COVID-19 in pediatrics: case report with many complications and a good clinical outcome

Coronavirus disease 2019 (COVID-19) is an acute infectious disease that caused the emergence of the new serious global pandemic. The infection in children is much less prevalent than in adults and most cases are asymptomatic or have mild symptoms. Severe cases represent less than 1% of the total, therefore information about the disease in this age group is scarce compared to data in older individuals. We exposed a case of a 16-year-old male adolescent with a previous diagnosis of myelomeningocele, hydrocephalus with peritoneal ventricle bypass (PVB), recurrent urinary tract infection, epilepsy, and obesity. The patient presented cough and convulsive crises, which worsened during hospitalization with severe acute respiratory syndrome due to SARS-CoV-2, septic shock, and cardiorespiratory arrest and invasive mechanical ventilation (IMV) for 9 days was required. Also presented several other complications and factors of critical prognosis, such as elevated inflammatory markers (C-reactive protein, D-dimer), elevated cardiac troponin, and the necessity of renal replacement therapy. Nevertheless, the clinical outcome was satisfactory and he was discharged after a 40-day stay in the Pediatric Intensive Care Unit.

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Tumoral C-reactive protein and nuclear factor kappa-B expression are associated with clinical outcome in patients with prostate cancer

Cancer Biomarkers ◽

10.3233/cbm-2012-0236 ◽

2012 ◽

Vol 10 (2) ◽

pp. 91-99 ◽

Cited By ~ 7

Author(s):

Pamela McCall ◽

Jamie Catlow ◽

Peter A McArdle ◽

Donald C McMillan ◽

Joanne Edwards

Keyword(s):

Prostate Cancer ◽

Clinical Outcome ◽

Nuclear Factor Kappa B ◽

Nuclear Factor ◽

C Reactive Protein ◽

Reactive Protein ◽

Nuclear Factor Kappa

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Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2014-0456 ◽

2015 ◽

Vol 53 (4) ◽

Cited By ~ 37

Author(s):

Andriy Zhydkov ◽

Mirjam Christ-Crain ◽

Robert Thomann ◽

Claus Hoess ◽

Christoph Henzen ◽

...

Keyword(s):

Clinical Outcome ◽

Clinical Outcomes ◽

Blood Cells ◽

White Blood Cells ◽

Community Acquired Pneumonia ◽

Adverse Clinical Outcome ◽

C Reactive Protein ◽

Prognostic Information ◽

Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

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Age modification of the relationship between C-reactive protein and fatigue: findings from Understanding Society (UKHLS)

Psychological Medicine ◽

10.1017/s0033291717002872 ◽

2017 ◽

Vol 48 (8) ◽

pp. 1341-1349 ◽

Cited By ~ 2

Author(s):

A. Hughes ◽

M. Kumari

Keyword(s):

Multilevel Models ◽

Inflammatory Marker ◽

Glycated Haemoglobin ◽

Clinical Disease ◽

Sensitivity Analyses ◽

Older Individuals ◽

Community Studies ◽

C Reactive Protein ◽

Adult Age ◽

Reactive Protein

AbstractBackgroundSystemic inflammation may play a role in the development of idiopathic fatigue, that is, fatigue not explained by infections or diagnosed chronic illness, but this relationship has never been investigated in community studies including the entire adult age span. We examine the association of the inflammatory marker C-reactive protein (CRP) and fatigue assessed annually in a 3-year outcome period for UK adults aged 16–98.MethodsMultilevel models were used to track fatigue 7, 19, and 31 months after CRP measurement, in 10 606 UK individuals. Models accounted for baseline fatigue, demographics, health conditions diagnosed at baseline and during follow-up, adiposity, and psychological distress. Sensitivity analyses considered factors including smoking, sub-clinical disease (blood pressure, anaemia, glycated haemoglobin), medications, ethnicity, and alcohol consumption.ResultsFatigue and CRP increased with age, and women had higher values than men. CRP was associated with future self-reported fatigue, but only for the oldest participants. Thus, in those aged 61–98 years, high CRP (>3 mg/L) independently predicted greater fatigue 7, 19, and 31 months after CRP measurement [odds ratio for new-onset fatigue after 7 months: 1.88, 95% confidence interval (CI) 1.21–2.92; 19 months: 2.25, CI 1.46–3.49; 31 months: 1.65, CI 1.07–2.54]. No significant longitudinal associations were seen for younger participants.ConclusionsOur findings support previously described CRP–fatigue associations in older individuals. However, there are clear age modifications in these associations, which may reflect a contribution of unmeasured sub-clinical disease of limited relevance to younger individuals. Further work is necessary to clarify intervening processes linking CRP and fatigue in older individuals.

