Ability of Laboratory Findings Upon Admission to Predict Lung Involvement and Its Severity in COVID-19 Patients Requiring Hospitalization

Mapping Intimacies ◽

10.32592/ircmj.2021.23.10.1183 ◽

2021 ◽

Keyword(s):

Troponin I ◽

Lung Parenchyma ◽

Lung Involvement ◽

Laboratory Findings ◽

Positive Polymerase Chain Reaction ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Single Center Study ◽

Thorax Ct

Background: The struggle of humanity with Coronavirus disease 2019 (COVID-19) infection, which affected the whole world and caused severe social and health crises, continues without deceleration. Objectives: This study aimed to determine the relationship between the abnormal laboratory parameters upon admission and the intensity of lung involvement using chest computerized tomography severity score (CT-SS). Methods: This single-center study evaluated a total of 242 patients who were admitted to our hospital due to COVID-19 with positive polymerase chain reaction (PCR) test results. The patients were divided into three groups of no involvement on thorax CT images, mild involvement, and moderate-severe involvement. Results: The mean ages of groups 1 (n=42), 2 (n=123), and 3 (n=77) were 38±10.6, 56.3±16, and 61±15.6 years, respectively (P<0.001). The three groups showed significant differences in terms of hypertension, diabetes mellitus, heart rate, oxygen saturation, lymphocyte count, platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII), ferritin, troponin-I, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) values (P<0.001). The CRP (R=0.545, P<0.001), ferritin (R=0.481, P<0.001), and SII (R=0.473, P<0.001) were moderately and positively correlated with CT-SS, while neutrophil-lymphocyte ratio (R=0.404, P<0.001), PLR (R=0.371, P<0.001), and ESR (R=0.327, P<0.001) were mildly and positively correlated with CT-SS. Conclusion: The results of the present study showed that elevation in CRP, as well as ferritin and SII values upon admission to the hospital was significantly correlated with CT-SS. The results also revealed that the presence of lung parenchyma involvement might be predicted in PCR positive COVID-19 patients without the need for thorax CT. Furthermore, it is believed that this information will provide great convenience to the clinicians who first welcome the patient in terms of predicting COVID-19 lung involvement.

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The role of coinfection with influenza viruses in the pathogenesis of severe infection in patients with COVID-19

Medical academic journal ◽

10.17816/maj78155 ◽

2021 ◽

Vol 21 (3) ◽

pp. 159-164

Author(s):

Tamara N. Shvedova ◽

Olga S. Kopteva ◽

Polina A. Kudar ◽

Anna A. Lerner ◽

Yuliya A. Desheva

Keyword(s):

Influenza A ◽

Fold Increase ◽

Igg Antibodies ◽

C Reactive Protein ◽

S Protein ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Coronavirus Infection

BACKGROUND: Despite the continuing global spread of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus, the mechanisms of the pathogenesis of severe infections remain poorly understood. The role of comorbidity with other seasonal viral infections, including influenza, in the pathogenesis of the severe course of COVID-19 remains unclear. MATERIALS AND METHODS: The present study used sera left over from ongoing laboratory studies of patients with varying degrees of severity of COVID-19. The study was approved by the Local Ethics Committee of the Federal State Budgetary Scientific Institution IEM (protocol 3/20 from 06/05/2020). We studied 28 paired samples obtained upon admission of patients to the hospital and after 57 days of hospital stay. Paired sera of patients with COVID-19 were tested for antibodies to influenza A and B viruses. The presence of IgG antibodies specific to the SARS-CoV-2 spike (S) protein was studied using an enzyme-linked immunosorbent assay (ELISA). The serum concentration of C-reactive protein and the neutrophil-lymphocyte ratio on the day of hospitalization were also assessed. RESULTS: At least a 4-fold increase in serum IgG antibodies to SARS-CoV-2 S protein was found both in patients with PCR-confirmed SARS-CoV-2 infection and without PCR confirmation. It was shown that out of 18 patients with moderate and severe forms of COVID-19 infection, six of them showed at least a 4-fold increase in antibodies to influenza A/H1N1, in one to influenza A/H3N2 and in two cases to the influenza B. Laboratory data in these two groups were characterized by significant increases in serum C-reactive protein and neutrophil-lymphocyte ratio concentrations compared with the moderate COVID-19 group. CONCLUSIONS: Serological diagnostics can additionally detect cases of coronavirus infection when the virus was not detected by PCR. In moderate and severe cases of COVID-19, coinfections with influenza A and B viruses have been identified. The results obtained confirm the need for anti-influenza immunization during the SARS-CoV-2 pandemic. Influenza virus screening can significantly improve patient management because recommended antiviral drugs (neuraminidase inhibitors) are available.

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Comparison of the Neutrophil/Lymphocyte Ratio and C-Reactive Protein Levels in Patients With Amputation for Diabetic Foot Ulcers

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734617696729 ◽

2017 ◽

Vol 16 (1) ◽

pp. 23-28 ◽

Cited By ~ 4

Author(s):

Hasan Metineren ◽

Turan Cihan Dülgeroğlu

Keyword(s):

Diabetic Foot ◽

Inflammatory Marker ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

C Reactive Protein ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Protein Levels ◽

Reactive Protein ◽

Before And After

This study compared the effectiveness of the neutrophil/lymphocyte ratio (NLR) versus C-reactive protein (CRP) for evaluating the prognosis and degree of inflammation in patients with amputation for a diabetic foot ulcer (DFU). This study enrolled 56 patients with amputations for DFU with gangrene and compared the CRP levels and NLR measured before and after surgery. Overall, 24 patients (42%) died within 2 weeks postoperatively. Mortality increased with a preoperative/postoperative CRP difference ≤1.5 ( P < .001) and age 73 years or older ( P < .001). The postoperative NLR was lower than the preoperative value but was not significant as a prognostic or inflammatory marker ( P = .945). An increasing serum CRP level is a significant predictor of mortality. CRP and old age are reliable prognostic factors in patients with DFU.

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