Biomarkers during intensive care for sepsis

The article presents the results of a prospective, single-center observational clinical trial, in which biomarker levels were compared in patients with sepsis.Objective: to evaluate the dynamics of the level of presepsin, procalciotonin and C-reactive protein in two groups - the dead and the surviving patients with sepsis.Materials and methods. The study consistently included 41 patients with a diagnosis of sepsis (based on the concept of "Sepsis-3"), divided into two groups: group 1 (21 people) – survivors, group 2 (20 people) – dead. Patients in both groups received conventional intensive therapy for sepsis. In addition to the standard laboratory and instrumental examination, patients in the dynamics were monitored for the level of presepsin, procalcitonin, C-reactive protein.Results. The average level of presepsin in group 1 and group 2 was 1718.00 and 3266.50 pg/ml, respectively, with half of the values being within (Me (25.75) 1021.00–3231.00 and 1618.50–7469.00 pg/ml. The average level of procalcitonin in group 1 and group – 0.995 and 4.465 ng/ml, respectively, while Me (25.75) 0.49–4.44 and 1.625–19.30 ng/ml. The average level of C-reactive protein in group No. 1 and group No. 2 is 95.5 and 215.0 mg/l, respectively, with Me (25.75) 64.00–155.00 and 155.00–264.00 mg/l. When comparing the values of biomarkers in the two groups of patients, significant differences were found (p-value for presepsin, procalсitonina and C-reactive protein are, respectively 0.000008, 0.000242, 0.0000001).

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Experience of using heliox in the treatment of viral pneumonia in COVID-19

MedAlliance ◽

10.36422/23076348-2021-9-2-8-14 ◽

2021 ◽

Vol 9 (2) ◽

pp. 8-14

Keyword(s):

Lactate Dehydrogenase ◽

Viral Pneumonia ◽

P Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Number Of Patients ◽

Helium Mixture ◽

Ct Data ◽

Group 2 ◽

Group 1

SummaryIntroduction. With the ongoing COVID-19 pandemic, finding new treatments is an extremely important issue. The effectiveness of heliox was previously demonstrated in the complex treatment of patients with various bron-chopulmonary pathologies. Therefore, this method has been recommended for the treatment of pneumonia associated with COVID-19. Purpose. To study the safety and efficacy of inhaled heliox therapy in the treatment of pneumonia in COVID-19. Materials and methods. A sing-le-center prospective study was carried out for the period from 01.12.2020 to 15.02.2021. The study included 91 pa-tients. The patients were divided into two groups: group 1 (using heliox) included 46 people, and group 2 (con-trol) — 45. Inhalations of a heated oxygen-helium mixture heliox (70% helium, 30% oxygen) were carried out using “Ingalit-B2-01” inhaler. Objective (saturation, O2 flow) and laboratory parameters (lactate dehydrogenase, C-reactive protein), as well as chest organs CT data were studied. Differences between groups were determined using the χ2 test, as well as the Mann–Whitney U-test. The p value <0.05 was considered significant. Results. In group 1, side effects developed in 5 (11.3%) patients. These patients refused to further participate in the study. Final number of patients in group 1 — 41. Among patients of group 1, there was a tendency towards a more rapid normalization of lactate dehydrogenase and C-reactive protein, as well as a decrease in oxygen dependence. In group 1, according to CT data, no progression of pneumonia was recorded. In group 2, progression was observed in 6 (13.3%) patients. The overall effectiveness of treatment among patients in group 1 was 100%, among patients in group 2 — 86.7%. The differences between the groups are statistically sig-nificant (p=0.02). Conclusion. The use of inhalations with a heated oxygen-helium mixture heliox (30% oxygen, 70% helium) has shown its effectiveness and safety in the treatment of viral pneumonia (CT1- 2) associated with COVID-19.

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Fever as a predictor of adverse outcomes in COVID-19

QJM ◽

10.1093/qjmed/hcab023 ◽

2021 ◽

Author(s):

N W Chew ◽

J N Ngiam ◽

S M Tham ◽

Z Y Lim ◽

T Y W Li ◽

...

