scholarly journals Antibiotic Overuse for COVID-19: Are We Adding Insult to Injury?

2021 ◽  
Author(s):  
Seid Getahun Abdela ◽  
Laurens Liesenborghs ◽  
Fentaw Tadese ◽  
Seid Hassen Abegaz ◽  
Fentaw Bialfew Bayuh ◽  
...  
Keyword(s):  
Low Income ◽  
Medical Records ◽  
Viral Disease ◽  
Low Income Countries ◽  
C Reactive Protein ◽  
Antibiotic Overuse ◽  
Reactive Protein ◽  
Cohort Study Design ◽  
Rational Use Of Antibiotics ◽  
Bacterial Superinfection

In this study, we described the proportion of COVID-19 patients started on antibiotics empirically and the work-ups performed to diagnose bacterial superinfection. We used a retrospective cohort study design involving medical records of symptomatic, hospitalized COVID-19 patients who were admitted to these centers. A total of 481 patients were included, with a median age of 41.0 years (interquartile range, 28-58.5 years). A total of 72.1% (N = 347) of COVID-19 patients received antibiotics, either before or during admission. This is troublesome because none of the patients’ bacterial culture or inflammatory markers, such as the erythrocyte sedimentation rate or C-reactive protein, were evaluated, and only 73 (15.2%) underwent radiological investigations. Therefore, national COVID-19 guidelines should emphasize the rational use of antibiotics for the treatment of COVID-19, a primarily viral disease. Integrating antimicrobial stewardship into the COVID-19 response and expanding microbiological capacities in low-income countries are indispensable. Otherwise, we risk one pandemic aggravating another.

scholarly journals The good and the bad: using C reactive protein to distinguish bacterial from non-bacterial infection among febrile patients in low-resource settings

2020 ◽  
Vol 5 (5) ◽  
pp. e002396 ◽  
Author(s):  
Camille Escadafal ◽  
Sandra Incardona ◽  
B Leticia Fernandez-Carballo ◽  
Sabine Dittrich
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Bacterial Infections ◽  
Laboratory Diagnostics ◽  
Antibiotic Prescribing ◽  
Health Coverage ◽  
C Reactive Protein ◽  
Low Resource Settings ◽  
Low Resource ◽  
Reactive Protein

C reactive protein (CRP), a marker for the presence of an inflammatory process, is the most extensively studied marker for distinguishing bacterial from non-bacterial infections in febrile patients. A point-of-care test for bacterial infections would be of particular use in low-resource settings where other laboratory diagnostics are not always available, antimicrobial resistance rates are high and bacterial infections such as pneumonia are a leading cause of death. This document summarises evidence on CRP testing for bacterial infections in low-income and middle-income countries (LMICs). With a push for universal health coverage and prevention of antimicrobial resistance, it is important to understand if CRP might be able to do the job. The use of CRP polarised the global health community and the aim of this document is to summarise the ‘good and the bad’ of CRP in multiple settings in LMICs. In brief, the literature that was reviewed suggests that CRP testing may be beneficial in low-resource settings to improve rational antibiotic use for febrile patients, but the positive predictive value is insufficient to allow it to be used alone as a single tool. CRP testing may be best used as part of a panel of diagnostic tests and algorithms. Further studies in low-resource settings, particularly with regard to impact on antibiotic prescribing and cost-effectiveness of CRP testing, are warranted.

scholarly journals Az anti-Jo-1-pozitív antiszintetáz szindróma jellegzetességei gondozott betegeink alapján

2016 ◽  
Vol 157 (15) ◽  
pp. 575-583 ◽  
Author(s):  
Katalin Szabó ◽  
Melinda Nagy-Vincze ◽  
Levente Bodoki ◽  
Katalin Hodosi ◽  
Katalin Dankó ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Clinical Phenotype ◽  
Demographic Data ◽  
Clinical Results ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Worse Prognosis

Introduction: In idiopathic inflammatory myopathies, the presence of anti-Jo-1 antibody defines a distinct clinical phenotype (myositis, arthritis, interstitial lung disease, Raynaud’s phenomenon fever, mechanic’s hands), called antisynthetase syndrome. Aim: To determine the demographic data as well as clinical, laboratory and terapeutical features of anti-Jo1 positive patients, followed by the department of the authors. Method: The medical records of 49 consecutive anti-Jo1 patients were reviewed. Results: Demographic and clinical results were very similar to those published by other centers. Significant correlation was found between the anti-Jo-1 titer and the creatine kinase and C-reactive protein levels. Distinct laboratory results measured at the time of diagnosis of the disease (C-reactive protein, antigen A associated with Sjogren’s syndrome, positive rheumatoid factor), and the presence of certain clinical symptoms (fever, vasculitic skin) may indicate a worse prognosis within the antisyntetase positive patient group. Conclusion: In the cases above more agressive immunosuppressive therapy may be required. Orv. Hetil., 2016, 157(15), 575–583.

