scholarly journals Laporan Kasus Silent Hypoxemia pada Penderita COVID-19 dengan Komorbid Diabetes Melitus

2020 ◽  
Vol 7 (1A) ◽  
pp. 203-206
Author(s):  
Muncieto Andreas ◽  
Muhammad Ali Romansyah ◽  
Reski Anugrah Zuandra
Keyword(s):  
Blood Pressure ◽  
Poor Prognosis ◽  
Severe Disease ◽  
Blood Oxygen ◽  
Peripheral Oxygen Saturation ◽  
Severity Of The Disease ◽  
Global Threat ◽  
Time Of Admission ◽  
D Dimer ◽  
Diabetes Melitus

Coronavirus disease 2019 atau COVID-19 menjadi pandemi yang masih menjadi ancaman global sampai saat ini. Gejala klinis bervariasi mulai dari demam, batuk, lemas, mialgia, dan diare. Derajat keparahannya pun bervariasi dari asimptomatik, gejala ringan, sampai gejala berat. Hipoksemia pun menjadi tanda prognosis buruk pada pasien COVID-19. Namun, banyak penderita COVID-19 datang dengan kandungan oksigen yang sangat rendah tetapi tanpa ada keluhan sesak. Kejadian tersebut sering disebut silent hypoxemia. Kejadian ini berhubungan dengan hiperkoagulasi yang dapat diperberat dengan komorbid penderita, salah satunya diabetes melitus. Pada laporan kasus ini, seorang wanita usia 47 tahun datang ke Instalasi Gawat Darurat Rumah Sakit Hermina Grand Wisata dengan keluhan demam sejak 5 hari sebelum masuk rumah sakit. Keluhan disertai batuk, mual, pusing, dan lemas, tetapi tanpa sesak. Pemeriksaan fisik didapatkan kesadaran kompos mentis dengan tekanan darah 120/70 mmHg, frekuensi nadi 120 kali per menit, frekuensi napas 21 kali per menit, suhu 37.80C, dan saturasi oksigen perifer 67% dengan suplemen oksigen nasal kanul 4 liter per menit. Pasien ditatalaksana ventilasi mekanik setelah pemberian non-rebreathing mask 15 liter per menit tidak menunjukkan perbaikan. Hasil pemeriksaan swab PCR untuk COVID-19 positif, disertai dengan d-dimer 1.2 dan HbA1C 8.2. Pasien ditatalaksana antikoagulan enoxaparin sejak awal admisi. Pada hari kelima perawatan hasil pemeriksaan foto toraks ulang menunjukkan perbaikan, tetapi pemeriksaan d-dimer ulang menunjukkan hasil d-dimer meningkat menjadi 1.8. Silent hypoxemia pada penderita COVID-19 dengan komorbid diabetes melitus menunjukkan kondisi hiperkoagulasi yang sulit ditangani. Kata Kunci: COVID-19; silent hypoxemia, diabetes, hiperkoagulasi   Coronavirus disease 2019 or COVID-19 became pandemy and still be a global threat. Symptoms varies from fever, cough, fatigue, myalgia, and diarrhea. Severity of the disease also varies from asymptomatic, mild, to severe disease. Hypoxemia is a sign of poor prognosis in COVID-19 patients. Unfortunately, many patients were admitted with very low blood oxygen content but without dyspnea symptom. This event is called silent hypoxemia. This event also related to hypercoagulation which is intensified by patient’s comorbidities, such as diabetes melitus. In this case report, a forty-seven years old woman was admitted to Emergency Department in Grand Wisata Hermina Hospital. The patient complained fever since 5 days before admission. Fever was accompanied by cough, nausea, dizziness, and fatigue. But, there was no dyspnea complained by patient. Patient was alerted with blood pressure 120/70mmHg, pulse rate 120 per minute, respiratory rate 21 per minute, temperature 37.8C, and peripheral oxygen saturation 67% with 4 litre per minute with nasal cannule. The patient was admitted with mechanical ventilation after therapy with 15 liter per minute with non-rebreathing mask show no sign of improvement. The patient was positive for COVID-19 after PCR swab test in a day after admission, with d-dimer result was 1.2 and HbA1C is 8.2. Patient was already given enoxaparin as anticoagulant in time of admission. In 5th day after admission, thorax photo showed improvement but d-dimer showed worsening result as the result increase from 1.2 to 1.8. Silent hypoxemia in COVID-19 patient with diabetes melitus as comorbidity shows hypercoagulation which is hard to control. Key words: COVID-19; silent hypoxemia, diabetes, hypercoagulation

