ELEVATED INTERLEUKIN–6 AND FERRITIN LEVELS EXACERBATE SEVERITY OF 2019 NOVEL CORONAVIRUS DISEASE (COVID-19): A PILOT STUDY

2021 ◽  
pp. 16-19
Author(s):  
Shelesh Kumar Swami ◽  
Nitesh Kumar Chauhan ◽  
Shuchi Goyal ◽  
A.K. Verma ◽  
Shweta Biyani
Keyword(s):  
Pilot Study ◽  
Interleukin 6 ◽  
Severe Disease ◽  
Close Monitoring ◽  
Medical Practitioners ◽  
Resultant Data ◽  
Initial Symptoms ◽  
Severe Group ◽  
Novel Coronavirus ◽  
Loss Of Appetite

Background & objectives: The 2019 novel coronavirus disease (COVID-19) pandemic is a big challenge for scientic and medical eld. Progression of severe disease is a difcult problem in treatment. Therefore, there is essential need to recognize severe forms of COVID-19 early in the disease course. Identication of effective biomarkers are able to classify patients based on severity. In this pilot study, we aimed to validate the association between immunologic biomarkers Interleukin-6 and ferritin with the severity of the COVID-19. Methods: A total of 1443 patients diagnosed with COVID-19 were enrolled including a severe group and a nonsevere group. Baseline clinical characteristics were collected. Serum interleukin-6 and ferritin were measured and the resultant data was statistically analyzed. Results: The most common initial symptoms were fever (68.81%) and cough (47.82%), followed by loss of appetite (9.28%), fatigue (17.46%) and breathlessness (15.52%). Level of IL-6 and Ferritin were signicantly higher in the severe patients (p<.05 for both) compared with nonsevere patients. Interpretation & conclusions: This pilot study conrmed that IL-6 and ferritin biomarkers are closely associated with the severity of COVID-19. Assessment of these biomarkers could be helpful to medical practitioners in starting treatment and close monitoring against COVID-19 infection which could improve prognosis and lower mortality

scholarly journals Baseline Interleukin-6 Level Predicts Risk of Severe COVID-19: A Two-Center, Retrospective Study

2020 ◽  
Author(s):  
Weigang Zhu ◽  
Yingping Wu ◽  
Yueping Liu ◽  
Bin Li ◽  
Pian Xiong ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Area Under The Curve ◽  
Severe Illness ◽  
Mild Disease ◽  
Predictive Variables ◽  
Initial Symptoms ◽  
Quartile Group

Abstract Background:The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has affected almost every country. Interleukin-6 (IL-6), a cytokine secreted by CD4+ T cell, has been shown to be a reliable marker of disease severity and a useful parameter for monitoring progression of coronavirus disease-2019 (COVID-19). However its value as a predictor of severe disease has not been assessed.Methods:A total of 160 laboratory-confirmed COVID-19 patients admitted to two hospitals were enrolledand separated into two groups according to whether or not they progressed to develop severe illness. Demographic and clinical characteristics at admission were compared between the groups.Results: Patients who developed severe COVID-19 had significantly higher baseline IL-6 levels than patients who had mild disease course in hospital (P< 0.001). Patients were further grouped according to quartiles of IL-6 level. The cumulative incidence of severe illnesswas significantly higher in the third and fourth quartiles groups than in the first quartile group (55% vs. 15% and 80% vs. 15%, respectively;bothP< 0.001). In multivariate logistic regression analysis, the risk for developing severe disease was markedly higher in the highest IL-6 quartile than in the lowest quartile (odds ratio: 14.95; 95% confidence interval: 3.65–61.30; P< 0.001). Receiver operating characteristic curve analysis of potential predictive variables showed the area under the curve to be largest for baseline IL-6, with the value of 5.20 pg/mL having the best balance of sensitivity and specificity for predicting risk of severe COVID-19.Conclusion: Serum baseline IL-6 appears to be a reliable predictor of risk of severe COVID-19. Early intervention may be advisable in patients with serum IL-6 levels >5.20 pg/mL, even if initial symptoms are mild.

scholarly journals The Society for Immunotherapy of Cancer perspective on regulation of interleukin-6 signaling in COVID-19-related systemic inflammatory response

2020 ◽  
Vol 8 (1) ◽  
pp. e000930 ◽  
Author(s):  
Fernanda I Arnaldez ◽  
Steven J O'Day ◽  
Charles G Drake ◽  
Bernard A Fox ◽  
Bingqing Fu ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Interleukin 6 ◽  
Severe Disease ◽  
Systemic Inflammatory Response ◽  
Interleukin 17 ◽  
Extensive Experience ◽  
Necrosis Factor Alpha ◽  
The Usa ◽  
Immunotherapy Of Cancer ◽  
Novel Coronavirus