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Serum C-reactive protein elevation predicts poor clinical outcome in patients with distal type acute aortic dissection: association with the occurrence of oxygenation impairment

International Journal of Cardiology ◽

10.1016/j.ijcard.2004.03.076 ◽

2005 ◽

Vol 102 (1) ◽

pp. 39-45 ◽

Cited By ~ 40

Author(s):

Yasuo Sugano ◽

Toshihisa Anzai ◽

Tsutomu Yoshikawa ◽

Toru Satoh ◽

Shiro Iwanaga ◽

...

Keyword(s):

Clinical Outcome ◽

Aortic Dissection ◽

Acute Aortic Dissection ◽

C Reactive Protein ◽

Poor Clinical Outcome ◽

Reactive Protein ◽

Oxygenation Impairment

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Prognostic values of C-reactive protein levels on clinical outcome after endovascular therapy in hemodialysis patients with peripheral artery disease

Yearbook of Vascular Surgery ◽

10.1016/j.yvas.2011.06.037 ◽

2011 ◽

Vol 2011 ◽

pp. 195-197

Author(s):

J.D. Raffetto

Keyword(s):

Clinical Outcome ◽

Peripheral Artery Disease ◽

Endovascular Therapy ◽

Hemodialysis Patients ◽

C Reactive Protein ◽

Peripheral Artery ◽

Protein Levels ◽

Reactive Protein ◽

Artery Disease

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Inflammatory Markers in Patients Using Domiciliary Non-invasive Mechanical Ventilation: C Reactive Protein, Procalcitonin, Neutrophil Lymphocyte Ratio

Frontiers in Public Health ◽

10.3389/fpubh.2018.00245 ◽

2018 ◽

Vol 6 ◽

Cited By ~ 4

Author(s):

Birsen Ocakli ◽

Eylem Tuncay ◽

Sinem Gungor ◽

Meltem Sertbas ◽

Nalan Adiguzel ◽

...

Keyword(s):

Mechanical Ventilation ◽

Inflammatory Markers ◽

Invasive Mechanical Ventilation ◽

C Reactive Protein ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Non Invasive

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CORRELATION C-REACTIVE PROTEIN LEVELS WITH CLINICAL OUTCOME INTRACEREBRAL HEMORRHAGE STROKE PATIENTS

MNJ (Malang Neurology Journal) ◽

10.21776/ub.mnj.2015.001.01.5 ◽

2015 ◽

Vol 1 (1) ◽

pp. 23-27

Author(s):

Catur Ari Setianto ◽

Hari Purnomo ◽

Eko Arisetijono ◽

Widodo Mardi Santoso

Keyword(s):

Clinical Outcome ◽

Intracerebral Hemorrhage ◽

C Reactive Protein ◽

Stroke Patients ◽

Protein Levels ◽

Reactive Protein

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Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Frontiers in Pediatrics ◽

10.3389/fped.2020.617039 ◽

2021 ◽

Vol 8 ◽

Author(s):

Elisa Fernández-Cooke ◽

Carlos D. Grasa ◽

Sara Domínguez-Rodríguez ◽

Ana Barrios Tascón ◽

Judith Sánchez-Manubens ◽

...