Keyword(s):

Tertiary Hospital ◽

Adverse Outcomes ◽

C Reactive Protein ◽

Reactive Protein ◽

End Point ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Design And Methods ◽

Group 1

Summary Background/Introduction There are little data on outcomes of COVID-19 patients with the presence of fever compared to the presence of symptoms. Aim We examined the associations between symptomology, presence of fever and outcomes of a COVID-19 cohort. Design and Methods Between 23 January and 30 April 2020, 554 COVID-19 patients were admitted to a tertiary hospital in Singapore. They were allocated into four groups based on symptomology and fever—Group 1: asymptomatic and afebrile, Group 2: symptomatic but afebrile, Group 3: febrile but asymptomatic and Group 4: symptomatic and febrile. The primary outcomes were intensive care unit (ICU) admissions and mortality. The composite end-point included ICU admissions, mortality or any COVID-19 related end-organ involvement. Results There were differences in ferritin (P=0.003), C-reactive protein (CRP) levels (P<0.001) and lymphopenia (P=0.033) across all groups, with the most favourable biochemical profile in Group 1, and the least in Group 4. Symptomatic groups (Groups 2 and 4) had higher ICU admissions (1.9% and 6.0%, respectively, P=0.003) than asymptomatic groups (Groups 1 and 3). Composite end-point was highest in Group 4 (24.0%), followed by Group 3 (8.6%), Group 2 (4.8%) and Group 1 (2.4%) (P<0.001). The presence of fever (OR 4.096, 95% CI 1.737–9.656, P=0.001) was associated with the composite end-point after adjusting for age, pulse rate, comorbidities, lymphocyte, ferritin and CRP. Presence of symptoms was not associated with the composite end-point. Discussion/Conclusion In this COVID-19 cohort, presence of fever was a predictor of adverse outcomes. This has implications on the management of febrile but asymptomatic COVID-19 patients.

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Endothelial function in men with type 2 diabetes without clinical signs of cardiovascular disease

Diabetes Mellitus ◽

10.14341/dm8017 ◽

2016 ◽

Vol 19 (5) ◽

pp. 383-387 ◽

Cited By ~ 1

Author(s):

Irina Alexandrovna Khripun ◽

Sergey Vladislavovich Vorobyev ◽

Maxim Nikolaevich Morgunov ◽

Michail Iosifovich Kogan

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Endothelial Function ◽

Reactive Hyperemia ◽

Clinical Signs ◽

C Reactive Protein ◽

Reactive Protein ◽

Group 2 ◽

Group 1

Type 2 diabetes mellitus (T2DM) increases the risk of cardiovascular disease that is based on endothelial dysfunction (ED). Currently, conventional diagnostic methods are unreliable, especially at early stages of disease.Aims. The aim of this work was to assess endothelial function in men with T2DM without clinical signs of cardiovascular disease.Materials and methods. The study included 100 patients (mean age, 54.3 ± 5.3 years) with a T2DM duration of less than 10 years and without signs of cardiovascular disease. The patients were divided into two groups: group 1 consisted of 60 patients with a T2DM duration of less than five years. Group 2 included 40 men with a history of diabetes between 5 and 10 years. Endothelial function was assessed by the levels of nitric oxide (NO), endothelial NO synthase type 3 (eNOS3), ICAM-1, VCAM-1, E-selectin, P-selectin, resistin and C-reactive protein and the arterial vasoreactivity of the brachial artery (BA) using the D. Celermajer method.Results. Results revealed decreases in levels of both eNOS3 by 2.5 fold (P = 0.0005) and NO by 1.9 fold (P = 0.043) in group 2 patients, compared to those in group 1 patients. When the duration of diabetes was greater than five years, levels of VCAM-1, resistin and C-reactive protein increased by 12.1% (P = 0.048), 62% (P = 0.01) and 45.6%, respectively. Additionally, the time until maximal BA vasodilatation during reactive hyperemia was observed to be higher in group 2 [105 (90; 180) seconds] than those in group 1 [90 (60; 120) seconds].Conclusions. Biochemical and imaging signs of ED begin to appear in the first five years of T2DM, long before clinical manifestations. The earliest symptoms are decreases in eNOS3 and NO levels, increases in VCAM-1 and resistin concentrations and increased time until maximal BA vasodilatation during reactive hyperemia.