The pandemic caused by the novel coronavirus SARS-CoV-2 has placed an unprecedented burden on healthcare systems around the world. In patients who experience severe disease, acute respiratory distress is often accompanied by a pathological immune reaction, sometimes referred to as ‘cytokine storm’. One hallmark feature of the profound inflammatory state seen in patients with COVID-19 who succumb to pneumonia and hypoxia is marked elevation of serum cytokines, especially interferon gamma, tumor necrosis factor alpha, interleukin 17 (IL-17), interleukin 8 (IL-8) and interleukin 6 (IL-6). Initial experience from the outbreaks in Italy, China and the USA has anecdotally demonstrated improved outcomes for critically ill patients with COVID-19 with the administration of cytokine-modulatory therapies, especially anti-IL-6 agents. Although ongoing trials are investigating anti-IL-6 therapies, access to these therapies is a concern, especially as the numbers of cases worldwide continue to climb. An immunology-informed approach may help identify alternative agents to modulate the pathological inflammation seen in patients with COVID-19. Drawing on extensive experience administering these and other immune-modulating therapies, the Society for Immunotherapy of Cancer offers this perspective on potential alternatives to anti-IL-6 that may also warrant consideration for management of the systemic inflammatory response and pulmonary compromise that can be seen in patients with severe COVID-19.

scholarly journals Clinical Symptom Differences Between Mild and Severe COVID-19 Patients in China: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaobo He ◽  
Xiao Cheng ◽  
Xudong Feng ◽  
Hong Wan ◽  
Sihan Chen ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Treatment Protocol ◽  
Initial Manifestation ◽  
Clinical Presentations ◽  
Initial Symptoms ◽  
Severe Group ◽  
Coronavirus Infection ◽  
Novel Coronavirus

Objective: The prognosis of mild and severe patients has prominent differences during the prevalence of COVID-19, and it will be significant to identify patients' potential risk of progressing to severe cases according to their first clinical presentations. Therefore, we aim to review the clinical symptoms of the COVID-19 epidemic systematically.Methods:We searched PubMed, Embase, Web of Science, and CNKI (Chinese Database) for studies about the clinical features of COVID-19 in China from March 18 to April 18. Then we used REVMAN to conduct a meta-analysis.Results: After screening, 20 articles including 3,326 COVID-19 confirmed cases were selected from 142 articles we retrieved at the beginning of our research. We divided all the cases into a severe group (including severe and critically severe patients) and a mild group according to the “Diagnosis and Treatment Protocol for Novel Coronavirus Infection-Induced Pneumonia” version 4 (trial). Of all the initial symptoms (including fever, cough, abdominal pain, anorexia, chest tightness, diarrhea, dyspnea, expectoration, fatigue, headache, hemoptysis, myalgia, nausea or vomiting, and pharyngalgia) we studied, we found that cough (odds ratio [OR] = 1.4, 95% confidence interval [CI]: 1.2–1.7; p &lt; 0.001), fever (OR = 1.5, 95% CI: 1.2–1.9; p &lt; 0.001), dyspnea (OR = 6.2, 95% CI: 3.6–10.6; p &lt; 0.001), diarrhea (OR = 2.6, 95% CI: 1.3–4.9; p &lt; 0.001), fatigue (OR = 2.1, 95% CI: 1.3–3.3; p &lt; 0.01), expectoration (OR = 1.7, 95% CI: 1.2–2.6; p &lt; 0.01), myalgia (OR = 1.6, 95% CI: 0.8–3.1; p &lt; 0.001), hemoptysis (OR = 4.0, 95% CI: 1.5–11.3; p &lt; 0.001), abdominal pain (OR = 7.5, 95% CI: 2.4–23.4; p &lt; 0.001), and anorexia (OR = 2.8, 95% CI: 1.5–5.1; p &lt; 0.001) had a different distribution in two groups and were statistically significant (p &lt; 0.05).Conclusion:COVID-19 patients whose initial manifestation is dyspnea, hemoptysis, anorexia, diarrhea, or fatigue, especially abdominal pain should be closely monitored to prevent disease deterioration.

