Diagnostic Role of C-reactive Protein, Procalcitonin and Lipopolysaccharide-Binding Protein in Discriminating Bacterial-Community Acquired Pneumonia from 2009 H1N1 Influenza A Infection

2011 ◽  
Vol 70 (6) ◽  
pp. 490 ◽  
Author(s):  
Seon-Sook Han ◽  
Se-Hyun Kim ◽  
Woo Jin Kim ◽  
Seung-Joon Lee ◽  
Sook-Won Ryu ◽  
...  
2021 ◽  
Vol 21 (3) ◽  
pp. 159-164
Author(s):  
Tamara N. Shvedova ◽  
Olga S. Kopteva ◽  
Polina A. Kudar ◽  
Anna A. Lerner ◽  
Yuliya A. Desheva

BACKGROUND: Despite the continuing global spread of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus, the mechanisms of the pathogenesis of severe infections remain poorly understood. The role of comorbidity with other seasonal viral infections, including influenza, in the pathogenesis of the severe course of COVID-19 remains unclear. MATERIALS AND METHODS: The present study used sera left over from ongoing laboratory studies of patients with varying degrees of severity of COVID-19. The study was approved by the Local Ethics Committee of the Federal State Budgetary Scientific Institution IEM (protocol 3/20 from 06/05/2020). We studied 28 paired samples obtained upon admission of patients to the hospital and after 57 days of hospital stay. Paired sera of patients with COVID-19 were tested for antibodies to influenza A and B viruses. The presence of IgG antibodies specific to the SARS-CoV-2 spike (S) protein was studied using an enzyme-linked immunosorbent assay (ELISA). The serum concentration of C-reactive protein and the neutrophil-lymphocyte ratio on the day of hospitalization were also assessed. RESULTS: At least a 4-fold increase in serum IgG antibodies to SARS-CoV-2 S protein was found both in patients with PCR-confirmed SARS-CoV-2 infection and without PCR confirmation. It was shown that out of 18 patients with moderate and severe forms of COVID-19 infection, six of them showed at least a 4-fold increase in antibodies to influenza A/H1N1, in one to influenza A/H3N2 and in two cases to the influenza B. Laboratory data in these two groups were characterized by significant increases in serum C-reactive protein and neutrophil-lymphocyte ratio concentrations compared with the moderate COVID-19 group. CONCLUSIONS: Serological diagnostics can additionally detect cases of coronavirus infection when the virus was not detected by PCR. In moderate and severe cases of COVID-19, coinfections with influenza A and B viruses have been identified. The results obtained confirm the need for anti-influenza immunization during the SARS-CoV-2 pandemic. Influenza virus screening can significantly improve patient management because recommended antiviral drugs (neuraminidase inhibitors) are available.


2011 ◽  
Vol 5 (6) ◽  
pp. 398-403 ◽  
Author(s):  
Shin Ahn ◽  
Won Young Kim ◽  
Sung-Han Kim ◽  
SangBum Hong ◽  
Chae-Man Lim ◽  
...  

2020 ◽  

Objective: In this study, we aimed to explore the role of the plasma presepsin level in patients with community-acquired pneumonia during admission to the emergency department in assessing the diagnosis, severity, and prognosis of the disease. In addition, we wanted to investigate the relationship of presepsinin with procalcitonin, C-reactive protein and pneumonia severity scores. Methods: One hundred twenty-three patients over the age of 18 who presented with a diagnosis of pneumonia to the emergency department were included in the study. The vital signs, symptoms, examination findings, background information, laboratory results, and radiological imaging results of the patients were recorded. The 30-day mortality rates of the patients were determined. Results: A statistically significant difference was found between the presepsin levels of the patients diagnosed with pneumonia and those of healthy subjects (p < 0.05). The plasma presepsin levels of the patients who died (8.63 ± 6.46) were significantly higher than those of the patients who lived (5.82 ± 5.97) (p < 0.05). The plasma procalcitonin and C-reactive protein levels of the dead patients were significantly higher than those living (p < 0.05). A presepsin cut-off value of 3.3 ng/mL for 30-day mortality was established (AUROC, 0.65; specificity, 45%; sensitivity, 82%). Procalcitonin is the most successful biomarker in the determination of mortality (AUROC, 0.70). A significant correlation was available between presepsin and lactate, C-reactive protein and procalcitonin (p < 0.05). There was a significant correlation between the Pneumonia Severity Index values and presepsin levels (p < 0.001, r = 0.311). Conclusion: The plasma presepsin level can be utilized for diagnosing community-acquired pneumonia. Plasma presepsin, procalcitonin and C-reactive protein levels can be used to predict the severity and mortality of community-acquired pneumonia.


2020 ◽  
Vol 9 (2) ◽  
pp. 201-209
Author(s):  
G. V. Bulava ◽  
S. I. Rey ◽  
G. A. Berdnikov ◽  
O. V. Nikitina ◽  
A. K. Shabanov ◽  
...  

Background Sepsis and septic shock are formidable and complications in surgery with mortality 20–50%. In the pathogenesis of sepsis, a significant role belongs to bacterial endotoxin (LPS - liposaccharide).Aim of study Assessment of the efficacy of selective lipopolysaccharides hemosorption (SLH) in treatment of sepsis.Material and methods We examined 65 patients with developed sepsis or suspected presence of gram-negative infection. Patients were retrospectively divided into two groups. In Group 1, 27 patients received Polymyxin B hemoperfusion using Toraymyxin cartridges. In Group 2 (38 patients), adsorber Alteco (LPSA) was used.Results It was established that 28-day mortality was 11.1% in Polymyxin group and 28.9% in LPS group A, p = 0.091, 60-day mortality was 33.3 and 55.3%, respectively (p=0.065). The use of SLH contributed to a decrease in the activity of endotoxin (EAA) from 0.52 (0.39; 0.65) to 0.40 (0.36; 0.57) EU (p=0.330) in Polymyxin group and from 0.59 ( 0.42; 0.72) to 0.54 (0.40; 0.81) EU ( p = 0.981) in the LPS-A group. At the same time, the level of procalcitonin (PCT) in the blood statistically significantly decreased from 8.4 (3.6; 29.0) to 4.8 (1.9; 36.3) ng/ml (p=0.0117) only in the LPS-A group. The level of C-reactive protein (CRB) in the blood statistically significantly decreased only in the Polymyxin group, from 205 (154; 264) to 162 (106; 202) mg/L (p<0.001). After SPH procedures, there was a tendency to a decrease in the level of blood cytokines in both groups. Conclusion 1. The trend of better survival among patients was noted during hemoperfusion when using Polymyxin B in comparison with the results of adsorption of lipopolysaccharide with Alteco cartridges: so, 28-day mortality was 11.1 and 28.9%, respectively (statistically not significant).2. As a result, the procedure of selective lipopolysaccharides hemosorbtion on hemosorbents with Polymyxin B in blood significantly decreased level of C-reactive protein (21%), there was statistically insignificant decrease in the level of endotoxin activity (23.1%), lipopolysaccharide binding protein (21.6%), procalcitonin (2.4 times), presepsin (20%), as well as the level of interleukin-6 (3.4 times) and interleukin-10 (1.6 times) . Adsorption of lipopolysaccharide with Alteco cartridges leads to a statistically significant reduction of procalcitonin in blood (1.8 times), and statistically insignificant decrease of: endotoxin activity (9.3%), lipopolysaccharide binding protein (28.6%), interleukin-6 (3.8 times), interleukin-10 (7.1 times) and soluble receptor to interleukin-2 (2.2 times).


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