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Neutrophil count to albumin ratio as a new predictor of mortality in patients with COVID-19 ınfection

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.s2.77 ◽

2020 ◽

Vol 66 (suppl 2) ◽

pp. 77-81 ◽

Cited By ~ 1

Author(s):

Ceyhun Varim ◽

Selcuk Yaylaci ◽

Taner Demirci ◽

Tezcan Kaya ◽

Ahmet Nalbant ◽

...

Keyword(s):

Platelet Count ◽

Neutrophil Count ◽

Mortality Risk ◽

Demographic Data ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Severe Group ◽

Group 2 ◽

Group 1

SUMMARY BACKGROUND Coronavirus Disease 2019 is an acute inflammatory respiratory disease. It causes many changes in hemogram parameters. Low albumin levels are associated with mortality risk in hospitalized patients. The aim of the present study is to reveal the place of neutrophil count to albumin ratio in predicting mortality in patients with COVID-19. METHODS 144 patients, 65 females and 79 males, were included in the study. Patients were divided into 2 groups. Group 1 was the non-severe group (n:85), and Group 2 was severe (n:59). Demographic data, neutrophil, lymphocyte and platelet counts, albumin and C-reactive protein (CRP) levels were recorded. Neutrophil count to albumin ratio (NAR) was calculated by dividing the absolute neutrophil counts by the albumin levels. The NAR and levels of the two groups were then compared. RESULTS There were no significant differences in gender and platelet count (201 vs. 211 K/mL) between the groups (p>0,05). Ages (62.0 ± 14.3 vs 68.6 ± 12.2 years), albumin (33.1 vs 29.9 gr/L), CRP (33 vs 113 mg/l), neutrophil count (4 vs 7.24 K/mL), WBC counts (6.70 vs 8.50 K/mL), NAR values (113.5 vs 267.2) and number of Death (5 vs 33) were found to be statistically higher (p <0.001) in Group 2 than in Group 1. The NAR value of 201.5 showed mortality in all patients with COVID-19 to have 71.1% sensitivity and 71.7% specificity (AUC:0.736, 95% CI: 0.641-0.832, p<0.001) CONCLUSION The present study showed that NAR levels can be a cheap and simple marker for predicting mortality in patients with COVID-19.

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Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.6.2961 ◽

2020 ◽

Vol 36 (6) ◽

Author(s):

Jin Zhu ◽

Cheng Chen ◽

Rongshu Shi ◽

Bangguo Li

Keyword(s):

Ct Scan ◽

High Sensitivity ◽

Chest Ct ◽

Ground Glass ◽

C Reactive Protein ◽

Reactive Protein ◽

Group 2 ◽

Chest Ct Scan ◽

D Dimer ◽

Group 1

Objectives: To study the correlations of CT scan with high-sensitivity C-reactive protein (hs-CRP) and D-dimer in patients with coronavirus disease 2019 (COVID-2019). Methods: From January to March 2020, COVID-19 patients were divided into two groups according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial version 7), with mild and ordinary cases as Group-1 and critical and severe cases as Group-2. The chest CT scan results, hs-CRP, D-dimmer levels of the two groups from admission to discharge were compared by the c2 test or Fisher’s exact test. The quantitative data were represented as mean ± standard deviation (±s). Intergroup comparisons were performed by the independent samples t test, and the ineligible data were subjected to the nonparametric rank sum test. Binary logistic regression model was used for multivariate correlation analysis, using independent variables that were significant in univariate analysis. The correlations between the above indices were analyzed. Results: In Group-1, there were two cases of normal chest CT scan results, one case of fibrosis, and 25 cases of abnormalities during the first diagnosis, mainly manifested as single or scattered ground-glass shadows. After treatment, the CT scan results became normal. The chest CT scan of Group-2 showed abnormalities, including 21 cases of multiple ground-glass shadows, and six cases of multiple consolidations accompanied by ground-glass shadows, who were critically ill and died. In addition, there were 16 cases of multiple ground glass shadows with partial consolidation, and the CRP and D-dimer levels of Group-2 were significantly higher than those of Group-1. Chest CT scan results were significantly positively correlated with CRP and D-dimer levels (P<0.05). Conclusion: The chest CT scan results of COVID-19 patients are characteristic, being correlated with CRP and D-dimer levels. D-dimer and CRP levels significantly increase in most severe and critical patients, which are closely related to their prognosis. The indices may play predictive roles in clinical treatment and prognosis evaluation. doi: https://doi.org/10.12669/pjms.36.6.2961 How to cite this:Zhu J, Chen C, Shi R, Li B. Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019. Pak J Med Sci. 2020;36(6):1397-1401. doi: https://doi.org/10.12669/pjms.36.6.2961 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study