Perfil dos Pacientes com Câncer Gástrico Atendidos no Hospital Municipal Dr. José de Carvalho Florence no Período de 2007 a 2012 / Profile of Gastric Cancer Patients Treated in Hospital Municipal Dr. José de Carvalho Florence Between the Period from 2007

1970 ◽  
Vol 6 (1) ◽  
pp. 25-42
Author(s):  
Rogério Mariotto Bitetti da Silva ◽  
Rosyane Rena de Freitas ◽  
Thiago Santos Rocha
Keyword(s):  
Gastric Cancer ◽  
Chi Square ◽  
Curative Intent ◽  
Metastatic Lesions ◽  
Initial Symptoms ◽  
Chi Square Test ◽  
Loss Of Appetite ◽  
Gastric Cancer Patients ◽  
Malignant Neoplasia ◽  
Cáncer Gástrico

RESUMOObjetivo: Avaliar o perfil dos pacientes com neoplasia maligna de estômago, que receberam atendimento e tratamento no Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF). Métodos: Estudo retrospectivo a partir do levantamento de prontuários. Análises foram feitas com uma amostragem e proporções esperadas desiguais e Quadros de contingência. Para se verificar associação entre as variáveis, utilizado o teste Qui–Quadrado de Pearson, considerando-se p ≤ 0,05, em um grau de confiabilidade de 95%. Resultados: O sexo masculino é o com maior número de casos na proporção de 2:1. A idade média ao diagnóstico é 65,16 anos. A queixa mais comum apresentada por estes pacientes foi a epigastralgia seguido pela inapetência. A maioria dos tumores encontrava-se no antro gástrico. Cinquenta e nove destes pacientes foram submetidos a cirurgia sendo 45 com intuito curativo. A sobrevida média foi de 15 meses e a taxa de sobrevida em 5 anos de apenas 6%.  Conclusão: O CG é uma doença muito agressiva e de prognóstico ruim. Suas manifestações iniciais são inespecíficas, o que torna seu diagnóstico em fases iniciais muito difícil.Palavras chave: Câncer Gástrico, Úlcera gástrica, Perfil de SaúdeABSTRACTObjective: Evaluate the profile of patients with malignant neoplasia of stomach, receiving care and treatment in Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF). Methods: Retrospective study based on a survey of medical records. Analysis were made with a sampling and unequal expected ratios and contingency tables. To assess the association between variables, will be used the chi-square test, considering p ≤ 0.05, at a reliability level of 95%. Results: The largest number of cases are male, ratio of 2:1. The average age at diagnosis is 65.16 years. Caucasians followed by mulatto were the most frequent with Gastric Cancer. The most common complaint presented by these patients was abdominal pain followed by loss of appetite. Most tumors found in the gastric antrum. Fifty-nine of these patients underwent surgery with curative intent in 45. Twenty of them had some type of metastasis intraoperatively and 12 outpatients progressed to metastatic lesions. The median survival was 15 months and the survivor rate in 5 years was only 6%. Conclusion: The Gastric Cancer is a very aggressive and poor prognosis disease. Its initial symptoms are nonspecific, making diagnosis difficult in the early stages.Keywords: Gastric Cancer, Gastric Ulcer, Health Profile.

A Case Series of SARS-CoV-2 RT-PCR-Positive Hospitalized Infants 60 Days of Age or Younger From 2 New York City Pediatric Emergency Departments

2021 ◽  
Vol 60 (4-5) ◽  
pp. 247-251
Author(s):  
Ameer Hassoun ◽  
Nessy Dahan ◽  
Christopher Kelly
Keyword(s):  
New York ◽  
Case Reports ◽  
Severe Disease ◽  
Case Series ◽  
Pediatric Emergency ◽  
Rt Pcr ◽  
Vulnerable Group ◽  
Mild Disease ◽  
Young Infants ◽  
Novel Coronavirus

The emergence of novel coronavirus disease-2019 poses an unprecedented challenge to pediatricians. While the majority of children experience mild disease, initial case reports on young infants are conflicting. We present a case series of 8 hospitalized infants 60 days of age or younger with coronavirus disease-2019. A quarter of these patients had coinfections (viral or bacterial). None of these infants had severe disease. Continued vigilance in testing this vulnerable group of infants is warranted.

scholarly journals Differences in coagulopathy indices in patients with severe versus non-severe COVID-19: a meta-analysis of 35 studies and 6427 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alberto Polimeni ◽  
Isabella Leo ◽  
Carmen Spaccarotella ◽  
Annalisa Mongiardo ◽  
Sabato Sorrentino ◽  
...  
Keyword(s):  
Platelet Count ◽  
Meta Analysis ◽  
Severe Disease ◽  
Coagulation Factors ◽  
Primary Analysis ◽  
Severe Group ◽  
Intravascular Coagulopathy ◽  
The Difference ◽  
D Dimer