Prenatal adversity and salivary C-reactive protein in children: results: From a low-income, diverse sample

2019 ◽  
Vol 100 ◽  
pp. S22
Author(s):  
Rina Das Eiden ◽  
Douglas A. Granger ◽  
Danielle S. Molnar ◽  
Jenna Riis ◽  
Shannon Shisler
Keyword(s):  
Low Income ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Clinical and radiographic characteristics, management and short-term outcomes of patients with COVID-19 in Wenzhou, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liang Hong ◽  
Enling Ye ◽  
Gangqiang Sun ◽  
Xiaoyang Wang ◽  
Shengguo Zhang ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Viral Disease ◽  
Medical Data ◽  
Shortness Of Breath ◽  
C Reactive Protein ◽  
Short Term ◽  
Protein Levels ◽  
Reactive Protein ◽  
Ct Examination ◽  
Medical Observation

Abstract Background Coronavirus disease 2019 (COVID-19) is an emerging viral disease. Here, we report the clinical features, management, and short-term outcomes of COVID-19 patients in Wenzhou, China, an area outside Wuhan. Methods Patients admitted to the Infectious Diseases Department of Ruian People’s Hospital in Wenzhou, from January 21 to February 7, 2020, were recruited. Medical data on epidemiological history, demographics, clinical characteristics, laboratory tests, chest computerized tomography (CT) examination, treatment, and short-term outcomes were retrospectively reviewed. Blood biochemistry and routine tests were examined using standard methods and automatic machines. CT examination was performed several times during hospitalization as necessary. Results A total of 67 confirmed COVID-19 cases were diagnosed; 64 (95.4%) were common cases and three (4.5%) were severe cases. The most common symptoms at admission were fever (86.6%), cough (77.6%), productive cough (52.2%), chest distress (17.9%), and sore throat (11.9%), followed by diarrhea (7.4%), headache (7.4%), shortness of breath (6.0%), dizziness (4.5%), muscular soreness (4.5%), and running nose (4.5%). Thirty patients (47.8%) had increased C-reactive protein levels. The CT radiographs at admission showed abnormal findings in 54 (80.6%) patients. The patients were treated mainly by oxygen therapy and antiviral drugs. By March 3, 2020, all 67 patients completely recovered and had negative nucleic acid tests. The patients were discharged from the hospital and transferred to a medical observation isolation center for further observation. Conclusion Cases of COVID-19 in Wenzhou are milder and have a better prognosis, compared to those in Wuhan. Timely and appropriate screening, diagnosis, and treatment are the key to achieve good outcomes.

Association between vitamin D level and prognostic factors among patients infected with SARS-CoV-2

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mehrdad Haghighi ◽  
Seyed Shayan Ebadi ◽  
Hussein Soleimantabar ◽  
Atefe Shadkam ◽  
Seyed Alireza Ebadi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Prognostic Factors ◽  
Medical Records ◽  
Lymphocyte Count ◽  
Cross Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
The Mean ◽  
D Dimer