BMC Infectious Diseases ◽

10.1186/s12879-020-05647-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Anna Maria Cattelan ◽

Eugenia Di Meco ◽

Marco Trevenzoli ◽

Alessia Frater ◽

Anna Ferrari ◽

...

Keyword(s):

Intensive Care ◽

Neutrophil Count ◽

Clinical Characteristics ◽

Primary Outcome ◽

Fatality Rate ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Group 2 ◽

Group 1

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.

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C-reactive protein evaluation in communityacquired pneumonia with comorbid chronic heart failure as criterion of antibiotic prescription

Kardiologiia ◽

10.18087/cardio.2661 ◽

2019 ◽

Vol 59 (2S) ◽

pp. 40-46

Author(s):

A. A. Bobylev ◽

S. A. Rachina ◽

S. N. Avdeev ◽

R. S. Kozlov ◽

V. V. Mladov

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Response ◽

Clinical Success ◽

C Reactive Protein ◽

Additional Measurement ◽

Reactive Protein ◽

Group 2 ◽

Serum Crp ◽

Group 1

Aim.To prove that diagnostic algorithm based on additional measurement of serum C-reactive protein (CRP) for administration of systemic antibacterial therapy (ABT) to patients with suspected community-acquired pneumonia (CAP) and concomitant chronic heart failure (CHF) does not influence outcomes of disease.Materials and methods.This open, single-center, randomized, prospective, noninferiority study included 160 adult patients with documented functional class II–IV CHF who had been admitted with a preliminary diagnosis of non-severe CAP. Patients were randomized at 1:1 to two groups; group 1 – with additional measurement of CRP (n=80) and group 2 – with the use of routine diagnostic methods (n=80). In group 1, systemic ABT was administered only when serum CRP was >28.5 mg / l (threshold level of the biomarker calculated at the previous stage of the study); group 2 received a standard treatment. Noninferiority test result for both algorithms was evaluated by the number of patients with clinical success on days 12–14 (primary endpoint). Non-inferiority margin was δ=–13.5 %. In addition secondary endpoints (early clinical response on days 3–5; early in-hospital adverse events (development of complications; admission to intensive care unit (ICU); death), death, recurrent CAP or CHF worsening with readmission at 28 day; mortality at 90 and 180 days) were estimated. Standard statistical tools were used for all intergroup comparisons.Results:76 patients of each group reached the primary endpoint. Systemic ABT was administered to 51 (67.1 %) patients in group 1 and 76 (100 %) patients in group 2 (p<0.05). Both groups were comparable (p>0.05) regarding all endpoints: clinical success, 70 (92.1 %) vs. 69 (90.8 %), Δ=1.3 % (one-sided 97.5 % CI: – 8.25 % for non-inferiority margin δ=–13.5 %); early clinical response, 66 (86.8 %) vs. 68 (89.5 %); admission to ICU, 1 (1.3 %) vs. 1 (1.3 %); development of complications, 20 (26.3 %) vs. 22 (28.9 %); readmission, 5 (6.6 %) vs. 6 (7.9 %); in-hospital mortality, 2 (2.6 %) vs. 1 (1.3 %), mortality at 28 day, 3 (3.9 %) vs. 2 (2.6 %), at 90 day, 5 (6.6 %) vs. 4 (5.3 %), at 180 day, 8 (10.5 %) vs. 9 (11.8 %) cases, respectively.Conclusion:additional measurement of serum CRP in patients with CHF and suspected non-severe CAP was able to reduce rate of systemic ABT administration without outcomes and prognosis worsening.

