scholarly journals Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Sergey G. Shcherbak ◽  
Anna Yu Anisenkova ◽  
Sergei V. Mosenko ◽  
Oleg S. Glotov ◽  
Alexander N. Chernov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Early Warning Score ◽  
Positive Test ◽  
City Hospital ◽  
Cytokine Storm ◽  
Positive Test Result ◽  
Test Result ◽  
D Dimer

ObjectiveA critical role in coronavirus disease 2019 (COVID-19) pathogenesis is played by immune dysregulation that leads to a generalized uncontrolled multisystem inflammatory response, caused by overproduction of proinflammatory cytokines, known as “a cytokine storm” (CS), strongly associated with a severe course of disease. The aim of this study is to identify prognostic biomarkers for CS development in COVID-19 patients and integrate them into a prognostic score for CS-associated risk applicable to routine clinical practice.Materials and MethodsThe authors performed a review of 458 medical records from COVID-19 patients (241 men and 217 women aged 60.0 ± 10.0) who received treatment in the St. Petersburg State Budgetary Institution of Healthcare City Hospital 40 (City Hospital 40, St. Petersburg), from Apr. 18, 2020 to Nov. 21, 2020. The patients were split in two groups: one group included 100 patients with moderate disease symptoms; the other group included 358 patients with progressive moderately severe, severe, and extremely severe disease. The National Early Warning Score (NEWS) score was used alongside with clinical assessment, chest computed tomographic (CT) scans, electrocardiography (ECG), and lab tests, like ferritin, C-reactive protein (CRP), interleukin (IL)-6, lactate dehydrogenase (LDH), and D-dimer.ResultsThe basic risk factors for cytokine storms in COVID-19 patients are male gender, age over 40 years, positive test result for replicative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, absolute lymphocyte count, dynamics in the NEWS score, as well as LDH, D-dimer, ferritin, and IL-6 levels. These clinical and instrumental findings can be also used as laboratory biomarkers for diagnosis and dynamic monitoring of cytokine storms. The suggested prognostic scale (including the NEWS score dynamics; serum IL-6 greater than 23 pg/ml; serum CRP 50 mg/L or greater; absolute lymphocyte count less than 0.72 × 109/L; positive test result for replicative coronavirus (SARS-CoV-2) RNA; age 40 years and over) is a useful tool to identify patients at a high risk for cytokine storm, requiring an early onset of anti-inflammatory therapy.

scholarly journals The lineage of coronavirus SARS-CoV-2 of Russian origin: Genetic characteristics and correlations with clinical parameters and severity of coronavirus infection

2022 ◽  
Vol 36 (4) ◽  
pp. 132-143
Author(s):  
O. S. Glotov ◽  
A. N. Chernov ◽  
A. I. Korobeynikov ◽  
R. S. Kalinin ◽  
V. V. Tsai ◽  
...  
Keyword(s):  
Blood Analysis ◽  
Viral Rna ◽  
Early Warning Score ◽  
Cdna Libraries ◽  
City Hospital ◽  
Genetic Characteristics ◽  
S Protein ◽  
Risk Of Death ◽  
Increased Risk ◽  
D Dimer

The identification of new SARS-CoV-2 and human protein and gene targets, which may be markers of the severity and outcome of the disease, are extremely important during the COVID-19 pandemic. The goal of this study was to carry out genetic analysis of SARS-CoV-2 RNA samples to elucidate correlations of genetic parameters (SNPs) with clinical data and severity of COVID-19 infection.Material and Methods. The study included viral RNA samples isolated from 56 patients with COVID-19 infection who received treatment at the City Hospital No. 40 of St. Petersburg from 04/18/2020 to 04/18/2021. Patients underwent physical examination with the assessments of hemodynamic and respiratory parameters, clinical risk according to National Early Warning Score (NEWS), computed tomography (CT) of the chest, and laboratory studies including clinical blood analysis, assessment of ferritin, C-reactive protein (CRP), interleukin-6 (IL-6), lactate dehydrogenase (LDH), D-dimer, creatinine, and glucose levels. All patients tested positive for SARS-CoV-2 RNA by polymerase chain reaction (PCR). Single nucleotide polymorphisms (SNPs) in viral RNA were identified through the creation of cDNA libraries by targeted sequencing (MiSeq Illumina). Bioinformatic analysis of viral samples was performed using the viralrecon v2 pipeline with the further annotation via Pangolin and Nextlade. Sampled genomes were visualized using the Integrative Genomics Viewer (IGV) software. Statistical data processing (descriptive statistics and graphical analysis of data relationships from diff erent tables) was performed using a GraphPad device on the Prism 8.01 platform.Results. A comparative analysis of SNP frequencies in the virus genome in samples from deceased and discharged patients was carried out. The SNPs associated with risk of death (OR > 1), neutral SNPs (OR = 1), and protective SNPs (OR < 1) were identifi ed. Patient samples were infected with 14 lines of SARS-CoV-2, fi ve of which (B.1.1.129, B.1.1.407, B.1.1.373, B.1.1.397, and B.1.1.152) were of Russian origin. The SNPs in the samples infected with the strains of non-Russian origin were associated with an increased risk of mortality (OR = 2.267, 95% confi dence interval 0.1594-8.653) compared to the SNPs in the samples obtained from the group of patients infected with the strains of Russian origin. Positive correlations were identifi ed between the average SNP number, nonsynonymous SNPs, and S-protein SNPs with the degree of respiratory failure, total NEWS score, CT-based form of disease, duration of treatment with mechanical ventilation, disease outcome, levels of LDH, glucose, D-dimer, and ferritin, and RNA amount in the PCR test. S-protein SNPs negatively correlated with the leukocyte and neutrophil counts.

