopenia was more common in the control group, whereas neutropenia was more common in the case group (P= .001, .011). Conclusions: We showed that most children younger than six months old had mild and asymptomatic COVID-19; however, the hospitalization rate was higher, and neutropenia was more common than older children.

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No difference in biomarkers of ischemic heart injury and heart failure in patients with COVID-19 who received treatment with chloroquine phosphate and those who did not

PLoS ONE ◽

10.1371/journal.pone.0256035 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256035

Author(s):

Josefine Beck-Friis ◽

Susannah Leach ◽

Elmir Omerovic ◽

Rickard Zeijlon ◽

Magnus Gisslen ◽

...

Keyword(s):

Heart Failure ◽

Troponin T ◽

Ischemic Heart ◽

Cardiac Biomarkers ◽

Control Group ◽

Laboratory Findings ◽

Reactive Protein ◽

Increased Risk ◽

Heart Injury ◽

Biochemical Analyses

Background Chloroquine was promoted as a COVID-19 therapeutic early in the pandemic. Most countries have since discontinued the use of chloroquine due to lack of evidence of any benefit and the risk of severe adverse events. The primary aim of this study was to examine if administering chloroquine during COVID-19 imposed an increased risk of ischemic heart injury or heart failure. Methods Medical records, laboratory findings, and electrocardiograms of patients with COVID-19 who were treated with 500 mg chloroquine phosphate daily and controls not treated with chloroquine were reviewed retrospectively. Controls were matched in age and severity of disease. Results We included 20 patients receiving chloroquine (500 mg twice daily) for an average of five days, and 40 controls. The groups were comparable regarding demographics and biochemical analyses including C-reactive protein, thrombocytes, and creatinine. There were no statistically significant differences in cardiac biomarkers or in electrocardiograms. Median troponin T was 10,8 ng/L in the study group and 17.9 ng/L in the control group, whereas median NT-proBNP was 399 ng/L in patients receiving chloroquine and 349 ng/L in the controls. Conclusions We found no increased risk of ischemic heart injury or heart failure as a result of administering chloroquine. However, the use of chloroquine to treat COVID-19 outside of clinical trials is not recommended, considering the lack of evidence of its effectiveness, as well as the elevated risk of fatal arrythmias.

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Study of adverse drug reactions and clinical profile of elderly in relation to polypharmacy

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i6.22757 ◽

2019 ◽

Vol 10 (6) ◽

pp. 80-84

Author(s):

Nagaraja BS ◽

Keerthana Sharma

Keyword(s):

Older Adults ◽

Adverse Drug Reactions ◽

The Elderly ◽

Control Group ◽

Case Group ◽

Drug Reactions ◽

Age Related ◽

Improve Compliance ◽

Clinical Conditions

Background: Polypharmacy is a becoming more prevalent in older adults and adverse risk increases with age-related change. Adverse drug reactions (ADRs) are common in older adults and worrisome aspect of treatment in elderly. Aims and Objective: The study aimed to identify the common clinical conditions leading to polypharmacy and to compare the adverse drug profiles of the 2 groups. Materials and Methods: This case-control study was conducted in Hospitals attached to BMCRI, where 200 patients aged 65 or more were interviewed. 100 elderly patients using 5 or more drugs were identified as cases and assessed against a control group of 100 patients. Results: Our study found that ADRs were found to be three times higher in individuals on polypharmacy compared to the control group (OR 3.4675 95% CI 1.6241 to 7.4035). The most commonly occurring ADRs were dyspepsia (OR 1.9259), drowsiness (OR 3.5926) and fatigue (OR 1.5319) with increased incidence in the case group. The most common conditions associated with polypharmacy were found to be hypertension (53%), diabetes mellitus(46%), COPD(14%) and IHD(14%). 66% of the study group had two or more of the above diseases, whereas in the control group only 32% had multiple illnesses. The most commonly prescribed medications were antihypertensives (61%), hypolipidemics (44%), antiplatelets (41%) and antibiotics(40%). Conclusion: Polypharmacy in the elderly comes with a significant increase in adverse effects. The reduced pill burden will not only decrease ADRs and improve compliance, but will also result in greater patient satisfaction and mental health, thereby improving the quality of geriatric care.