scholarly journals Clinical Characteristic of Thoracic Malignancy Patients with Coronavirus Disease 2019 Related to Mitigation Strategy in Dharmais National Cancer Center Hospital, Indonesia

2021 ◽  
Vol 9 (B) ◽  
pp. 692-697
Author(s):  
Arif Hanafi ◽  
Noorwati Soetandyo ◽  
Achmad Mulawarman Jayusman ◽  
Leovinna Widjaja ◽  
Fifi Dwijayanti ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Disease Severity ◽  
Poor Prognosis ◽  
Severe Disease ◽  
Mitigation Strategy ◽  
Cancer Center ◽  
P Value ◽  
Lymphocyte Ratio ◽  
Thoracic Malignancy ◽  
D Dimer

Aim: To describe the clinical data and disease severity of thoracic malignancy patients with COVID-19 and its relation to the mitigation process at the Dharmais National Cancer Center, Indonesia. Methods: Total 5256 cancer patients registered from May 2020 to March 2021. There were 681 cancer patients diagnosed with COVID-19. Forty-five thoracic malignancy patients were enrolled. Data from medical records were obtained at the Dharmais Cancer Hospital, then analyzed using SPSS version 25. Comparative result was considered significant, as p-value < 0.05. Results: There were 12.9% of total patients registered infected by COVID-19, which 6% with thoracic malignancy dominated by Non-small cell lung carcinoma (57.8%). Patients who have asymptomatic (31.1%), mild (13.3%), and moderate COVID-19 disease (8.9%) were alive. Patient with severe disease (46.7%) tend to deteriorate. Neutrophilia (mean 78.0%), lymphopenia (mean 13.0%), high neutrophil to lymphocyte ratio (mean 13.1), hyperuricemia (mean 31.6 mg/dL), high fibrinogen (mean 521.7 mg/dL), and high d-dimer (mean 3821.6 ng/mL) were significantly associated with disease severity (p-value < 0.05). Conclusions: Only small number of cancer patients affected by COVID-19 and mostly do not progress to severe disease, showing the strict mitigation strategy was successful. Severe disease patients have a poor prognosis, with neutrophilia, lymphopenia, high neutrophil to lymphocyte ratio, hyperuricemia, high fibrinogen, and high d-dimer may be valuable for predicting poor prognosis.

scholarly journals COVID-19-associated coagulopathy: thromboembolism prophylaxis and poor prognosis in ICU

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Runhui Zheng ◽  
Jing Zhou ◽  
Bin Song ◽  
Xia Zheng ◽  
Ming Zhong ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Calcium Concentration ◽  
Severe Disease ◽  
Scoring Systems ◽  
Thromboembolism Prophylaxis ◽  
Thromboembolic Prophylaxis ◽  
Serum Calcium Concentration ◽  
Coagulation Abnormalities ◽  
Low Platelet Count ◽  
D Dimer

Abstract Background Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities which are indicators of higher mortality especially in severe cases. Methods We studied patients with proven COVID-19 disease in the intensive care unit of Jinyintan Hospital, Wuhan, China from 30 to 2019 to 31 March 2020. Results Of 180 patients, 89 (49.44 %) had died, 85 (47.22 %) had been discharged alive, and 6 (3.33 %) were still hospitalised by the end of data collection. A D-dimer concentration of > 0.5 mg/L on admission was significantly associated with 30 day mortality, and a D-dimer concentration of > 5 mg/L was found in a much higher proportion of non-survivors than survivors. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scoring systems were dichotomised as < 4 or ≥ 4 and < 5 or ≥ 5, respectively, and the mortality rate was significantly different between the two stratifications in both scoring systems. Enoxaparin was administered to 68 (37.78 %) patients for thromboembolic prophylaxis, and stratification by the D-dimer concentration and DIC score confirmed lower mortality in patients who received enoxaparin when the D-dimer concentration was > 2 than < 2 mg/L or DIC score was ≥ 5 than < 5. A low platelet count and low serum calcium concentration were also related to mortality. Conclusions A D-dimer concentration of > 0.5 mg/L on admission is a risk factor for severe disease. A SIC score of > 4 and DIC score of > 5 may be used to predict mortality. Thromboembolic prophylaxis can reduce mortality only in patients with a D-dimer concentration of > 2 mg/L or DIC score of ≥ 5.

