scholarly journals Lipid Profile Features and Their Associations With Disease Severity and Mortality in Patients With COVID-19

2020 ◽  
Vol 7 ◽  
Author(s):  
Jia Teng Sun ◽  
Zhongli Chen ◽  
Peng Nie ◽  
Heng Ge ◽  
Long Shen ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Disease Severity ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Density Lipoprotein ◽  
Strongly Correlated ◽  
Discrimination Ability ◽  
Reactive Protein ◽  
Low Hdl ◽  
Hospital Deaths

Background: Emerging studies have described and analyzed epidemiological, clinical, laboratory, and radiological features of COVID-19 patients. Yet, scarce information is available regarding the association of lipid profile features and disease severity and mortality.Methods: We conducted a prospective observational cohort study to investigate lipid profile features in patients with COVID-19. From 9 February to 4 April 2020, a total of 99 patients (31 critically ill and 20 severely ill) with confirmed COVID-19 were included in the study. Dynamic alterations in lipid profiles were recorded and tracked. Outcomes were followed up until 4 April 2020.Results: We found that high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A-1 (apoA-1) levels were significantly lower in the severe disease group, with mortality cases showing the lowest levels (p < 0.0001). Furthermore, HDL-C and apoA-1 levels were independently associated with disease severity (apoA-1: odds ratio (OR): 0.651, 95% confidence interval (CI): 0.456–0.929, p = 0.018; HDL-C: OR: 0.643, 95% CI: 0.456–0.906, p = 0.012). For predicting disease severity, the areas under the receiver operating characteristic curves (AUCs) of HDL-C and apoA-1 levels at admission were 0.78 (95% CI, 0.70–0.85) and 0.85 (95% CI, 0.76–0.91), respectively. For in-hospital deaths, HDL-C and apoA-1 levels demonstrated similar discrimination ability, with AUCs of 0.75 (95% CI, 0.61–0.88) and 0.74 (95% CI, 0.61–0.88), respectively. Moreover, patients with lower serum concentrations of apoA-1 (<0.95 g/L) or HDL-C (<0.84 mmol/l) had higher mortality rates during hospitalization (log-rank p < 0.001). Notably, levels of apoA-1 and HDL-C were inversely proportional to disease severity. The survivors of severe cases showed significant recovery of apoA-1 levels at the end of hospitalization (vs. midterm apoA-1 levels, p = 0.02), whereas the mortality cases demonstrated continuously lower apoA-1 levels throughout hospitalization. Correlation analysis revealed that apoA-1 and HDL-C levels were negatively correlated with both admission levels and highest concentrations of C-reactive protein and interleukin-6.Conclusions: Severely ill COVID-19 patients featured low HDL-C and apoA-1 levels, which were strongly correlated with inflammatory states. Thus, low apoA-1 and HDL-C levels may be promising predictors for severe disease and in-hospital mortality in patients suffering from COVID-19.

scholarly journals Clinical features and disease severity in an Iranian population of COVID-19 patients

2020 ◽  
Author(s):  
Shima Nabavi ◽  
Zahra Javidarabshahi ◽  
Abolghasem Allahyari ◽  
Mohammad Ramezani ◽  
Mohsen Seddigh-Shamsi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Features ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
Severity Of The Disease ◽  
Lung Ct

Abstract Objectives: Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age of 69.75±6.39 years, of whom 82 (41%) were female were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age, malignant comorbidities, dyspnea, nausea/vomiting, confusion, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock, coagulopathy, acidosis, sepsis, acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea/vomiting, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea/vomiting, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease in COVID-19 patients.

scholarly journals Clinical features and disease severity in an Iranian population of inpatients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shima Nabavi ◽  
Zahra Javidarabshahi ◽  
Abolghasem Allahyari ◽  
Mohammad Ramezani ◽  
Mohsen Seddigh-Shamsi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Features ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
Severity Of The Disease ◽  
Lung Ct

AbstractCoronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 inpatients with different severities. This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February–April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P < 0.05 was considered statistically significant. Overall, 200 patients with mean age of 69.75 ± 6.39 years, of whom 82 (41%) were female were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age, malignant comorbidities, dyspnea, nausea/vomiting, confusion, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P < 0.05). Moreover, complications including shock, coagulopathy, acidosis, sepsis, acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities (P < 0.05). O2 saturation, nausea/vomiting, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR 0.342, 45.93, and 25.48, respectively; P < 0.05). Our results indicate O2 saturation, nausea/vomiting, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors to predict severe disease in COVID-19 patients.

