scholarly journals A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Joachim Linssen ◽  
Anthony Ermens ◽  
Marvin Berrevoets ◽  
Michela Seghezzi ◽  
Giulia Previtali ◽  
...  
Keyword(s):  
Cell Activation ◽  
Validation Cohort ◽  
Complete Blood Count ◽  
Prognostic Score ◽  
Fatal Outcome ◽  
Activation Parameters ◽  
Clinical Severity ◽  
Symptom Duration ◽  
Individual Parameter ◽  
Hospital Days

COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration, and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723–0.781) increasing to 0.875 (95% CI 0.806–0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients.

scholarly journals A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study

2020 ◽  
Author(s):  
Joachim Linssen ◽  
Anthony Ermens ◽  
Marvin Berrevoets ◽  
Michela Seghezzi ◽  
Giulia Previtali ◽  
...  
Keyword(s):  
Cell Activation ◽  
Validation Cohort ◽  
Complete Blood Count ◽  
Prognostic Score ◽  
Fatal Outcome ◽  
Activation Parameters ◽  
Clinical Severity ◽  
Symptom Duration ◽  
Individual Parameter ◽  
Hospital Days

COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723-0.781) increasing to 0.875 (95% CI 0.806-0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients.

scholarly journals Vascular Abnormalities Detected with Chest CT in COVID-19: Spectrum, Association with Parenchymal Lesions, Cardiac Changes, and Correlation with Clinical Severity (COVID-CAVA Study)

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 606
Author(s):  
Salah D. Qanadli ◽  
Alexander W. Sauter ◽  
Hatem Alkadhi ◽  
Andreas Christe ◽  
Pierre-Alexandre Poletti ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Fatal Outcome ◽  
National Registry ◽  
Clinical Severity ◽  
Prognostic Role ◽  
Vascular Abnormalities ◽  
Cardiovascular Abnormalities ◽  
Vascular Congestion ◽  
Potential Impact ◽  
And Biological Markers

Although vascular abnormalities are thought to affect coronavirus disease 2019 (COVID-19) patients’ outcomes, they have not been thoroughly characterized in large series of unselected patients. The Swiss national registry coronavirus-associated vascular abnormalities (CAVA) is a multicentric cohort of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who underwent a clinically indicated chest computed tomography (CT) aiming to assess the prevalence, severity, distribution, and prognostic value of vascular and non-vascular-related CT findings. Clinical outcomes, stratified as outpatient treatment, inpatient without mechanical ventilation, inpatient with mechanical ventilation, or death, will be correlated with CT and biological markers. The main objective is to assess the prevalence of cardiovascular abnormalities–including pulmonary embolism (PE), cardiac morphology, and vascular congestion. Secondary objectives include the predictive value of cardiovascular abnormalities in terms of disease severity and fatal outcome and the association of lung inflammation with vascular abnormalities at the segmental level. New quantitative approaches derived from CT imaging are developed and evaluated in this study. Patients with and without vascular abnormalities will be compared, which is supposed to provide insights into the prognostic role and potential impact of such signs on treatment strategy. Results are expected to enable the development of an integrative score combining both clinical data and imaging findings to predict outcomes.

scholarly journals Variable immunodeficiency score upfront analytical link (VISUAL), a proposal for combined prognostic score at diagnosis of common variable immunodeficiency

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kissy Guevara-Hoyer ◽  
Adolfo Jiménez-Huete ◽  
Julia Vasconcelos ◽  
Esmeralda Neves ◽  
Silvia Sánchez-Ramón
Keyword(s):  
Common Variable Immunodeficiency ◽  
Severity Score ◽  
Prognostic Score ◽  
Clinical Severity ◽  
Risk Category ◽  
Close Monitoring ◽  
Accurate Identification ◽  
Visual Score ◽  
Severity Scores ◽  
Common Variable