scholarly journals The Role of Laboratory Parameters in Assessment of Disease Severity and Outcome in COVID-19 patients – A Retrospective Study in a Tertiary Care Centre in Southern India

2021 ◽  
Vol 8 (7) ◽  
pp. A164-173
Author(s):  
Rajeshwari B ◽  
Salapathi Shanmugam ◽  
Anila Mathan ◽  
Dhananjayan R ◽  
Isabella Princess B ◽  
...  
Keyword(s):  
Virus Disease ◽  
Severe Disease ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Initial Assessment ◽  
P Value ◽  
Laboratory Parameters ◽  
Severity Of The Disease ◽  
Laboratory Biomarkers ◽  
Time Of Admission

Background: Corona Virus Disease 2019 (COVID19) is a global pandemic, the outbreak of which started in China in December 2019. Apart from the clinical symptoms and pulmonary computed tomography (CT) findings, several laboratory biomarkers also play an important role in management of these patients so that immediate attention can be given to those with severe disease and critical illness. In this study we tried to find the association of various laboratory biomarkers in COVID-19 patients, analyzed around the time of admission, with the severity of the disease and outcome. Methods: In this study 1048 COVID19 positive cases admitted in our hospital during the study period from April 2020 to October 2020 were included. The cases were clinically assessed based on the severity of the disease at the time of presentation and during the course in hospital and categorized into 3 categories as Mild, Moderate and Severe according to our hospital protocol for management of COVID 19 patients. The clinical and laboratory data were retrieved from electronic medical records. The levels of various laboratory parameters at/around the time of admission were compared with clinical categories, severity and outcome of the disease. Result: We found a statistically significant association of severity and outcome of COVID-19 with various laboratory parameters. There were significantly higher levels of D-dimer, LDH, CK, CRP, Sr Ferritin, cTnI, NT pro BNP, PCT, IL-6 and lower ALC in non survivors compared to survivors and in severe disease compared to mild disease with a p value of <0.05. Conclusion: In this study we propose that along with the initial clinical assessment, age and concurrent co-morbidities of COVID-19 patients which determine the need for their admission to ICUs, the initial assessment of several laboratory parameters is helpful in triaging the patients who need intensive care so that proper allocation of resources can be done.

scholarly journals D-dimer levels and lymphocyte counts as prognostic and predictive factors in patients with COVID-19

2021 ◽  
Vol 8 (2) ◽  
pp. 101-106
Author(s):  
Fatma Çölkesen ◽  
Şule Özdemir Armağan ◽  
Fatih Yucel ◽  
Arzu Tarakçı ◽  
Fatma Kacar ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Poor Prognosis ◽  
Treatment Guidelines ◽  
Severe Disease ◽  
National Institutes Of Health ◽  
Discrimination Power ◽  
Specificity And Sensitivity ◽  
Patient Groups ◽  
D Dimer

