Clinical laboratory and radiation parameters associated with different outcomes of severe new coronavirus infection (COVID­19) with pneumonia in patients receiving tocilizumab

MedAlliance ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 35-42
Keyword(s):  
Lung Tissue ◽  
Tissue Damage ◽  
Ferritin Level ◽  
High Morbidity ◽  
Neutrophil Lymphocyte Ratio ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Lung Tissue Damage ◽  
Group 1

ntroduction. Coronavirus infection 2019 (COVID-19) is characterized by high morbidity and mortality. Interleu- kin-6 receptor inhibitors, including tocilizumab, are used for the anti-inflammatory therapy of COVID-19. The aim of the study was to compare the clinical, lab and radia- tion characteristics of surviving and deceased patients with severe COVID-19 and pneumonia caused by SARS- CoV-2 who received tocilizumab and identify features that were associated with various outcomes. Methods. The medical records of 31 hospitalized COVID-19 pa- tients were stu died. All patients received a single dose of tocilizumab 400 mg. Two groups were created. Group 1 included 17 patients who were discharged with improve- ment, Group 2–14 fatal cases. The methods of parametric and nonparametric statistics were used for processing. Results. The condition of patients from Group 2 more often than in Group 1 was assessed as severe already at admission, p=0.022. Only 4 patients from Group 1 and all patients from Group 2 were allocated to the intensive care unit; the mechanical ventilation was used exclusively in group 2, p <0.001. The groups differed in terms of the SpO2 le vel, p=0.023, and the concentration of C-reactive protein (CRP) at admission, p=0.047, as well as in the vo- lume of lung tissue damage, p=0.027. Tocilizumab was admi nistered to all patients within a comparable period from the onset of the disease. There was an increase in the neutrophil/lymphocyte ratio in peripheral blood (NLR) by the day of its administration in Group 2, p=0.026. The NLR le vel increased even more significantly within 5–7 days after administration, p=0.045 (p=0.007 compared to baseline). The NLR value in Group 2 changed insigni- ficantly. The blood ferritin level in patients from Group 1 by the day of tocilizumab administration was lower than in Group 2, p=0.014, and decreased after the treatment, p=0.01, in contrast to Group 2. The decrease in the CRP concentration after the appointment of tocilizumab in Group 1 was also significant, p=0.001. Conclusions. The deceased COVID-19 patients who received tocilizu- mab were characterized, compared with the survivors, by the initially more severe course of the disease, more pronounced hypoxemia, as well as the volume of lung tissue damage and laboratory abnormalities, inclu ding the le vels of NLR, CRP and ferritin. Monitoring of these in- dicators appears to be necessary to assess the course of COVID-19 and make a decision on the anti-inflammatory therapy with tocilizumab.

ANALYSIS OF COMPLICATIONS AMONG PATIENTS AFTER PREVIOUS NEW CORONOVIRAL COVID-19 INFECTION

2021 ◽  
pp. 15-23
Author(s):  
Дмитрий Валериевич Судаков ◽  
Олег Валериевич Судаков ◽  
Артём Николаевич Шевцов ◽  
Евгений Владимирович Белов ◽  
Оксана Александровна Андросова
Keyword(s):  
Lung Tissue ◽  
Tissue Damage ◽  
Clinical Manifestations ◽  
Physical Exertion ◽  
Treatment And Prevention ◽  
Organ Systems ◽  
Coronavirus Infection ◽  
Group 2 ◽  
Almost All ◽  
Lung Tissue Damage