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Serum Pentraxin 3 Concentration in Neonatal Sepsis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0039-1688930 ◽

2019 ◽

Vol 14 (05) ◽

pp. 219-222

Author(s):

Fatih Battal ◽

Özgül Emel Bulut ◽

Şule Yıldırım ◽

Hakan Aylanç ◽

Nazan Kaymaz ◽

...

Keyword(s):

Neonatal Sepsis ◽

Bacterial Infections ◽

Clinical Signs ◽

Neonatal Morbidity ◽

Gene Organization ◽

Control Group ◽

Case Group ◽

Pentraxin 3 ◽

Suspected Sepsis ◽

Reactive Protein

Objective Neonatal sepsis is one of the most important causes of neonatal morbidity and mortality. Symptoms and signs of neonatal sepsis can be silent; therefore, laboratory investigation is necessary in cases of doubt or if there are risk factors. Early diagnosis is important for early intervention and treatment. The most valuable method for diagnosis is blood culture; however, false positivity due to contamination or false negativity despite ongoing fatal bacterial infections can be seen. Pentraxin 3 is a prototype of the long pentraxin family. It has some differences from C-reactive protein (CRP) in terms of gene organization and localization and production site. It is effective in the early phase of inflammation and it is detected as an early marker of sepsis in adults. The aim of this study was to investigate whether pentraxin 3 can be used as a marker in neonatal sepsis. Materials and Methods Thirty newborns with suspected sepsis with antenatal history or the presence of clinical signs of sepsis, such as hypo/hyperthermia, feed intolerance, lethargy, hypotonia, irregular cardiac rhythms, bradycardia, cyanosis, apnea, respiratory distress, or metabolic acidosis, were enrolled in the study as a case group, and 28 healthy newborns were included as a control group. Serum pentraxin 3, procalcitonin, CRP, and hemogram in the study group and serum procalcitonin and pentraxin in the control group were examined. Results Serum pentraxin 3 (pg/mL) and serum procalcitonin (ng/mL) levels were 2,273.82 ± 1,260.75 and 0.86 ± 0.52 in the case group and 957.41 ± 268.00 and 0.19 ± 0.18 in the control group (p < 0.001 for both), respectively. Conclusion The present study showed that serum pentraxin 3 levels may be a useful marker in the diagnosis of neonatal sepsis.

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Age-Related Variations in Acylcarnitine and Free Carnitine Concentrations Measured by Tandem Mass Spectrometry

Clinical Chemistry ◽

10.1373/clinchem.2004.043646 ◽

2005 ◽

Vol 51 (4) ◽

pp. 745-752 ◽

Cited By ~ 37

Author(s):

Catia Testa Cavedon ◽

Pierre Bourdoux ◽

Karl Mertens ◽

Hong Vien Van Thi ◽

Nadine Herremans ◽

...

Keyword(s):

Mass Spectrometry ◽

Tandem Mass Spectrometry ◽

Cord Blood ◽

Reference Values ◽

Free Carnitine ◽

Control Group ◽

Tandem Mass ◽

Older Children ◽

Blood Spots ◽

Age Related

Abstract Background: The acylcarnitine profiles obtained from dried blood spots on “Guthrie cards” have been widely used for the diagnosis and follow-up of children suspected of carrying an inherited error of metabolism, but little attention has been paid to potential age-related variations in the reference values. In this study, we evaluated the variations in free carnitine and acylcarnitine concentrations with age, as measured by tandem mass spectrometry. Methods: Filter-paper blood spots were collected from 433 healthy individuals over a period of 17 months. Eight age groups were defined: cord blood, 3–6 days (control group), 15–55 days, 2–18 months, 19–59 months, 5–10 years, 11–17 years, and 18–54 years. Free carnitine and acylcarnitines were measured for each individual. Mean values were calculated for each age group and compared with those for the control group. Results: Free carnitine was significantly higher in older children than in newborns (P <0.05), but the concentrations of several acylcarnitines tended to be significantly lower in cord blood and in groups of older children than in the control group. Only minor sex-related differences were observed. Conclusion: Although the risk of underdiagnosis of fatty acid oxidation disorders with the use of newborn values as reference can be considered as small, in some circumstances the use of age-related reference values may have a potential impact on the diagnosis and management of inherited errors of metabolism.