AbstractCoronavirus disease 2019 (COVID-19) is a highly contagious disease that appeared in China in December 2019 and spread rapidly around the world. Several patients with severe COVID-19 infection can develop a coagulopathy according to the ISTH criteria for disseminated intravascular coagulopathy (DIC) with fulminant activation of coagulation, resulting in widespread microvascular thrombosis and consumption of coagulation factors. We conducted a meta-analysis in order to explore differences in coagulopathy indices in patients with severe and non-severe COVID-19. An electronic search was performed within PubMed, Google Scholar and Scopus electronic databases between December 2019 (first confirmed Covid-19 case) up to April 6th, 2020. The primary endpoint was the difference of D-dimer values between Non-Severe vs Severe disease and Survivors vs Non-Survivors. Furthermore, results on additional coagulation parameters (platelet count, prothrombin time, activated partial thromboplastin time) were also analyzed. The primary analysis showed that mean d-dimer was significantly lower in COVID-19 patients with non-severe disease than in those with severe (SMD − 2.15 [− 2.73 to − 1.56], I2 98%, P < 0.0001). Similarly, we found a lower mean d-dimer in Survivors compared to Non-Survivors (SMD − 2.91 [− 3.87 to − 1.96], I2 98%, P < 0.0001). Additional analysis of platelet count showed higher levels of mean PLT in Non-Severe patients than those observed in the Severe group (SMD 0.77 [0.32 to 1.22], I2 96%, P < 0.001). Of note, a similar result was observed even when Survivors were compared to Non-Survivors (SMD 1.84 [1.16 to 2.53], I2 97%, P < 0.0001). Interestingly, shorter mean PT was found in both Non-Severe (SMD − 1.34 [− 2.06 to − 0.62], I2 98%, P < 0.0002) and Survivors groups (SMD − 1.61 [− 2.69 to − 0.54], I2 98%, P < 0.003) compared to Severe and Non-Survivor patients. In conclusion, the results of the present meta-analysis demonstrate that Severe COVID-19 infection is associated with higher D-dimer values, lower platelet count and prolonged PT. This data suggests a possible role of disseminated intravascular coagulation in the pathogenesis of COVID-19 disease complications.

scholarly journals Active matrix metalloproteinase-8 and interleukin-6 detect periodontal degeneration caused by radiotherapy of head and neck cancer: a pilot study

2021 ◽  
pp. 1-8
Author(s):  
Mutlu Keskin ◽  
Hanna Lähteenmäki ◽  
Nilminie Rathnayake ◽  
Ismo T. Räisänen ◽  
Taina Tervahartiala ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Pilot Study ◽  
Matrix Metalloproteinase ◽  
Head And Neck ◽  
Neck Cancer ◽  
Interleukin 6 ◽  
Active Matrix

scholarly journals POS1232 COVID-19 IN PATIENTS WITH SYSTEMIC SCLEROSIS: ONE RHEUMATOLOGY CENTER EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 899.2-899
Author(s):  
M. Starovoytova ◽  
O. Desinova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
L. Garzanova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Severe Disease ◽  
High Risk Group ◽  
Nasopharyngeal Swab ◽  
Frequent Use ◽  
Diffuse Form ◽  
Novel Coronavirus ◽  
Almost All ◽  
Dose Prednisone ◽  
Frequent Presence