Статья посвящена анализу возникающих осложнений различных органов и систем органов у пациентов перенесших новую коронавирусную инфекцию. Данная тематика в настоящее время представляет большой интерес для врачей самых разнообразных специальностей. Подобный интерес обусловлен тем, что пандемия Covid-19 возникла лишь в 2020 году. Врачам и ученым, несмотря на все прилагаемые ими усилия еще не удалось полностью расшифровать природу вирусной инфекции, не удалось определить все аспекты этиологии и патогенеза. В настоящее время множество ресурсов различного плана практически во всех странах мира направлены, как на решение данных аспектов, так и на изучение основных клинических проявлений новой коронавирусной инфекции, вариантов ее лечения и предупреждения возможных осложнений, изучение которых и стало целью данной работы. Объектами исследования послужило 200 пациентов, мужчин и женщин трудоспособного возраста, перенесших Covid-19 и обращающихся в стационар и в поликлинику с различными жалобами. Все больные были разделены на 4 группы по 50 человек. 1 группу составили пациенты, которые перенесли данную инфекцию бессимптомно или в легкой форме, зачастую узнав о болезни по результатам определения антител в крови (иммуноглобулины G). 2 группу составили больные, которым был поставлен диагноз «пневмония» 1 степени (по объему поражения легочной ткани). 3 группу составили пациенты, которым был поставлен диагноз «пневмония» 2 степени (по объему поражения легочной ткани). 4 группу составили больные, которым был поставлен диагноз «пневмония» 3 степени (по объему поражения легочной ткани). Было установлено, что наиболее часто встречались осложнения дыхательной, сердечно-сосудистой и пищеварительной систем. Осложнения на нервную систему, опорно-двигательную и выделительную у данных испытуемых встречались гораздо реже. При этом по отдельным нозологиям и симптомам наиболее часто выделяли: дыхательная система - кашель и одышка при физической нагрузки (которой ранее не наблюдалось); сердечно-сосудистая система - боли в области сердца и различные нарушения ритма; пищеварительная система - симптоматика панкреатита и холецистита. Подобное исследование может быть интересным не только для врачей, занимающихся лечением пациентов с Covid-19, но и для врачей, занимающихся лечением последствий данной инфекции The article is devoted to the analysis of emerging complications of various organs and organ systems in patients who have undergone a new coronavirus infection. This topic is currently of great interest for doctors of various specialties. This interest is due to the fact that the Covid-19 pandemic only emerged in 2020. Doctors and scientists, despite all their efforts, have not yet been able to fully decipher the nature of the viral infection, have not been able to determine all aspects of the etiology and pathogenesis. Currently, many resources of various kinds in almost all countries of the world are aimed both at solving these aspects and at studying the main clinical manifestations of a new coronavirus infection, options for its treatment and prevention of possible complications, the study of which became the purpose of this work. The objects of the study were 200 patients, men and women of working age, who had undergone Covid-19 and went to a hospital and a polyclinic with various complaints. All patients were divided into 4 groups of 50 people. Group 1 consisted of patients who underwent this infection asymptomatically or in a mild form, often learning about the disease by the results of the determination of antibodies in the blood (immunoglobulins G). Group 2 consisted of patients who were diagnosed with pneumonia of the 1st degree (by the volume of lung tissue damage). Group 3 consisted of patients who were diagnosed with grade 2 pneumonia (by the volume of lung tissue damage). Group 4 consisted of patients who were diagnosed with grade 3 pneumonia (by the volume of lung tissue damage). It was found that the most common complications of the respiratory, cardiovascular and digestive systems. Complications of the nervous system, musculoskeletal and excretory systems were much less common in these subjects. At the same time, according to individual nosologies and symptoms, the following were most often distinguished: respiratory system - cough and shortness of breath during physical exertion (which was not previously observed); cardiovascular system - pain in the heart and various rhythm disturbances; digestive system - symptoms of pancreatitis and cholecystitis. Such a study may be interesting not only for doctors treating patients with Covid-19, but also for doctors treating the consequences of this infection

scholarly journals Serum Neopterin Levels and the Clinical Presentation of COVID-19

Pteridines ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 185-192
Author(s):  
Deniz Öğütmen Koç ◽  
Hande Sipahi ◽  
Cemile Dilşah Sürmeli ◽  
Mustafa Çalık ◽  
Nilgün Bireroğlu ◽  
...  
Keyword(s):  
Disease Activity ◽  
Clinical Presentation ◽  
Serum Levels ◽  
Neutrophil Lymphocyte Ratio ◽  
Serum Neopterin ◽  
Protein Levels ◽  
Reactive Protein ◽  
Group 2 ◽  
Immune Activation Marker ◽  
Group 1

AbstractIn Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investigate possible biomarkers. Therefore, in this study, we investigated the relationship between disease activity and serum levels of possible immune activation marker neopterin in patients with COVID-19. The study enrolled 45 patients (23 females, 51.1%) treated for COVID-19. The patients were divided into two groups according to their clinical presentation: those who recovered quickly (Group 1) and those who worsened progressively (Group 2). The neopterin and C-reactive protein levels were high in all patients on admission. In Group 1, neopterin concentrations and serum neopterin/creatinine ratios were significantly higher on admission compared to Day 14 of the disease, whereas in Group 2, levels were significantly higher at Day 14 of the disease than on admission. Neopterin levels at admission were significantly higher in Group 1. The serum neopterin concentrations at admission were markedly higher in patients with a derived neutrophil–lymphocyte ratio (dNLR) > 2.8 compared to those with a dNLR ≤ 2.8 (p < 0.05). Serum neopterin levels can be used as a prognostic biomarker in predicting disease activity in COVID-19.

scholarly journals The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial

2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  
Keyword(s):  
Growth Factors ◽  
Critically Ill ◽  
Inflammatory Cytokines ◽  
Clinical Manifestations ◽  
Systematic Effect ◽  
Cytokine Storm ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

Methods of early diagnostics of severe pneumonia in children

2020 ◽  
Vol 03 (04) ◽  
pp. 43-46
Author(s):  
Sabir Nurgalam Amiraliev ◽  
Keyword(s):  
Young Children ◽  
Key Words ◽  
Lung Tissue ◽  
Tissue Damage ◽  
Severe Pneumonia ◽  
Early Diagnostics ◽  
Key Words Pneumonia ◽  
Pneumonia Severity ◽  
Acute Pneumonia ◽  
Lung Tissue Damage