scholarly journals Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2077
Author(s):  
Yi-Min Huang ◽  
Chiao Lo ◽  
Chiao-Feng Cheng ◽  
Cheng-Hsun Lu ◽  
Song-Chou Hsieh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Serum Biomarkers ◽  
Healthy Controls ◽  
Granulomatous Mastitis ◽  
C Reactive Protein ◽  
Idiopathic Granulomatous Mastitis ◽  
Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

scholarly journals Factors Associated with Disease Severity and Mortality among Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Nyan Lynn Tun ◽  
Waqas Haque ◽  
Marie Gilbert Majella ◽  
Ranjith Kumar Sivakumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
English Language ◽  
Clinical Decision Making ◽  
Clinical Laboratory ◽  
Data Extraction ◽  
Meta Analysis ◽  
Severe Disease ◽  
Factors Associated ◽  
Risk Of Mortality

Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results: Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45; 95%CI 1.23,1.71), dyspnea (RR 2.55; 95%CI 1.88,2.46), diabetes (RR 1.59; 95%CI 1.41,1.78), hypertension (RR 1.90; 95%CI 1.69,2.15). Congestive heart failure (OR 4.76; 95%CI 1.34,16.97), hilar lymphadenopathy (OR 8.34; 95%CI 2.57,27.08), bilateral lung involvement (OR 4.86; 95%CI 3.19,7.39) and reticular pattern (OR 5.54; 95%CI 1.24,24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion: Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

scholarly journals A Single Consumption of High Amounts of the Brazil Nuts Improves Lipid Profile of Healthy Volunteers

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Elisângela Colpo ◽  
Carlos Dalton de Avila Vilanova ◽  
Luiz Gustavo Brenner Reetz ◽  
Marta Maria Medeiros Frescura Duarte ◽  
Iria Luiza Gomes Farias ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Lipid Profile ◽  
Serum Lipid ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Lipid Profile ◽  
Brazil Nut ◽  
Plasma Selenium ◽  
Reactive Protein ◽  
Liver And Kidney

Background. This study investigates the effects of Brazil nut ingestion on serum lipid profile in healthy volunteers.Methods. Ten healthy subjects were enrolled in the study. Each subject was tested 4 times in a randomized crossover in relation to the ingestion of different serving sizes of the Brazil nut: 0, 5, 20, or 50 g. At each treatment point, peripheral blood was drawn before and at 1, 3, 6, 9, 24, and 48 hours and 5 and 30 days. Blood samples were tested for total cholesterol, high- and low-density lipoprotein cholesterol (HDL-c and LDL-c, resp.), triglycerides, selenium, aspartate and alanine aminotransferases, albumin, total protein, alkaline phosphatase, gamma GT, urea, creatinine, and C-reactive protein.Results. A significant increase of the plasma selenium levels was observed at 6 hours within the groups receiving the nuts. Serum LDL-c was significantly lower, whereas HDL-c was significantly higher 9 hours after the ingestion of 20 or 50 g of nuts. The biochemical parameters of liver and kidney function were not modified by ingestion of nuts.Conclusions. This study shows that the ingestion of a single serving of Brazil nut can acutely improve the serum lipid profile of healthy volunteers.

scholarly journals Serum Level of Interleukin-33, C-Reactive Protein, and Troponin in Iraqi Coronary Artery Disease Patients

2020 ◽  
pp. 314-321
Author(s):  
Athraa Z. Al-Obaidi ◽  
Jinan M. J. Al-Saffar
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Level ◽  
Lipid Profile ◽  
Supply And Demand ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Artery Disease

     Coronary artery disease (CAD) is a condition of an inadequate supply of oxygenated blood to a portion of the myocardium. It typically occurs when there is an imbalance between supply and demand of myocardial oxygen. The most common cause of myocardial ischemia is atherosclerotic disease of an epicardial coronary artery or arteries which is sufficient to cause a regional reduction in myocardial blood flow and inadequate perfusion of the myocardium supplied by the involved coronary artery. Fifty CAD subjects (23 females and 27 males) were enrolled in this study in addition to thirty healthy control subjects (13 female and 17 male). This study aimed to measure the serum levels of interleukin IL- 33, C- reactive protein and troponin in CAD and their association with lipid profile by using enzyme-linked immune sorbent assay (ELISA). T results showed that high-density lipoprotein (HDL) was statistically high while differences in cholesterol, triglyceride and low-density lipoprotein (LDL) were statistically non-significant between CAD patients and controls. Moreover, the serum level of IL-33 and CRP were statistically higher in patients than controls, while troponin levels were not significantly different. In addition, the present study demonstrates that IL-33, CRP, and Troponin were not associated with lipid profile. The relationship of IL-33 with CRP and troponin was non-significant.

scholarly journals Prevalence of dyslipidemia in young adults.