Background:Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) virus infection or COVID-19 is a serious problem for patients with systemic autoimmune diseases Given the serious complications, including acute lung injury, patients with systemic sclerosis (SSc), especially SSs associated with interstitial lung disease (ILD), may represent a high risk group for infection and the development of severe COVID-19.Objectives:We present an analysis of the COVID-19 course and outcomes in 110 SSc pts.Methods:The study included 147 patients with SSc. The information was clarified by means of telephone survey after 10 months of the pandemic (December 2020). Covid-19 was diagnosed when confirmed by positive oral /nasopharyngeal swab, in the presence of positive antibodies and/or characteristic symptoms, and data from chest computed tomography (CT). 110 pts (77%) out of 147 patients in the SSc registry, gave the necessary information. COVID-19 was diagnosed in 59 pts (53 %). 42 pts (71%) had SSc-ILD. Pts mean age was 54.96 (s.d.11, min 31, max 79), 83% women (49 women and 10 men). 38 pts (65%) had a limited form of SSc, 15 (26%) pts had diffuse form SSc, 6% had overlap (SSc-polymyositis (PM) and SSc had rheumatoid arthritis (RA) and 3% had visceral form of SSc). All patients received low-dose prednisone, and more than half of the pts received immunosuppressive therapy. Rituximab therapy was performed in 24 pts (41%).Results:Almost all patients had positive swab from the oral cavity/nasopharynx. And only in 4 (7%) pts nasopharyngeal swabs were negative, in these patients specific antibodies and characteristic CT changes were detected. Chest CT was performed in 51 (86%) pts. Novel coronavirus pneumonia developed in the vast majority of pts - in 46 (78 %) pts. CT1 (up to 25% of lung lesions) had 10 (17%) pts, CT2 (25-50%) – 21(36%) pts, CT 3 (50-75%) – 15(25%) pts. In 5 (8.5%) pts no changes were detected on CT. The course of COVID-19 was mild and moderate (20 (34%) pts and 18 (31%) pts respectively), severe course was observed in 21 (35%) pts, including fatal in 12 (20%) pts. Among the deceased pts, only 1 patient with SSc-PM had not had ILD, but 7 patients had been treated with rituximab.Conclusion:SSc SARS-CoV-2-infected patients may be at risk of severe disease and mortality due to the frequent presence of ILD and the frequent use of immunosuppressive, including biological, therapy.Disclosure of Interests:None declared

scholarly journals Outpatient Management of COVID-19 Disease: A Holistic Patient-Centered Proposal Based on the Greek Experience

2021 ◽  
Vol 11 (8) ◽  
pp. 709
Author(s):  
Adamantia Liapikou ◽  
Eleni Tzortzaki ◽  
Georgios Hillas ◽  
Miltiadis Markatos ◽  
Ilias C. Papanikolaou ◽  
...  
Keyword(s):  
Preventive Measures ◽  
Severe Disease ◽  
Hospital Setting ◽  
Guidance Document ◽  
Outpatient Management ◽  
Patient Centered ◽  
Mild Disease ◽  
Novel Coronavirus ◽  
Second Wave ◽  
Close Contacts

Novel coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a worldwide pandemic and affected more than 227 countries or territories, resulting in more than 179 million cases with over 3.890.00 deaths, as of June 25, 2021. The Hellenic Thoracic Society (HTS) during the second wave of COVID-19 pandemic released a guidance document for the management of patients with COVID-19 in the community and in hospital setting. In this review, with guidance the HTS document, we are discussing the outpatient management of COVID-19 patients, including the preventive measures, the patients’ isolation and quarantine criteria of close contacts, the severity and risk stratification, including the decisions for advanced hospitalization, and the disease management at home in patients with mild disease and after hospital discharge for those with more severe disease.

scholarly journals Natural variants in SARS-CoV-2 Spike protein pinpoint structural and functional hotspots with implications for prophylaxis and therapeutic strategies

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Suman Pokhrel ◽  
Benjamin R. Kraemer ◽  
Scott Burkholz ◽  
Daria Mochly-Rosen
Keyword(s):  
Amino Acid ◽  
Severe Disease ◽  
Single Amino Acid ◽  
Amino Acid Substitutions ◽  
Severe Respiratory Distress ◽  
S Protein ◽  
Individual Sequences ◽  
Natural Variants ◽  
Novel Coronavirus ◽  
The Individual

AbstractIn December 2019, a novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of pneumonia with severe respiratory distress and outbreaks in Wuhan, China. The rapid and global spread of SARS-CoV-2 resulted in the coronavirus 2019 (COVID-19) pandemic. Earlier during the pandemic, there were limited genetic viral variations. As millions of people became infected, multiple single amino acid substitutions emerged. Many of these substitutions have no consequences. However, some of the new variants show a greater infection rate, more severe disease, and reduced sensitivity to current prophylaxes and treatments. Of particular importance in SARS-CoV-2 transmission are mutations that occur in the Spike (S) protein, the protein on the viral outer envelope that binds to the human angiotensin-converting enzyme receptor (hACE2). Here, we conducted a comprehensive analysis of 441,168 individual virus sequences isolated from humans throughout the world. From the individual sequences, we identified 3540 unique amino acid substitutions in the S protein. Analysis of these different variants in the S protein pinpointed important functional and structural sites in the protein. This information may guide the development of effective vaccines and therapeutics to help arrest the spread of the COVID-19 pandemic.

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