Studies have shown that the severity and outcome of acute pneumonia largely depends on the prevalence of the focus of inflammation in the lung tissue, which is determined radiologically. We analyzed and determined a statistically significant effect of the degree of lung tissue damage on the severity and prognosis of pneumonia in young children, taking into account the conditions of infection. In pneumonia, χ² = 47.13 (p <0.001), indicates that the greater the degree of damage, the greater the likelihood of a severe course and unfavorable outcome of pneumonia. Key words: pneumonia, severity of the course, outcome, young children

scholarly journals Pengaruh Pemberian Taurin terhadap Gambaran Histopatologi Paru Mencit (Mus musculus) yang Diinduksi Karsinogen Benzo(α)Piren secara In Vivo

2017 ◽  
Vol 17 (1) ◽  
pp. 22
Author(s):  
Arini Pradita Roselyn ◽  
Endang Linirin Widiastuti ◽  
G. Nugroho Susanto ◽  
Sutyarso '
Keyword(s):  
Lung Tissue ◽  
Mus Musculus ◽  
Tissue Damage ◽  
Corn Oil ◽  
Group Vi ◽  
Normal Tissues ◽  
Randomized Design ◽  
Group I ◽  
Lung Tissue Damage

Lung cancer is a disease that causes high mortality. Drugs used to prevent and cure cancer mostly causes intoxicity to the normal tissues due to its less effectiveness. Therefore, it is necessary to find out any agent or substance which works much more effective and safe for cancer treatment. The aim of the study was to elucidate the role of taurine on the lung tissue of mice (Mus musculus) induced by carcinogenic benzo(α)pyrene. The experiment was conducted in a completely randomized design with 5 replications. Six treatment groups were perfomed. Group I was given 0.2 mL of corn oil and given aquadest until the end of the study period, group II was induced by benzo(α)pyrene without administration of taurine, group III before induced with benzo(α)pyrene, was given taurine dosage 7.8 mg/BW/day for two weeks, group IV after induced benzo(α)pyrene, was given taurine with dosage 3.9 mg/BW/day, group V after induced benzo(α)pyrene, was given taurine with dosage7. 8 mg/BW/day, group VI after induced with benzo(α)pyrene, was given taurine with dosage 15.6 mg/BW/day. The results of the Kruskal-Wallis analysis and one way ANOVA with LSD (p>0,05) showed that taurine reduced lung tissue damage 72.73% due to the administration of benzo(α)pyrene of 0.3 mg/BW/day. In addition, the effective dose of taurine reduce lung tissue damage was 15.6 mg/BW/day.

scholarly journals FEATURES OF HEMATOLOGICAL INDICES IN PATIENTS WITH IMPAIRED CARDIAC FUNCTION IN UP-TO-DATE CLINICAL PRACTICE

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
V.K. Tashchuk ◽  
R.A. Nesterovska ◽  
V.O. Kalarash
Keyword(s):  
New York ◽  
White Blood Cells ◽  
Heart Association ◽  
Functional Class ◽  
Hematological Indices ◽  
Neutrophil Lymphocyte Ratio ◽  
Versus Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Purpose – to investigate the distribution of hematological indices in patients withcardiac insufficiency.Material and methods. Data of 26 case histories with diagnosis of IHD have beenanalyzed. Patients with stable angina pectoris of II-III functional class (FC), Diffusecardiosclerosis, complicated in 17 patients with syndromic manifestations of HF II-IIIFC according to New York Heart Association (NYHA), made up group 1, and 9 patientswithout CH -group 2. Of the group 1 surveyed, there were 8 men and 9 women. Ratioindex of leucocytes and erythrocyte sedimentation rate (ESR): L/ESR=L×ESR/100;Neutrophil-lymphocyte ratio index (N/Li); Lymphocyte to monocyte ratio index (Li / Mo);Lymphocyte to eosinophil index (Li/ E) was used among hematological markers.Results. Analyzing the haemogram data, it was found that group 1 patients, unlike group2 patients, had a significantly higher overall white blood cell count (7,96±1,73) × 109and (4,22 ± 0,24) × 109; p<0,05 due to the number of neutrophils (69,41 ± 6,21) % ascompared to group 2 (51,78±1,79)%; p<0,05 as well as a lower level of lymphocyteswas defined in group 1 (22,06±4,07)% versus group 2 (38,55±1,01)%; p<0,05. In genderstudies, men show elevated levels of eosinophils (4,12±0,83)%, as opposed to women(1,56±0,73) %; p<0,05 and lower level of lymphocytes (18,38±1,69)% versus (25,33±2,24)%; p<0,05 and women had a high level of total white blood cells (9,36±0,66) ×109 thanmen (6,36±0,99)×109; p<0,05, in particular lymphocytes. Analysis of hematologicalindices showed that there was a statistically significant difference in determining theN / Li index, which was increased in group 1 patients (3,28±0,78) у.о versus group 2(1,34±0,05) у.о, p<0,05.Conclusion. In gender comparisons, there is an increase in lymphocytes among womencompared to men, so we can assume that women are less susceptible to systemicinflammation. The increase in the N/Li index ratio is due to severe cardiovascularconsequences among patients with coronary heart disease complicated by heart failure.

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