scholarly journals Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study

BMJ ◽  
2021 ◽  
pp. n2060
Author(s):  
Lynda Fenton ◽  
Ciara Gribben ◽  
David Caldwell ◽  
Sam Colville ◽  
Jen Bishop ◽  
...  
Keyword(s):  
General Population ◽  
Hospital Admission ◽  
Healthcare Workers ◽  
Population Based ◽  
Positive Test ◽  
Positive Test Result ◽  
Working Age ◽  
Household Members ◽  
Test Result ◽  
Control Study

Abstract Objective To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. Design Population based nested case-control study. Setting Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. Participants All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. Main outcome measures The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. Results Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. Conclusion Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.

scholarly journals ‘Immunity Passports’ for SARS-CoV-2: an online experimental study of the impact of antibody test terminology on perceived risk and behaviour

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e040448
Author(s):  
Jo Waller ◽  
G James Rubin ◽  
Henry W W Potts ◽  
Abigail L Mottershaw ◽  
Theresa M Marteau
Keyword(s):  
Perceived Risk ◽  
Antibody Test ◽  
Open Science ◽  
Hand Washing ◽  
Physical Contact ◽  
Positive Test ◽  
Positive Test Result ◽  
Risk Of Infection ◽  
The Impact ◽  
Test Result

ObjectiveTo assess the impact of describing an antibody-positive test result using the terms Immunity and Passport or Certificate, alone or in combination, on perceived risk of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and protective behaviours.Design2×3 experimental design.SettingOnline.Participants1204 adults from a UK research panel.InterventionParticipants were randomised to receive one of six descriptions of an antibody test and results showing SARS-CoV-2 antibodies, differing in the terms describing the type of test (Immunity vs Antibody) and the test result (Passport vs Certificate vs Test).Main outcome measuresPrimary outcome: proportion of participants perceiving no risk of infection with SARS-CoV-2 given an antibody-positive test result. Other outcomes include: intended changes to frequency of hand washing and physical distancing.ResultsWhen using the term Immunity (vs Antibody), 19.1% of participants (95% CI 16.1% to 22.5%) (vs 9.8% (95% CI 7.5% to 12.4%)) perceived no risk of catching coronavirus given an antibody-positive test result (adjusted OR (AOR): 2.91 (95% CI 1.52 to 5.55)). Using the terms Passport or Certificate—as opposed to Test—had no significant effect (AOR: 1.24 (95% CI 0.62 to 2.48) and AOR: 0.96 (95% CI 0.47 to 1.99) respectively). There was no significant interaction between the effects of the test and result terminology. Across groups, perceiving no risk of infection was associated with an intention to wash hands less frequently (AOR: 2.32 (95% CI 1.25 to 4.28)); there was no significant association with intended avoidance of physical contact (AOR: 1.37 (95% CI 0.93 to 2.03)).ConclusionsUsing the term Immunity (vs Antibody) to describe antibody tests for SARS-CoV-2 increases the proportion of people believing that an antibody-positive result means they have no risk of catching coronavirus in the future, a perception that may be associated with less frequent hand washing.Trial registration numberOpen Science Framework: https://osf.io/tjwz8/files/

scholarly journals Clinical predictors of a positive test result in patients undergoing genetic evaluation for a hereditary kidney cancer syndrome

2019 ◽  
Vol 14 (8) ◽  
Author(s):  
Andrea Kokorovic ◽  
Aidan Thomas ◽  
Jesus Serrano-Lomelin ◽  
Meghan Ferguson ◽  
Ricardo A. Rendon
Keyword(s):  
High Risk ◽  
Kidney Cancer ◽  
Genetic Counselling ◽  
Real Life ◽  
Medical Genetics ◽  
Positive Test ◽  
Positive Test Result ◽  
Clinical Implementation ◽  
Cancer Syndrome ◽  
Test Result