Objective: Coronavirus Disease 2019 (COVID-19) is characterized by high fever, sudden developing respiratory distress, and radiological findings failing to respond to conventional treatments. The purpose of this study is to identify the association of D-dimer levels and lymphocyte counts with poor prognosis and to predict the clinical course in patients with COVID-19. Methods: A total of 118 hospitalized adult patients diagnosed with COVID-19  were included in the study. According to the National Institutes of Health (NIH) COVID-19 treatment guidelines, patients were divided into two groups with severe disease (n= 26) and non-severe (n= 92) disease. Detected at the time of diagnosis, D-dimer levels and lymphocyte counts were compared between severe and non-severe COVID-19 patient groups. Distinctive performance analysis of  these values  was performed, and cut-off  values were determined. Results: The mean age of patients was 62 ± 7 years (range 42-80 years), and 63 (53.4 %) were female. The lymphocyte count was  lower (p <0.001), and D-dimer was  higher in patients with severe COVID-19 compared to non-severe patients (p <0.001). D-dimer's cut-off point when the sum of specificity and sensitivity is maximized was 2 mg/L (sensitivity, 0.731; specificity, 0.913), and 1500/mm3 was for lymphocyte count (sensitivity, 0.692; specificity, 0.609). Lymphocyte count and D-dimer had a significant discrimination power (AUC: 0.745 [95 CI: 0.644 - 0.846 ],  AUC: 0.928 [95% CI: 0.879 - 0.978] respectively, p <0.0001). Conclusion: The lymphocyte value of  ≤ 1500/mm3 and D-dimer value of  ≥ 2 mg/L  can be used in the early determination of patients with poor prognosis in COVID-19. Using these cut-off values for D-dimer and lymphocyte count will help predict prognosis and make rapid treatment decisions in patients with COVID-19.

PARALISIA BULBAR PROGRESSIVA (PBP): relato de caso

2020 ◽  
Vol 6 (2) ◽  
pp. 480-487
Author(s):  
Heuler dos Reis Rodrigues ◽  
Mariane Fernandes Ribeiro ◽  
Carla Cristina Ferreira de Andrade
Keyword(s):  
Blood Pressure ◽  
Progressive Disease ◽  
Rapid Evolution ◽  
Peripheral Oxygen Saturation ◽  
Course Of Action ◽  
Clinical Syndromes ◽  
Bulbar Paralysis ◽  
Pressure Maximum ◽  
Maximum Expiratory Pressure ◽  
Object Of Study

Motor neuron disease is a term used in several clinical syndromes, among them Progressive Bulbar Paralysis, a rare degenerative and progressive disease of rapid evolution and loss of early respiratory muscle strength. The characteristics are dysphonia, dysphagia, dysarthria, inability in bronchial hygiene, wheezing breaths and atrophy of the tongue musculature, affecting chewing, the grinding of food is increasingly difficult, affecting chewing, causing a potentially disabling and debilitating disease. This study aimed to describe a clinical case of an individual with a clinical diagnosis of Progressive Bulbar Paralysis in Propaedeutics at the Clinical School of the Faculty of the Alto Paranaíba-MG region. The object of study was a 57-year-old male, who underwent an initial physical therapy evaluation and was collected with maximum physiological pressure: maximum inspiratory pressure, maximum expiratory pressure, Borg CR-10 scale, heart rate (HR), respiratory pressure (RF), systolic blood pressure (SBP), diastolic blood pressure (DBP), peripheral oxygen saturation (SPO2). Then, follow a course of action in accordance with the provisions of the literature on the performance of the disease. The results found in this study are satisfactory, for all eight variables analyzed, with the possibility of highlighting the variable Borg CR-10 as the most satisfactory variable compared.

scholarly journals Clinical and angiographic characteristics of patients with STEMI and confirmed diagnosis of COVID-19: an experience of Tanta University Hospital

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Ahmed Alaarag ◽  
Timoor Hassan ◽  
Sameh Samir ◽  
Mohamed Naseem
Keyword(s):  
Poor Prognosis ◽  
Management Strategy ◽  
Clinical Presentation ◽  
Underlying Mechanism ◽  
Fibrinolytic Therapy ◽  
University Hospital ◽  
Total Occlusion ◽  
St Elevation ◽  
Primary Management ◽  
D Dimer