AbstractThe broad and heterogeneous clinical spectrum that characterizes common variable immunodeficiency (CVID) is associated with quite different disease course and prognosis, highlighting the need to develop tools that predict complications. We developed a multianalyte VISUAL score (variable immunodeficiency score upfront analytical link) aimed to predict severity using individual CVID patient data at baseline of a cohort of 50 CVID patients from two different centers in Portugal and Spain. We retrospectively applied VISUAL to the CVID clinical severity scores proposed by Ameratunga and Grimbacher after 15 years follow-up of our cohort. VISUAL score at CVID diagnosis showed adequate performance for predicting infectious and non-infectious severe complications (Cluster B). Compared to switched memory B lymphocyte phenotype alone, VISUAL provided a more accurate identification of clinically meaningful outcome, with significantly higher sensitivity (85% vs 55%, p = 0.01), and negative predictive value (77% vs 58%) and AUC of the ROC curves (0.72 vs 0.64), with optimal cut-off level of 10. For every increase of 1 point in the VISUAL scale, the odds of being in the higher risk category (Cluster B) increased in 1.3 (p = 0.005) for Ameratunga’s severity score and 1.26 (p = 0.004) for Grimbacher’s severity score. At diagnosis of CVID, VISUAL score ≥ 10 showed 8.94-fold higher odds of severe prognosis than below this threshold. Kaplan–Meier estimates for the VISUAL ≥ 10 points showed significantly earlier progression to Cluster B than those with VISUAL < 10 (p = 0.0002). This prognostic laboratory score might allow close monitoring and more aggressive treatment in patients with scores ≥ 10 on a personalized basis approach. Further studies are needed to prospectively validate VISUAL score.

Multiple CD4 and CD8 T-cell activation parameters predict vaccine efficacy in vivo mediated by individual DC-activating agonists

Vaccine ◽  
2007 ◽  
Vol 25 (8) ◽  
pp. 1379-1389 ◽  
Author(s):  
Marij J.P. Welters ◽  
Martijn S. Bijker ◽  
Susan J.F. van den Eeden ◽  
Kees L.M.C. Franken ◽  
Cornelis J.M. Melief ◽  
...  
Keyword(s):  
T Cell ◽  
T Cell Activation ◽  
Vaccine Efficacy ◽  
Cell Activation ◽  
Activation Parameters ◽  
Cd8 T Cell

scholarly journals Area postrema syndrome

Neurology ◽  
2018 ◽  
Vol 91 (17) ◽  
pp. e1642-e1651 ◽  
Author(s):  
Eslam Shosha ◽  
Divyanshu Dubey ◽  
Jacqueline Palace ◽  
Ichiro Nakashima ◽  
Anu Jacob ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Utility ◽  
Validation Cohort ◽  
Area Postrema ◽  
Outcome Measurement ◽  
Symptom Duration ◽  
Severity Scale ◽  
International Database ◽  
High Prevalence ◽  
Dorsal Medulla

ObjectiveTo define the frequency, duration, and severity of intractable nausea, vomiting, or hiccups in aquaporin-4–immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD) and propose diagnostic criteria and a severity scale for area postrema syndrome (APS).MethodsAn International NMOSD database was interrogated for frequency of APS. Patients with AQP4-IgG–positive NMOSD completed an APS symptom questionnaire. Nausea and vomiting severity was derived from the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) score. The diagnostic criteria, severity scale, and immunotherapy response was applied to a prospective validation cohort of patients from multiple centers.ResultsAnalysis of an international database for AQP4-IgG–seropositive NMOSD (n = 430) revealed a high prevalence of isolated APS attacks (onset 7.1%–10.3%; subsequent 9.4%–14.5%) across continents. For 100 patients with 157 episodes of APS, nausea (n = 127, 81%) lasted for a median of 14 days (range 2–365), vomiting (113, 72%) with a median of 5 episodes/d (2–40) lasted 1–20 minutes, and hiccups (102, 65%) lasted a median of 14 days (2–365). Symptoms consistently and completely resolved following immunotherapy. Data were used to propose APS diagnostic criteria and repurpose PUQE score (hiccups severity grade based on symptom duration). The clinical utility was demonstrated in a prospective validation cohort.ConclusionIsolated APS attacks are frequently encountered both at onset and during the NMOSD course. The diagnostic criteria proposed here will assist clinicians in recognizing APS. Diagnosis of an APS attack earlier than 48 hours is possible if a dorsal medulla lesion is detected. Accurate diagnosis and evaluation of APS attack severity will assist in outcome measurement in NMOSD clinical trials.