Introduction: Guidelines are available to assist providers in identifying patients with renal cell carcinoma (RCC) that may benefit from genetic counselling, however, the evidence for these recommendations lacks support from the literature and controversy remains as to who should be referred. We aimed to delineate risk factors associated with a positive genetic test in a real-life cohort of patients with RCC referred to a regional medical genetics unit for evaluation of a hereditary kidney cancer syndrome. Methods: Patients with a diagnosis of RCC referred to Maritime Medical Genetics Service (Nova Scotia, Canada) from 2006–2017 were reviewed using retrospective data. The primary outcome was identification of clinical features that were associated with a positive test result. Logistic regression models were used for analysis. Results: A total of 135 patients were referred to medical genetics for evaluation; 102 patients were evaluated, 75 underwent testing, and 74 were included in the final analysis. Five patients tested positive: three Birt Hogg Dube, one Cowden syndrome, and one Von Hippel Lindau. Presence of dermatological lesions (specifically fibrofolliculomas) and more than two high-risk features were the only predictors of a positive test result. Conclusions: The presence of dermatological lesions and more than two high-risk features are the only predictors of a positive test result in patients with a suspected hereditary kidney cancer syndrome. These findings are not reflected in current guidelines, and the clinical implementation of our results may improve the identification of high-risk patients for genetic counselling.

scholarly journals Impact ofBRCA1/2 testing and disclosure of a positive test result on women affected and unaffected with breast or ovarian cancer

2004 ◽  
Vol 124A (4) ◽  
pp. 346-355 ◽  
Author(s):  
Mari�lle S. van Roosmalen ◽  
P.F.M. Stalmeier ◽  
L.C.G. Verhoef ◽  
J.E.H.M. Hoekstra-Weebers ◽  
J.C. Oosterwijk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Test ◽  
Positive Test Result ◽  
Test Result

scholarly journals Erratum to: Parameters related to a positive test result for FDG PET(/CT) for large vessel vasculitis: a multicenter retrospective study

2012 ◽  
Vol 31 (5) ◽  
pp. 873-875 ◽  
Author(s):  
G. A. Hooisma ◽  
H. Balink ◽  
P. M. Houtman ◽  
R. H. J. A. Slart ◽  
K. D. F. Lensen
Keyword(s):  
Retrospective Study ◽  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Positive Test ◽  
Positive Test Result ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Test Result

Risk Model Predictive of Severe Anemia Requiring RBC Transfusion After Chemotherapy in Pediatric Solid Tumor Patients

2003 ◽  
Vol 21 (22) ◽  
pp. 4235-4238 ◽  
Author(s):  
Perrine Marec-Berard ◽  
Jean Yves Blay ◽  
Matthias Schell ◽  
Murielle Buclon ◽  
Corrine Demaret ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Lymphocyte Count ◽  
Risk Model ◽  
Pediatric Population ◽  
Performance Status ◽  
Univariate Analysis ◽  
Absolute Lymphocyte Count ◽  
The Difference ◽  
Rbc Transfusion

Purpose: Severe anemias requiring RBC transfusions is a frequent complication of chemotherapy. A model elaborated by Ray-Coquard et al in adults pointed to three independent risk factors for RBC transfusion: performance status (PS) more than 1, hemoglobin less than 12 g/dL, and prechemotherapy absolute lymphocyte count (ALC) ≤ 700/μL. This model is tested on a pediatric population.Patients and Methods: One hundred nineteen children with solid tumors consecutively admitted for conventional chemotherapy throughout 1 year were included. The study end point was the RBC-transfusion risk in the month following chemotherapy. Only one course was considered for each patient. Age, sex, number of courses, platinum-containing regimens, PS, and hemoglobin and lymphocyte count at day 1 were tested in univariate and multivariate analyses.Results: Thirty-one (26%) of 119 children required RBC transfusion within 31 days of chemotherapy. Three factors correlated to transfusion risk in the univariate analysis: PS more than 1 (P < .001), hemoglobin less than 12 g/dL (P = .007), and pretreatment ALC ≤ 700/μL (P < .001). In the multivariate analysis, hemoglobin less than 12 g/dL, PS more than 1, and ALC ≤ 700/μL were identified as independent factors predicting RBC transfusion. The calculated probability of receiving RBC transfusion within 31 days of chemotherapy was high with three risk factors (96%), intermediate with two risk factors (53% to 77%), low with one risk factor (10% to 26%), and very low when no risk factor was present (2%). The difference of transfusion needs was significant (P < .001).Conclusion: The risk model elaborated for adults may also segregate children at high risk of postchemotherapy RBC transfusion, thus facilitating assessment of risk of transfusion and/or prophylactic erythropoietin support.

Sign in / Sign up

Export Citation Format

Share Document