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EFFECT OF PNEUMOPERITONEUM IN MODEL OF ABDOMINAL SEPSIS

JOURNAL OF SURGICAL AND CLINICAL RESEARCH ◽

10.20398/jscr.v11i1.20837 ◽

2020 ◽

Vol 11 (1) ◽

pp. 31-38

Author(s):

Cybelle Dutra Silva ◽

Evelynne Mayara Araújo Silva ◽

Vítor Brasil Medeiros ◽

Aldo Cunha Medeiros

Keyword(s):

Cecal Ligation ◽

Serum Levels ◽

Abdominal Sepsis ◽

Sepsis Group ◽

C Reactive Protein ◽

Serum Cytokine ◽

Reactive Protein ◽

Cytokine Levels ◽

Group 2 ◽

Group 1

ABSTRACT Purpose: This study aims to examine the effects of CO2 pneumoperitoneum on the level of inflammation biomarkers in a model of abdominal sepsis in rats. Methods: Twelve Wistar rats were randomly assigned to two groups of 6 rats each. Under anesthesia, abdominal sepsis was induced by cecal ligation and puncture (CLP). Rats were observed for 24 hours. Group 1: sepsis; group 2: sepsis + pneumoperitoneum with CO2 for 30 min. Six hours after pneumoperitoneum deflation, blood samples were collected by cardiac puncture to measure (TNFα), interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (PCR) and procalcitonin (PCT). Statistical analysis using Student t test (p<0.05). Results: All animals survived. The rats with sepsis + pneumoperitoneum had levels of TNFα, IL-1β and IL-6 (542.4 ± 21pg / mL; 312.1 ± 12 pg / mL and 115.4 ± 11 pg / mL (respectively ), significantly lower than in the sepsis group (p = 0.01). Serum cytokine levels in the sepsis group were TNFα = 733.2 ± 24pg / mL; IL-1β = 432.1 ± 15 pg / mL and IL-6 = 232.3 ± 16 pg / mL. Serum levels of PCT and CRP were significantly lower in the sepsis + pneumoperitoneum group than in the sepsis group. (p=0.01). Conclusion: In conclusion, pneumoperitoneum CO2 attenuates the biomarkers of the acute phase inflammatory response associated with perioperative sepsis by PLC.

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Value of biomarkers in the diagnosis of community-acquired pneumonia with concomitant chronic heart failure: a prospective observation study.

10.21203/rs.2.20488/v1 ◽

2020 ◽

Author(s):

Svetlana Rachina ◽

Andrey Bobylev ◽

Sergey Avdeev ◽

Roman Kozlov ◽

Pavel Lazarev ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Serum Levels ◽