Abstract Objectives The present study aimed to evaluate the presence of any relationship between vitamin D and prognostic factors among patients infected with SARS-CoV-2. Methods This retrospective cross-sectional study was conducted among patients admitted from March to August 2020 in a referral hospital, Tehran, Iran. All patients aged 18–65 who had not any comorbidity participated in the study. The diagnosis of COVID-19 was established using the rRT-PCR test for SARS-CoV-2 detection. Then the incidence of lung involvement and biochemical markers including vitamin D level, c-reactive protein, D-dimer, lymphocyte count, platelet count, white blood cell count, and lactic acid dehydrogenase, were extracted through medical records. Results Altogether, 84 patients met our study criteria, and the information of 68 (80.9%) participants were collected. Among all 68 patients, 45 (66.2%) were male. The mean (SD) age of all participants was 52.4 (10.4) years old. Among 24 (35.2%) clients who died due to SARS-CoV-2, 20 (83.3%) patients were male (p=0.02). The mean (SD) of vitamin D level was 24.1 (13.6) ng/dL. No association between vitamin D level and prognostic factors, including CRP, lymphocyte count, D-dimer, LDH, and HRCT scan score, was observed. Also, the vitamin D level of the dead patients was not significantly different from that of the treated patients. Conclusions Our findings indicated no significant relationship between vitamin D level and prognostic factors or outcomes of patients infected with SARS-CoV-2.

scholarly journals Inverse association of calcium intake with abdominal adiposity and C-reactive protein in Brazilian children

2018 ◽  
Vol 21 (10) ◽  
pp. 1912-1920 ◽  
Author(s):  
Lara Gomes Suhett ◽  
Brenda Kelly Souza Silveira ◽  
Mariana De Santis Filgueiras ◽  
Maria do Carmo Gouveia Peluzio ◽  
Helen Hermana Miranda Hermsdorff ◽  
...  
Keyword(s):  
Public Schools ◽  
Low Income ◽  
Milk Powder ◽  
Prevalence Ratio ◽  
Inverse Association ◽  
Abdominal Adiposity ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Brazilian Children

AbstractObjectiveTo evaluate Ca intake and its association with cardiometabolic risk factors during childhood.DesignA cross-sectional study with a representative sample. Food consumption was assessed through three 24 h dietary recalls. Anthropometry, body composition and biochemical measurements were also conducted.SettingViçosa, Minas Gerais, Brazil.SubjectsChildren between 8 and 9 years old (n 350) enrolled in public and private schools in the urban area of the municipality of Viçosa.ResultsAlmost all children had inadequate intake of Ca (97·4 %), especially those with low income, non-white and who studied in public schools. Foods that contributed most to Ca intake were ‘milk’ and ‘cheeses and yoghurts’ (R2=0·66 and 0·13, respectively), and intake of ‘milk’ was correlated with ‘chocolate milk powder’ intake (r=0·538, P<0·01). Children with lower Ca intake had a higher prevalence of increased C-reactive protein (prevalence ratio=2·93; 95 % CI 1·21, 7·07), increased waist circumference (prevalence ratio=2·86; 95 % CI 1·01, 8·13) and a lower prevalence of high LDL cholesterol (prevalence ratio=0·64; 95 % CI 0·41, 0·99).ConclusionsLower Ca intake was associated with excess abdominal adiposity and subclinical inflammation in Brazilian children. Monitoring of adequate Ca intake is important, especially in poorer communities.

scholarly journals Social isolation, inflammation, and cancer mortality from the National Health and Nutrition Examination Survey - a study of 3,360 women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexander Koh-Bell ◽  
Joshua Chan ◽  
Amandeep K. Mann ◽  
Daniel S. Kapp
Keyword(s):  
Physical Activity ◽  
Social Isolation ◽  
National Health ◽  
Low Income ◽  
Cancer Mortality ◽  
Nutrition Examination Survey ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Health And Nutrition ◽  
Markers Of Inflammation

Abstract Background This study evaluates the role of social isolation on inflammation and cancer mortality among women. Methods Data were abstracted from the U.S. National Health and Nutrition Examination Survey from 1988 to 1994. The Social Network Index was used to assess participants’ degree of social isolation. C-reactive protein and fibrinogen levels were included as markers of inflammation. We used the National Death Index to identify causes and dates of mortality. Chi-square and multivariable Cox regressions were employed for statistical analyses. Results Of 3360 women (median age: 54 years), the most isolated, very isolated, somewhat isolated, and not isolated comprised 14.5, 30.2, 37.1, and 18.2% of the sample, respectively. The most isolated participants were more likely to have low income (56.8% vs 12.2%, p < 0.001), have fewer years of education (40.8% vs 12.3%; p < 0.001), have low physical activity (27.3% vs 14.7%; p < 0.003), be obese (32.5% vs 24.4%; p = 0.02), and be current smokers (34.2% vs 10.3%; p < 0.001) compared to the not isolated ones. Mean fibrinogen levels increased with degree of social isolation (p = 0.003), but C-reactive protein showed no association (p = 0.52). Kaplan-Meier estimates indicated higher cancer mortality rates among participants with elevated fibrinogen levels, though not with statistical significance (p = 0.08). Furthermore, there was no association between social isolation and cancer mortality (p = 0.54). On multivariate analysis, obesity (HR = 1.56; 95% CI: 1.11–2.18), higher education (HR = 1.36; 95% CI: 1.01–1.83), and smoking (HR = 4.42, 95% CI: 2.84–6.88) were independent predictors for cancer mortality, while high physical activity predicted for lower mortality from cancer (HR = 0.67, 95% CI: 0.51–0.87). However, social isolation was not a predictor. Conclusion Social isolation among women was associated with an increased level of fibrinogen, but not associated with cancer mortality. The relationship between inflammation and cancer mortality warrants further investigation.