Keyword(s):

Kawasaki Disease ◽

Clinical Characteristics ◽

Myocardial Dysfunction ◽

Clinical Signs ◽

Pediatric Intensive Care ◽

Terminal Segment ◽

C Reactive Protein ◽

Reactive Protein ◽

Aneurysm Development ◽

Inflammatory Syndrome

Introduction: COVID-19 has a less severe course in children. In April 2020, some children presented with signs of multisystem inflammation with clinical signs overlapping with Kawasaki disease (KD), most of them requiring admission to the pediatric intensive care unit (PICU). This study aimed to describe the prevalence and clinical characteristics of KD SARS-CoV-2 confirmed and negative patients during the pandemic in Spain.Material and Methods: Medical data of KD patients from January 1, 2018 until May 30, 2020 was collected from the KAWA-RACE study group. We compared the KD cases diagnosed during the COVID-19 period (March 1–May 30, 2020) that were either SARS-CoV-2 confirmed (CoV+) or negative (CoV–) to those from the same period during 2018 and 2019 (PreCoV).Results: One hundred and twenty-four cases were collected. There was a significant increase in cases and PICU admissions in 2020 (P-trend = 0.001 and 0.0004, respectively). CoV+ patients were significantly older (7.5 vs. 2.5 yr) and mainly non-Caucasian (64 vs. 29%), had incomplete KD presentation (73 vs. 32%), lower leucocyte (9.5 vs. 15.5 × 109) and platelet count (174 vs. 423 × 109/L), higher inflammatory markers (C-Reactive Protein 18.5vs. 10.9 mg/dl) and terminal segment of the natriuretic atrial peptide (4,766 vs. 505 pg/ml), less aneurysm development (3.8 vs. 11.1%), and more myocardial dysfunction (30.8 vs. 1.6%) than PreCoV patients. Respiratory symptoms were not increased during the COVID-19 period.Conclusion: The KD CoV+ patients mostly meet pediatric inflammatory multisystem syndrome temporally associated with COVID-19/multisystem inflammatory syndrome in children criteria. Whether this is a novel entity or the same disease on different ends of the spectrum is yet to be clarified.

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Prognostic value of pro-inflammatory neutrophils and C-reactive protein in cancer patient with COVID-19: a multi-center, retrospective study

10.21203/rs.3.rs-37464/v1 ◽

2020 ◽

Author(s):

Bo Zhang ◽

Yuanhang Yu ◽

Shawna Herbet ◽

Yue Zhang ◽

Jianhua Lu ◽

...

Keyword(s):

Critical Illness ◽

Clinical Outcome ◽

Cancer Patients ◽

Influencing Factor ◽

Adverse Outcomes ◽

Inflammatory Factors ◽

Adverse Clinical Outcome ◽

C Reactive Protein ◽

Cross Sectional ◽

Reactive Protein

Abstract Background: At present, the epidemic of the novel coronavirus disease 2019 (COVID-19) has quickly engulfed the world. Inflammatory cytokines are associated with the severity and outcomes of patients with COVID-19. However, the effects of pro-inflammatory factors in cancer patients with COVID-19 are unknown. Methods: A multi-center, retrospective, cross-sectional study, based on 5 designated tertiary hospitals for the treatment of COVID-19 in Hubei Province, China. 112 cancer patients with COVID-19, and 105 COVID-19 patients without cancer were enrolled in the study between January 1 st , 2020 and April 30 th , 2020. The risk assessment of pro-inflammatory factors for disease severity and clinical adverse outcomes was identified by univariable and multivariable logistic regression models. Results: Of the 112 cancer patients with COVID-19, 40 (35.7%) patients were in critical condition and 18 (16.1%) patients died unfortunately. Univariate and multivariate analysis demonstrated that hemoglobin count and pro-inflammatory neutrophil and C-reactive protein, can be used as independent factors affecting the severity of COVID-19; Meanwhile, pro-inflammatory neutrophils and C-reactive protein can be used as an independent influencing factor for adverse clinical outcome. Moreover, the dynamic changes of neutrophils and C-reactive protein were also presented, and compared with COVID-19 patients without cancer, cancer patients with COVID-19 showed higher neutrophil counts and C-reactive protein levels. Conclusions: In cancer patients with COVID-19, the significant increase in pro-inflammatory neutrophil and C-reactive protein indicated a more critical illness and adverse clinical outcome, and pro-inflammatory neutrophils and C-reactive protein played a more adverse effect compare with COVID-19 patients without cancer, which may be the cause of critical illness and adverse clinical outcomes of cancer patients with COVID-19.

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