Abstract Background Patients with established cardiovascular diseases have a poor prognosis when affected by the coronavirus disease 2019 (COVID-19). Also, the cardiovascular system, especially the heart, is affected by COVID-19. So we aimed to evaluate the angiographic and clinical characteristics of COVID-19 patients presented by ST-elevation myocardial infarction (STEMI). Results Our retrospective study showed that STEMI patients with COVID-19 had elevated inflammatory markers with mean of their CRP (89.69 ± 30.42 mg/dl) and increased laboratory parameters of thrombosis with mean D-dimer (660.15 ± 360.11 ng/ml). In 69.2% of patients, STEMI was the first clinical presentation and symptoms suggestive of COVID-19 developed during the hospital stay; about one third of patients had a non-obstructive CAD, while patients with total occlusion had a high thrombus burden. Conclusion STEMI may be the initial presentation of COVID-19. A non-obstructive CAD was found in about one third of patients; on the other hand, in patients who had a total occlusion of their culprit artery, the thrombus burden was high. Identification of the underlying mechanism responsible for the high thrombus burden in these patients is important as it may result in changes in their primary management strategy, either primary PCI, fibrinolytic therapy, or a pharmaco-invasive strategy. Furthermore, adjunctive anticoagulation and antiplatelet therapy may need to be revised.

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 Inflammatory and Hypercoagulable Biomarkers and Clinical Outcomes in COVID-19 Patients

2021 ◽  
Vol 10 (14) ◽  
pp. 3086
Author(s):  
Hiroki Kitakata ◽  
Shun Kohsaka ◽  
Shunsuke Kuroda ◽  
Akihiro Nomura ◽  
Takeshi Kitai ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Risk Estimation ◽  
Interquartile Range ◽  
Proportional Hazard ◽  
Multicenter Observational Study ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Time Of Admission ◽  
Mortality Hazard Ratio ◽  
D Dimer

Systemic inflammation and hypercoagulopathy are known pathophysiological processes of coronavirus disease 2019 (COVID-19), particularly in patients with known cardiovascular disease or its risk factors (CVD). However, whether a cumulative assessment of these biomarkers at admission could contribute to the prediction of in-hospital outcomes remains unknown. The CLAVIS-COVID registry was a Japanese nationwide retrospective multicenter observational study, supported by the Japanese Circulation Society. Consecutive hospitalized patients with pre-existing CVD and COVID-19 were enrolled. Patients were stratified by the tertiles of CRP and D-dimer values at the time of admission. Multivariable Cox proportional hazard models were constructed. In 461 patients (65.5% male; median age, 70.0), the median baseline CRP and D-dimer was 58.3 (interquartile range, 18.2–116.0) mg/L and 1.5 (interquartile range, 0.8–3.0) mg/L, respectively. Overall, the in-hospital mortality rate was 16.5%, and the rates steadily increased in concordance with both CRP (5.0%, 15.0%, and 28.2%, respectively p < 0.001) and D-dimer values (6.8%, 19.6%, and 22.5%, respectively p = 0.001). Patients with the lowest tertiles of both biomarkers (CRP, 29.0 mg/L; D-dimer, 1.00 mg/L) were at extremely low risk of in-hospital mortality (0% until day 50, and 1.4% overall). Conversely, the elevation of both CRP and D-dimer levels was a significant predictor of in-hospital mortality (Hazard ratio, 2.97; 95% confidence interval, 1.57–5.60). A similar trend was observed when the biomarker threshold was set at a clinically relevant threshold. In conclusion, the combination of these abnormalities may provide a framework for rapid risk estimation for in-hospital COVID-19 patients with CVD.

scholarly journals Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

2021 ◽  
Author(s):  
Rohit Jain ◽  
Arun Gopal ◽  
Basant Kumar Pathak ◽  
Sourya Sourabh Mohakuda ◽  
TVSVGK Tilak ◽  
...  
Keyword(s):  
Disease Severity ◽  
Complete Blood Count ◽  
Wide Spectrum ◽  
Statistical Significance ◽  
Severe Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Screening Tools ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Time Of Admission

Abstract Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

scholarly journals CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aya Yassin ◽  
Maryam Ali Abdelkader ◽  
Rehab M. Mohammed ◽  
Ahmed M. Osman
Keyword(s):  
Pulmonary Embolism ◽  
Disease Severity ◽  
Laboratory Data ◽  
Pulmonary Angiography ◽  
Significant Relation ◽  
Ct Pulmonary Angiography ◽  
Laboratory Results ◽  
Severity Of The Disease ◽  
The Relationship ◽  
D Dimer

Abstract Background Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity. Results Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one. Conclusion CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.

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