scholarly journals Association between clinical characteristics and laboratory findings with outcome of hospitalized COVID-19 patients, a report from northeast of Iran

2021 ◽  
Author(s):  
Sahar Sobhani ◽  
Reihaneh Aryan ◽  
Elham Kalantari ◽  
Salman Soltani ◽  
Nafise Malek ◽  
...  
Keyword(s):  
Chest Pain ◽  
Medical Records ◽  
Clinical Characteristics ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Level Of Consciousness ◽  
Laboratory Features ◽  
Duration Of Hospitalization ◽  
Male Sex

AbstractCoronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza hospital, northeast of Iran. Clinical and laboratory features were evaluated among survivors and non-survivors. The correlation between variables and duration of hospitalization and admission to the Intensive Care Unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived (p = 0.017). It was also related to a shorter stay in the hospital (p = 0.032) as opposed to patients who experienced chest pain (p = 0.033). Decreased levels of consciousness and dyspnea were statistically more frequent in non-survivors (p = 0.003 and p = 0.011, respectively). Baseline white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in non-survivors (p < 0.001). Patients with higher WBC and CRP levels were more likely to be admitted to ICU (p = 0.009 and p = 0.001, respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.

Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele

2022 ◽  
pp. 1-10
Author(s):  
Makoto Asakawa ◽  
Mayuko Fukuzawa ◽  
Midori Goto Asakawa ◽  
James A. Flanders
Keyword(s):  
Medical Records ◽  
Protein Concentration ◽  
Interquartile Range ◽  
C Reactive Protein ◽  
Abdominal Ultrasonography ◽  
Reactive Protein ◽  
Preoperative Serum ◽  
Sensitivity Specificity ◽  
Serum Crp ◽  
Gallbladder Rupture

Abstract OBJECTIVE To determine whether serum C-reactive protein (CRP) concentration could be used to detect gallbladder rupture (GBR) prior to surgery in dogs undergoing cholecystectomy for treatment of gallbladder mucocele (GBM). ANIMALS 45 dogs that underwent cholecystectomy because of GBM at a companion animal referral hospital from 2017 to 2020. PROCEDURES Electronic medical records were reviewed, and dogs were included if serum CRP concentration had been measured within 24 hours prior to cholecystectomy. Dogs were grouped as to whether the gallbladder was found to be ruptured or intact during surgery. Accuracy of using preoperative CRP concentration to predict GBR was compared with accuracy of abdominal ultrasonography and other preoperative blood tests. RESULTS GBR was present in 15 dogs at the time of surgery. Median preoperative CRP concentration was significantly higher in dogs with GBR (15.1 mg/dL; interquartile range, 7.4 to 16.8 mg/dL) than in dogs with an intact gallbladder (2.65 mg/dL; interquartile range, 0.97 to 13.4 mg/dL). Sensitivity, specificity, and accuracy of using preoperative CRP concentration to predict GBR were 100%, 67%, and 78%, respectively. CLINICAL RELEVANCE Measurement of preoperative CRP concentration provided excellent sensitivity and moderate specificity for detection of GBR in dogs undergoing cholecystectomy because of GBM. Accuracy of using preoperative CRP concentration for detection of GBR was not superior to the accuracy of preoperative abdominal ultrasonography. However, when CRP concentration was combined with results of ultrasonography, the sensitivity, specificity, and accuracy for detection of GBR were 100%, 93%, and 96%, respectively.

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