2020 ◽  
Vol 27 (05) ◽  
pp. 987-993
Author(s):  
Mir Tahir Hussain Talpur ◽  
Muhammad Tauqeer Katbar ◽  
Khalil Ullah Shabir ◽  
Kashif Ullah Shabir ◽  
Uzair Yaqoob ◽  
...  
Keyword(s):  
Young Adults ◽  
Lipid Profile ◽  
Serum Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Institutional Review ◽  
Low Hdl ◽  
Males And Females

Objectives: This study will help us to understand what lipid profile is normally present in our population, if abnormal, timely screening, education, and proper management can be done. Study Design: Cross-sectional study. Setting: Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan. Period: November 2018-April 2019. Material & Methods: For the lipid profile, intravenous blood samples were collected in testing bottles after overnight fasting of 9-12 hours and sent to the institutional laboratory for testing. Dyslipidemia was defined as abnormal levels of any of the following components of the lipid profile. Total cholesterol of <200mg/dL was considered “desirable” while that of >240mg/dL was termed as hypercholesterolemia. High-density lipoprotein (HDL) was considered as “low” when it was <40mg/dL while Low-density lipoprotein (LDL) was considered as “optimal” when it was less than 100 mg/dL. Triglycerides level >150 mg/dL was identified as hypertriglyceridemia. We defined isolated dyslipidemias as abnormal levels of any of these. This study was assessed and approved by the institutional review board of JPMC. Results: 112 participants of age <40 and >20 years were registered with 62 males and 50 females. Prevalence of dyslipidemia was found to be 75.9% with significantly high percentage in females (p < 0.05). 55.4% of the participants had desirable serum cholesterol and 42.9% had hypertriglyceridemia. 58% of these had HDL levels <40 mg/dL while 18.8% had high LDL levels. The mean serum cholesterol was significantly different in males and females (p=0.018). 7.1% of the total had isolated hypertriglyceridemia, 18.8% had isolated low HDL levels, and 46.4% had mixed hyperlipidemia, with significant differences between males and females in the former two. Conclusion: Dyslipidemia is a major risk factor for numerous systemic disorders and should be detected early in life for an effective management prior to the appearance of symptoms. This study gave a high prevalence of dyslipidemia in asymptomatic young adults, with females being more frequently affected than females.

scholarly journals Proadrenomedullin Predicts Severe Disease in Children with Suspected Community-Acquired Pneumonia

2020 ◽  
Author(s):  
Todd A Florin ◽  
Lilliam Ambroggio ◽  
Cole Brokamp ◽  
Yin Zhang ◽  
Eric S Nylen ◽  
...  
Keyword(s):  
Disease Severity ◽  
Odds Ratio ◽  
Severe Disease ◽  
Antibiotic Use ◽  
Supplemental Oxygen ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Chest Drainage ◽  
Reactive Protein ◽  
Complicated Pneumonia

Abstract Background Proadrenomedullin (proADM), a vasodilatory peptide with antimicrobial and anti-inflammatory properties, predicts severe outcomes in adults with community-acquired pneumonia (CAP) to a greater degree than C-reactive protein and procalcitonin. We evaluated the ability of proADM to predict disease severity across a range of clinical outcomes in children with suspected CAP. Methods We performed a prospective cohort study of children 3 months to 18 years with CAP in the emergency department (ED). Disease severity was defined as: mild (discharged home), mild-moderate (hospitalized but not moderate-severe or severe), moderate-severe (e.g., hospitalized with supplemental oxygen, broadening of antibiotics, complicated pneumonia), and severe (e.g., vasoactive infusions, chest drainage, severe sepsis). Outcomes were examined using proportional odds logistic regression within the cohort with suspected CAP and in a subset with radiographic CAP. Results Among 369 children, median proADM increased with disease severity [mild: median 0.53 nmol/L (IQR:0.43, 0.73), mild-moderate: 0.56 nmol/L (IQR:0.45, 0.71), moderate-severe: 0.61 nmol/L (IQR:0.47, 0.77), severe: 0.70 nmol/L (IQR:0.55, 1.04) (p=.002)]. ProADM was significantly associated with increased odds of developing severe outcomes (suspected CAP odds ratio (OR) 1.68 [95% CI, 1.2, 2.36], radiographic CAP OR 2.11 [95% CI, 1.36, 3.38]) adjusted for age, fever duration, antibiotic use, and pathogen. ProADM had an area under the ROC curve (AUC) of 0.64 (95%CI, 0.56,0.72) in those with suspected CAP and AUC 0.77 (95% CI, 0.68,0.87) in radiographic CAP. Conclusions ProADM was associated with severe disease and discriminated moderately well children who developed severe disease from those who did not, particularly in radiographic CAP.