scholarly journals 4172 Introduction to R Programming and GitHub: Developing Automated Analysis of Complete Blood Count Data as a Translational Science Undergraduate Project

2020 ◽  
Vol 4 (s1) ◽  
pp. 63-63
Author(s):  
Jeffrey Robinson ◽  
Annica Wayman
Keyword(s):  
Software Development ◽  
Open Source ◽  
Complete Blood Count ◽  
Life Sciences ◽  
Statistical Testing ◽  
Translational Science ◽  
Development Environment ◽  
Individual Parameter ◽  
R Language ◽  
R Programming

OBJECTIVES/GOALS: Introduce students to programming and software development practices in the life sciences by analyzing standard clinical diagnostic bloodwork for differential immune responses. Including lectures and a semester project with the goal of enhancing undergraduate students’ education to prepare them for careers in translational science. METHODS/STUDY POPULATION: The educational content was taught for the first time as a component of the newly developed course BTEC 330 “Software Applications in the Life Sciences” in UMBC’s Translational Life Science Technology (TLST) Bachelor’s degree program at the Universities at Shady Grove campus. Eleven students took the course. All were beginners with no programming background. Lectures provided background on the diagnostic components of the CBC, criteria for differential diagnosis in the clinical setting, and introduction to hematology and flow cytometry, forming underpinnings for interpretation of the CBC results. Weekly computer lab practical sessions provided training fundamentals of R programming language, the R-studio integrated development environment (IDE), and the GitHub.com open-source software development platform. RESULTS/ANTICIPATED RESULTS: The graded assignment consisted of a coding project in which students were each assigned an individual parameter from the CBC results. These include, for example, relative lymphocyte count or hemoglobin readouts. Students each created their own R-language script using R-studio, with functional code which: 1) Read in data from a file provided, 2) Performed statistical testing, 3) Read out statistical results as text, and charts as image files, 4) “Diagnosed” individuals in the dataset as being inside or outside the clinical normal range for that parameter. Each student also registered their own GitHub account and published their open-source code. Grading was performed on code functionality by downloading each student repository and running the code with the instructor as an outside developer using the resource. DISCUSSION/SIGNIFICANCE OF IMPACT: In this curriculum, students with no background in programming learned to code a basic R-language script and use GitHub to automate interpretation of CBC results. With advanced automation now becoming commonplace in translational science, such course content can provide introductory level of literacy in development of clinical informatics software.

scholarly journals Sequential Analysis of Anaplasma phagocytophilum msp2 Transcription in Murine and Equine Models of Human Granulocytic Anaplasmosis

2007 ◽  
Vol 15 (3) ◽  
pp. 418-424 ◽  
Author(s):  
Diana G. Scorpio ◽  
Christian Leutenegger ◽  
Jeannine Berger ◽  
Nicole Barat ◽  
John E. Madigan ◽  
...  
Keyword(s):  
Anaplasma Phagocytophilum ◽  
Complete Blood Count ◽  
Clinical Manifestations ◽  
Clinical Severity ◽  
Human Granulocytic Anaplasmosis ◽  
High Passage ◽  
Granulocytic Anaplasmosis ◽  
Low Passage