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The Inflammatory Markers of Multisystem Inflammatory Syndrome in children (MIS-C) and Adolescents During the COVID-19 Pandemic: A Meta-Analysis

10.21203/rs.3.rs-127768/v1 ◽

2021 ◽

Author(s):

Yan Zhao ◽

Li-juan Yin ◽

Jenil Patel ◽

Lei Tang ◽

Ying Huang

Keyword(s):

Inflammatory Markers ◽

Meta Analysis ◽

Absolute Lymphocyte Count ◽

Older Children ◽

C Reactive Protein ◽

Reactive Protein ◽

Erythrocyte Sedimentation ◽

Quality Check ◽

Inflammatory Syndrome ◽

D Dimer

Abstract As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS-C patients with COVID-19, Kawasaki disease (KD), and coronary artery abnormalities. We searched nine databases for studies on inflammatory markers of MIS-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS-C patients. Compared to non-severe COVID-19 patients, MIS-C patients had lower ALC and higher ANC, CRP and D-dimer levels. Compared to severe COVID-19 patients, MIS-C patients had lower LDH and PLT counts and higher ESR levels. Compared to KD patients, MIS-C patients had lower ALC and PLT, and higher CRP and ferritin levels. Severe MIS-C patients had higher levels of WBC, CRP, D-dimer and ferritin. For MIS-C, younger children had lower CRP and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS-C and the associated disorders.

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Correlation Between Serum C-Reactive Protein And Cystatin C In Patients With Acute Cerebral Infarction And Carotid Artery Stenosis

Advanced Emergency Medicine ◽

10.18686/aem.v7.124 ◽

2018 ◽

Vol 7 (1) ◽

Author(s):

Tao Zhang ◽

Xiaowen Yang ◽

Hui Wang ◽

Jie Luo ◽

Anrong Li ◽

...

Keyword(s):

Carotid Artery ◽

Cerebral Infarction ◽

Carotid Artery Stenosis ◽

Serum Levels ◽

Artery Stenosis ◽

Acute Cerebral Infarction ◽

Control Group ◽

Case Group ◽

Reactive Protein ◽

Serum Crp

To investigate the correlation between serum C-reactive protein (CRP) and serum cystatin C (Cys-C) levels in patients with acute cerebral infarction and carotid artery stenosis. Methods: From January 2015 to December 2016 admitted to our hospital new acute cerebral infarction parallel neck vascular color Doppler ultrasound examination showed 121 cases of carotid stenosis as the case group; select the same period of hospitalized patients with non-cerebrovascular disease in 50 cases As a control group. Fasting venous blood was collected on the third day after onset of the disease and serum levels of CRP and Cys-C were measured and compared. Results: Serum levels of CRP and Cys-C in case group were significantly higher than those in control group (P <0.05). The correlation between serum CRP and Cys-C was found in any pairwise comparison (r = 0.4732). The level of CRP and Cys-C were closely related to the degree of carotid artery stenosis (P <0.05). Conclusion: The combined detection of serum CRP and Cys-C levels can be used to evaluate the degree of carotid artery stenosis in patients with acute cerebral infarction and provide a reference for the next carotid endarterectomy.