scholarly journals A descriptive and validation study of a predictive model of severity of SARS-COV-2 infection

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yolanda Villena-Ortiz ◽  
Marina Giralt ◽  
Laura Castellote-Bellés ◽  
Rosa M. Lopez-Martínez ◽  
Luisa Martinez-Sanchez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Predictive Model ◽  
Clinical Laboratory ◽  
Demographic Data ◽  
Severe Disease ◽  
External Validation ◽  
Predictive Values ◽  
Reactive Protein ◽  
Predictive Variables ◽  
Moderate Disease

Abstract Objectives The strain the SARS-COV-2 pandemic is putting on hospitals requires that predictive values are identified for a rapid triage and management of patients at a higher risk of developing severe COVID-19. We developed and validated a prognostic model of COVID-19 severity. Methods A descriptive, comparative study of patients with positive vs. negative PCR-RT for SARS-COV-2 and of patients who developed moderate vs. severe COVID-19 was conducted. The model was built based on analytical and demographic data and comorbidities of patients seen in an Emergency Department with symptoms consistent with COVID-19. A logistic regression model was designed from data of the COVID-19-positive cohort. Results The sample was composed of 410 COVID-positive patients (303 with moderate disease and 107 with severe disease) and 81 COVID-negative patients. The predictive variables identified included lactate dehydrogenase, C-reactive protein, total proteins, urea, and platelets. Internal calibration showed an area under the ROC curve (AUC) of 0.88 (CI 95%: 0.85–0.92), with a rate of correct classifications of 85.2% for a cut-off value of 0.5. External validation (100 patients) yielded an AUC of 0.79 (95% CI: 0.71–0.89), with a rate of correct classifications of 73%. Conclusions The predictive model identifies patients at a higher risk of developing severe COVID-19 at Emergency Department, with a first blood test and common parameters used in a clinical laboratory. This model may be a valuable tool for clinical planning and decision-making.

scholarly journals Gut microbiota diversity and C-Reactive Protein are predictors of disease severity in COVID-19 patients

2021 ◽  
Author(s):  
André Moreira-Rosário ◽  
Cláudia Marques ◽  
Hélder Pinheiro ◽  
João Ricardo Araújo ◽  
Pedro Ribeiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gut Microbiota ◽  
Disease Severity ◽  
Severe Disease ◽  
Clinical Severity ◽  
Rrna Gene ◽  
C Reactive Protein ◽  
Clinical Progression ◽  
Reactive Protein ◽  
Microbiota Diversity

AbstractRisk factors for COVID-19 disease severity are still poorly understood. Considering the pivotal role of gut microbiota on host immune and inflammatory functions, we investigated the association between changes in gut microbiota composition and the clinical severity of COVID-19. We conducted a multicentre cross-sectional study prospectively enrolling 115 COVID-19 patients categorized according to: 1) WHO Clinical Progression Scale - mild 19 (16.5%), moderate 37 (32.2%) or severe 59 (51.3%); and 2) location of recovery from COVID-19 - ambulatory 14 (household isolation; 12.2%), hospitalized in ward 40 (34.8%) or intensive care unit 61 (53.0%). Gut microbiota analysis was performed through 16S rRNA gene sequencing and data obtained was further related with clinical parameters of COVID-19 patients. Risk factors for COVID-19 severity were identified by univariate and multivariable logistic regression models.In comparison with mild COVID-19 patients, the gut microbiota of moderate and severe patients has: a) lower Firmicutes/Bacteroidetes ratio, b) higher abundance of Proteobacteria; and c) lower abundance of beneficial butyrate-producing bacteria such as Roseburia and Lachnospira genera. Multivariable regression analysis showed that Shannon index diversity (odds ratio [OR] 2.85 [95% CI 1.09-7.41]; p=0.032) and C-Reactive Protein (OR 3.45 [95% CI 1.33-8.91]; p=0.011) were risk factors for COVID-19 severe disease (a score of 6 or higher in WHO clinical progression scale).In conclusion, our results demonstrated that hospitalised moderate and severe COVID-19 patients have microbial signatures of gut dysbiosis and for the first time, the gut microbiota diversity is pointed out as a prognostic biomarker for COVID-19 disease severity.

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