Community Acquired Pneumonia ◽

P Value ◽

Observation Study ◽

Reactive Protein ◽

Group 2 ◽

Factor Α ◽

Group 1

Abstract Background The diagnosis of community-acquired pneumonia (CAP) in patients with chronic heart failure (CHF) is associated with objective difficulties due to similar clinical presentation. We aimed to evaluate the utility of serum biomarkers - С-reactive protein (CRP), procalcitonin (PCT), tumour necrosis factor α (TNFα), interleukin-6 (IL-6) and brain natriuretic peptide (BNP) in diagnosis of CAP in the presence of СHF.Methods Prospective observational study included patients with previously diagnosed CHF and suspected non-severe CAP. Participants underwent routine procedures and chest multispiral computed tomography (MSCT); serum levels of biomarkers (CRP, PCT, TNFα, IL-6) and BNP were measured. All patients were divided into group 1 with confirmed CAP and group 2 with excluded CAP according to MSCT findings. Standard statistical tools were applied, p-value <0.05 in two-tailed tests was considered statistically significant. The value of biomarkers was determined using logistic regression, their discriminatory efficacy was assessed by analyzing Receiver Operation Characteristic (ROC) curves.Results Altogether 35 with CAP (median age 78 (64-82) years, female 24/35 (68.6%)) and 35 - without CAP (median age 77 (71-82) years, female 22/35 (62.9%)) were enrolled. There were no differences between groups in baseline characteristics, with the exception of body temperature. We found significantly higher levels of CRP 50.0 (35.5-98.5) mg/L, PCT 0.10 (0.05-0.54) ng/mL and IL-6 46.1 (21.4-150.3) pg/mL in group 1 as compared to group 2 - 15.0 (9.5-25.0) mg/L, 0.05 (0.05-0.05) ng/mL and 13,6 (9,5; 25,0) pg/mL, respectively. AUC (95% CI) was the highest for CRP – 0.91 (0.83-0.98), followed by PCT – 0.81 (0.72-0.90) and IL-6 – 0.81 (0.71-0.91). CRP value of 28.5 mg/L had optimal sensitivity and specificity ratio (85.7/91.4%).Conclusion The measurement of serum CRP, PCT, IL-6 levels can be useful for diagnostics of CAP in patients with concomitant CHF. CRP had the optimal diagnostic utility in this population. Key words: community-acquired pneumonia, chronic heart failure, inflammatory biomarkers

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The effect of immunomodulators on various markers of the acute inflammation phase in patients with mild community-acquired pneumonia

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2021-99-4-36-43 ◽

2021 ◽

Vol 99 (4) ◽

pp. 36-43

Author(s):

M. P. Kostinov ◽

V. V. Gaynitdinova ◽

S. V. Kazharova ◽

V. N. Zorina ◽

V. B. Polischuk ◽

...

Keyword(s):

Acute Inflammation ◽

Community Acquired Pneumonia ◽

Control Group ◽

Blood Levels ◽

C Reactive Protein ◽

Reactive Protein ◽

Tnf Α ◽

Group 3 ◽

Group 2 ◽

Group 1

The objective: to study the effect of immunomodulators on markers of the acute inflammation phase in patients with mild community-acquired pneumonia (CAP).Subjects and methods. Patients (n = 64) with mild CAP (39.62 ± 9.82 years, CRB – 650.15 ± 0.04 scores) were enrolled in the study. The patients were divided into 2 groups: Group 1 (control) received only standard CAP therapy; in the other two groups, immunomodulators were prescribed simultaneously with standard therapy: in Group 2 – bacterial lysate (BL), in Group 3 – azoximer bromide (AB). In the patients, the blood levels of IL-6, TNF-α, C-reactive protein (CRP), lactoferrin were tested before treatment (day 1), and on days 13 and 60 of observation.Results. The initial levels of TNF-α, IL-6, CRP and lactoferrin in the patients were statistically significantly higher above normal ones. A significant decrease in the levels of TNF-α, IL-6, CRP was found in all patients on the 13th and 60th days of observation compared to the 1st day, the maximum reduction was observed in the patients receiving immunomodulators. The biggest decrease in the level of lactoferrin on the 60th day of observation was noted in the group of patients taking BL. The changes in the rate of TNF-α and IL-6 levels decrease on the 13th and 60th days were also statistically significantly more pronounced (compared to the control group). The changes in the rate of decreasing from the baseline on the 13th and 60th days in TNF-α in the BL Group made 44 [-64; -32]% and 85 [-89; -82]%; in the AB Group – 28 [-40; -20]% and 82 [-86; -80]%; in IL-6 in the BL group – 32 [-40; -18]% and 86 [-90; -85]%, in the AB group – 45 [-53; -38]% and 86 [-88; -84]%. In the control group, this parameter for TNF-α was 18 [-32; -8]% and 64 [-78; -56]%, for IL-6 – 11 [-20; -1]% and 75 [-81; -74]%.Conclusion. The addition of immunomodulators (BL, AB) to the therapy of patients with mild CAP results in statistically significant decrease in the blood levels of biomarkers of the acute inflammation phase on the 13th and 60th days.

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