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The Seasonality, Steroid and the Lower Ratio of Neutrophil to Lymphocyte Associated With Listeriosis in Japan

10.21203/rs.3.rs-692559/v1 ◽

2021 ◽

Author(s):

Yusuke Watanabe ◽

Itaru Nakamura ◽

Yuri Miura ◽

Hidehiro Watanabe

Keyword(s):

Mortality Rate ◽

Clinical Symptoms ◽

Warm Season ◽

Underlying Disease ◽

University Hospital ◽

Control Group ◽

Case Group ◽

Steroid Use ◽

Lower Ratio ◽

Tokyo Medical

Abstract Background: Although listeriosis is a foodborne infection with a high mortality rate, studies of listeriosis from Asia are limited. We aimed to compare the characteristics of listeriosis and non-listeriosis (defined as bacteremia without Listeria monocytegenes infection) in Japan.Methods: We conducted a case–control study of adults with listeriosis or with bacteremia without L. monocytegenes infection from January 1, 2010, to December 31, 2019, at Tokyo Medical University Hospital in Japan. We recorded the incidence of admissions and the clinical characteristics, including age and sex; underlying disease; clinical symptoms; onset month; whether listeriosis was community-associated or health care–associated; medicine; blood count; biochemical findings; antibiotics use; admission to the intensive care unit; and outcome.Results: A total of 12 patients were included in the case group and 28 patients were included in the control group. Most cases of listeriosis were present in patients of an advanced age, with underlying disease, and/or on immunosuppressant therapy. Two patients died within 30 days and one developed a brain abscess. Listeriosis onset was associated with the warm season (90.9% vs. 53.8%; P = 0.033), steroid use (54.5% vs. 19.2%; P = 0.042), and a lower ratio of neutrophils to lymphocytes (9.46 vs. 18.44; P = 0.015).Conclusion: The incidence of listeriosis in this study was similar to that in other Asian countries and the 30-day mortality rate was 18.2%. We observed that listeriosis onset was associated with the warm season, steroid use, and a lower ratio of neutrophils to lymphocytes.

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Probiotic Therapy in Patients with Nonalcoholic Steatohepatitis in Zagazig University Hospitals

Euroasian Journal of Hepato-Gastroenterology ◽

10.5005/jp-journals-10018-1226 ◽

2017 ◽

Vol 7 (1) ◽

pp. 101-106 ◽

Cited By ~ 9

Author(s):

Sameh M Abdel Monem

Keyword(s):

Liver Biopsy ◽

Fatty Liver ◽

Nonalcoholic Steatohepatitis ◽

Laboratory Evaluation ◽

Control Group ◽

Case Group ◽

University Hospitals ◽

Laboratory Findings ◽

Nonalcoholic Fatty Liver ◽

Group I

ABSTRACT Aim Nonalcoholic fatty liver disease (NAFLD) is probably the most common liver disorder in the world. A subgroup of NAFLD patients is characterized by injury to the hepatocytes and inflammation in addition to excessive fat (steatohepatitis), the latter condition is nominated nonalcoholic steatohepatitis (NASH). This work aimed to evaluate the role of probiotics on the outcome of NASH in patients admitted to the Tropical Medicine Department, Faculty of Medicine, Zagazig University (inpatients and outpatients). Materials and methods This study was performed on 30 patients (17 males and 13 females), with body mass index from 30 to 35 and average age of 44 years with bright fatty liver in ultrasonography and raised alanine transaminase (ALT) and aspartate transaminase (AST) and positive liver biopsy findings. The patients were divided into group I (case group) that included 15 patients who received probiotics and group II of 15 patients as control group who did not receive probiotics; the study was conducted between November 2014 and April 2016. Clinical assessment, laboratory evaluation, pelvic-abdominal ultrasound, and liver biopsy of all cases were carried out. Results In this study, there was significant decrease in liver enzymes (ALT and AST) and no statistically significant other laboratory findings. Also there was relief for dyspepsia in some patients. Conclusion Probiotics treatment is effective, safe, well-tolerated, inexpensive, appropriate for long-term use, and optimally, works at multiple levels to downregulate inflammatory mediators, and therefore, probiotics could be an option in the treatment of NASH. How to cite this article Monem SMA. Probiotic Therapy in Patients with Nonalcoholic Steatohepatitis in Zagazig University Hospitals. Euroasian J Hepato-Gastroenterol 2017;7(1):101-106.