ABSTRACT Anaplasma phagocytophilum causes human granulocytic anaplasmosis by inducing immunopathologic responses. Its immunodominant Msp2 protein is encoded by a family of >100 paralogs. Msp2 (msp2) expression modulates in the absence of immune pressure, and prolonged in vitro passage modulates in vivo virulence. Because programmed MSP2 expression occurs in Anaplasma marginale, we hypothesized a similar event in A. phagocytophilum in vivo, with specific Msp2 expression triggering immunopathologic injury or clinical manifestations of disease. We examined msp2 transcripts in 11 B6 mice and 6 horses inoculated with low- or high-passage A. phagocytophilum Webster strain. Blood was sequentially obtained through 3 weeks postinfection for msp2 reverse transcription-PCR. Horses were additionally assessed for clinical manifestations, seroconversion, complete blood count, blood chemistry, and cytokine gene transcription. In both species, there was no consistent emergence of msp2 transcripts, and all 22 msp2 variants were detected in both passage groups. Clinical severity was much higher for high-passage-infected than for low-passage-infected horses, preceded by higher levels of blood gamma interferon transcription on day 7. Antibody was first detected on day 7, and all horses seroconverted by day 22, with a trend toward lower antibody titers in low-passage-infected animals. Leukocyte and platelet counts were similar between experimental groups except on day 13, when low-passage-infected animals had more profound thrombocytopenia. These findings corroborate studies with mice, where msp2 diversity did not explain differences in hepatic histopathology, but differ from the paradigm of low-passage A. phagocytophilum causing more significant clinical illness. Alteration in transcription of msp2 has no bearing on clinical disease in horses, suggesting the existence of a separate proinflammatory component differentially expressed with changing in vitro passage.

scholarly journals Endothelial Cell Activation in Muscle Biopsy Samples Is Related to Clinical Severity in Human Cerebral Malaria

1999 ◽  
Vol 179 (2) ◽  
pp. 475-483 ◽  
Author(s):  
Felipe García ◽  
Mireia Cebrián ◽  
Martinho Dgedge ◽  
Jordi Casademont ◽  
José Luis Bedini ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cerebral Malaria ◽  
Muscle Biopsy ◽  
Cell Activation ◽  
Clinical Severity ◽  
Endothelial Cell Activation

scholarly journals Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19 Pneumonia: A Multicenter Study

2020 ◽  
Author(s):  
Yun Yang ◽  
Xiaofei Zhu ◽  
Jian Huang ◽  
Cui Chen ◽  
Yang Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Validation Cohort ◽  
Fatal Outcome ◽  
Treatment Strategies ◽  
Training Cohort ◽  
Factors Associated ◽  
Risk Of Death ◽  
High Risk Factors ◽  
Cox Analysis

Abstract Background & Aims: To develop an effective model of predicting fatal Outcome in the severe coronavirus disease 2019 (COVID-19) patients.Methods: Between February 20, 2020 and April 4, 2020, consecutive COVID-19 patients from three designated hospitals were enrolled in this study. Independent high- risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results: There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184, 95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300, 95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L (HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95% CI 1.567-7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC 0.900, [95% CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC 0.862, [95% CI 0.763-0.961], sensitivity 92.9%, specificity 64.5%); in validation cohort 2 (AUC 0.811, [95% CI 0.698-0.924], sensitivity 77.3%, specificity 73.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. Conclusions: This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients.

scholarly journals Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19: A Multicenter Study

2021 ◽  
Author(s):  
Yun Yang ◽  
Xiaofei Zhu ◽  
Jian Huang ◽  
Cui Chen ◽  
Yang Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Validation Cohort ◽  
Fatal Outcome ◽  
Treatment Strategies ◽  
Training Cohort ◽  
Factors Associated ◽  
Risk Of Death ◽  
High Risk Factors ◽  
Cox Analysis

Abstract Background & Aims: To develop an effective model of predicting fatalOutcome in the severe coronavirus disease 2019 (COVID-19) patients.Methods: Between February 20, 2020 and April 4, 2020, consecutive COVID-19 patients from three designated hospitals were enrolled in this study. Independent high- risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results: There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184, 95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300, 95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L (HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95% CI 1.567-7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC 0.900, [95% CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC 0.811, [95% CI 0.763-0.961], sensitivity 77.3%, specificity 73.5); in validation cohort 2 (AUC 0.862, [95% CI 0.698-0.924], sensitivity 92.9%, specificity 64.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. The prognosis of severe COVID-19 patients with high levels of interleukin-6 (IL-6) receiving tocilizumab was better than that of those patients without tocilizumab both in the training and validation cohorts, but without difference (p = 0.105 for training cohort, p = 0.133 for validation cohort 1, and p = 0.210 for validation cohort 2).Conclusions: This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients. Tocilizumab may improve the prognosis of severe COVID-19 patients with high levels of IL-6.

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