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Serum High Sensitive C-Reactive Protein in Obese Persons with Normal Glucose Tolerance & Impaired Fasting Glucose

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v4i1.37676 ◽

2018 ◽

Vol 4 (1) ◽

pp. 21-24

Author(s):

Soniya Fahmi ◽

Sunjida Shahriah ◽

Omma Hafsa Any ◽

Mahbuba Akter ◽

Samia Afrin

Keyword(s):

Fasting Glucose ◽

Normal Glucose Tolerance ◽

Control Group ◽

Case Group ◽

Obese Patients ◽

C Reactive Protein ◽

Reactive Protein ◽

Normal Glucose ◽

Obese Subjects ◽

Hs Crp

Background: Obesity, characterized by increased fat mass and is currently regarded as a proinflammatory state and frequently associated with increased risk of cardiovascular diseases including Myocardial Infarction and also future risk for development of metabolic disorders such as T2DM. Highsensitivity C-reactive protein is a well-known inflammatory marker. Objective: In this study we aimed to determine the levels of serum high-sensitive C-reactive protein in obese parsons with normal glucose tolerance (NGT) and obese with impaired fasting glucose (IFG) individuals. Methodology: This was a case-control study which was conducted in the Department of Biochemistry, ZH Sikder Women’s Medical College, Dhaka during the period of July 2014 to June 2015. The age, sex and body mass index (BMI ≥ 30 kg / m²) matched 25 obese subjects with NGT were selected as control group and 25 obese patients with IFG were selected as case group. We measured levels of serum high sensitive Creactive protein in all groups. Subjects of both obese groups had significantly higher hs-CRP levels than the normal range. Results: A total number of 50 subjects were recruited for this study of which 25 obese subjects with NGT were selected as control group and 25 obese patients with IFG were selected as case group. The level of hs-CRP in obese with NGT and with IFG were found 2.91±1.56 mg/L & 3.42±1.72 mg/L, respectively. There are no significant difference between hs-CRP levels of obese subjects than the subjects with IFG (p>0.1). Conclusion: This study finding has concluded that obesity raises serum hsCRP level. IFG obese individuals are not at much higher cardiovascular and metabolic risk level than normal obese parsons. Bangladesh Journal of Infectious Diseases 2017;4(1):21-24

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Anxiety disorders and age-related changes in physiology

The British Journal of Psychiatry ◽

10.1192/bjp.2021.189 ◽

2022 ◽

pp. 1-10

Author(s):

Julian Mutz ◽

Thole H. Hoppen ◽

Chiara Fabbri ◽

Cathryn M. Lewis

Keyword(s):

Blood Pressure ◽

Body Composition ◽

Anxiety Disorders ◽

Grip Strength ◽

Hand Grip Strength ◽

Control Group ◽

Case Group ◽

Physiological Measures ◽

Hand Grip ◽

Age Related

Background Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan and associated with substantially increased morbidity and early mortality. Aims The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared with healthy controls. Method The UK Biobank study recruited >500 000 adults, aged 37–73, between 2006 and 2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in a case group and in a control group. Results The main data-set included 332 078 adults (mean age 56.37 years; 52.65% women). In both genders, individuals with anxiety disorders had a lower hand-grip strength and lower blood pressure, whereas their pulse rate and body composition measures were higher than in the healthy control group. Case–control group differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between females in the anxiety disorder case group and healthy controls were most evident for blood pressure, pulse rate and body composition, whereas this was the case in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between the case and control groups decreased with increasing age. Conclusions Findings in individuals with a lifetime history of anxiety disorders differed from a healthy control group across multiple physiological measures, with some evidence of case–control group differences by age. The differences observed varied by chronicity/severity and depression comorbidity.

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