scholarly journals Novel Coronavirus Infection: A Review on Haematological Markers of Disease Severity

2020 ◽  
Author(s):  
Angela Ogechukwu Ugwu ◽  
Theresa Ukamaka Nwagha
Keyword(s):  
Respiratory Failure ◽  
Disease Severity ◽  
White Cell Count ◽  
Strong Relationship ◽  
Ventilator Support ◽  
Increased Risk ◽  
Wide Range ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Prophylactic Anticoagulation

The Corornavirus Disease (COVID-19) virus infection has a wide range of presentation- asymptomatic, mild, severe and critical forms that often lead to death from respiratory failure. There is a strong relationship between the severity of COVID-19 infection and some haematological parameters. Patients often present with lymphocytopenia at diagnosis despite having a normal total white cell count. The degree of lymphocytopenia could predict the progression to pneumonia and subsequent need for ventilator support due to respiratory failure. Apart from lymphocytopenia, thrombocytopenia has been linked with increased severity of COVID-19 symptoms. The lymphocyte-platelet ratio has been found to a better marker for disease severity than isolated lymphocytopenia or thrombocytopenia. COVID-19 patients have been found to be at increased risk of Venous Thromboembolism (VTE). There is elevation of D-dimers, abnormalities of the Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT) among hospitalised COVID-19 patients. This has necessitated the use of prophylactic anticoagulation even in the early phases of the infection.

scholarly journals COVID-19 :Correlation Between CRP and LDH to Disease Severity and Mortality In Hospitalized COVID-19 Patients

2020 ◽  
Vol 7 (1A) ◽  
pp. 144-149
Author(s):  
Rizal Muldani Tjahyadi ◽  
Triwahju Astuti ◽  
Aditya Sri Listyoko
Keyword(s):  
Statistical Analysis ◽  
Respiratory Failure ◽  
Disease Severity ◽  
Retrospective Cohort ◽  
Pearson Correlation ◽  
Lung Lesion ◽  
Strong Positive Correlation ◽  
Intensive Care Patients ◽  
Wide Range ◽  
Severe Group

Background and Objective:COVID–19 is a newly emerging disease and considered an emergency health problem, worldwide.It has a wide range of clinical features, from mild fever to severe respiratory failure that leads to a higher mortality rate. Previous studies state that CRPhas a very strong positive correlation with the diameter of the lung lesion, and in intensive care patients had a higher level of LDH. This study aims to determine the correlation between CRP, LDH and disease severity and mortality in hospitalized COVID-19 patients. Methods: We conducted a retrospective cohort, a single-center study including  69 laboratory-confirmed patients in our hospital in Malang City, Indonesia from April - June 2020. Result: Subjects consisted of 26 patients (37.7%) in the mild-moderate group and 43 patients in severe group (62.3%).Statistical analysis showed CRP and LDH associated with disease severity (p=0.011 and p<0.001). Analysis of CRPand LDH in survivor and non-survivior group showed that CRP and LDH also asscociated with mortality in hospitalized COVID-19 patients (p=0.034 and 0.002). We also evaluate CRP and LDH with degrees of hypoxemia  by assessed P/F ratio. Statistical analysis showed that CRP did not correlate with degrees of hypoxemia (p=0.079) but LDH inverse correlate with degrees of hypoxemia (p<0.001, pearson correlation = -0,489)  Conclusion: In our retrospective cohort study demonstrated LDH and CRP can be a crucial indicator to predict severity and mortality for hospitalized COVID-19 patients and LDH may usefull test for predict early identification of patients who become respiratory failure or ARDS. Keywords: COVID-19, LDH, CRP, P/F Ratio

scholarly journals Novel coronavirus infection COVID-19: extrapulmonary manifestations

2020 ◽  
Vol 92 (8) ◽  
pp. 4-11 ◽  
Author(s):  
I. V. Maev ◽  
A. V. Shpektor ◽  
E. Yu. Vasilyeva ◽  
V. N. Manchurov ◽  
D. N. Andreev
Keyword(s):  
Arterial Thrombosis ◽  
Respiratory Symptoms ◽  
Myocardial Damage ◽  
Cardiovascular Complications ◽  
Clinical Syndrome ◽  
The Novel ◽  
Wide Range ◽  
Serum Transaminases ◽  
Coronavirus Infection ◽  
Novel Coronavirus

The novel coronavirus infection COVID-19 in most cases manifests with respiratory symptoms and fever, however, some patients may have cardiovascular and gastroenterological manifestations. A feature of the clinical syndrome of COVID-19 is the development of pronounced immunopathological reactions and disorders of hemostasis, leading to the development of a wide range of cardiovascular complications. The course of COVID-19 may be complicated by the development of acute myocardial infarction, venous and arterial thrombosis and thromboembolism in various vascular pools, the development of acute myocardial damage and myocarditis. Among the gastroenterological manifestations, diarrhea, nausea or vomiting, as well as abdominal pain, are most often detected. These symptoms may precede the appearance of respiratory signs of the disease, and in some cases come to the fore in the clinical picture of the disease. In addition, in some patients there are laboratory signs of liver injury (increased serum transaminases). The exact pathogenesis of the above disorders continues to be studied.

scholarly journals ROLE OF TOLL-LIKE RECEPTORS IN CORONAVIRUS INFECTION AND IMMUNE RESPONSE

2020 ◽  
Vol 8 (Spl-1-SARS-CoV-2) ◽  
pp. S66-S78
Author(s):  
Muhammad Sarfaraz Iqbal ◽  
◽  
Nimra Sardar ◽  
Wajiha Akmal ◽  
Rabia Sultan ◽  
...  
Keyword(s):  
Adaptor Proteins ◽  
Microbial Pathogens ◽  
Natural Resistance ◽  
Toll Like Receptors ◽  
Wide Range ◽  
Rapid Transmission ◽  
A Cell ◽  
Coronavirus Infection ◽  
Novel Coronavirus

The emergence of a novel coronavirus referred to as SARS-CoV-2 has become a global health apprehension due to rapid transmission tendency, severity, and wide geographical spread. This emergence was started from Wuhan, China in 2019 from the zoonotic source and spread worldwide, infecting almost half of the community on this earth. Many of the receptors are involved in proceeding with this infection in the organism's body. Toll-like receptors (TLRs) play essential and protective functions from a wide range of microbial pathogens. Small setup of TLR adaptor proteins leads to activate nuclear factor kappa B (NF-kB) and interferon-regulatory factor (IRF). Consequently, various advanced inflammatory cytokines, chemokines, and interferon reaction properties can be up-regulated. Similarly, TLR flagging works on autophagy in macrophages. Autophagy is a cell response to starvation that helps to eliminate damaged cytosol organelles and persistent proteins. It is also able to prevent the replication of intracellular pathogens. Several microbes subvert the autophagy pathways to sustain their viability. This review investigates how TLRs can modulate a macrophagic system and analyze the role of natural resistance autophagy.

scholarly journals Novel Coronavirus Infection (COVID-19) Related Thrombotic and Bleeding Complications in Critically Ill Patients: Experience from an Academic Medical Center

2021 ◽  
Vol 10 (23) ◽  
pp. 5652
Author(s):  
Thejus Jayakrishnan ◽  
Aaron Haag ◽  
Shane Mealy ◽  
Corbyn Minich ◽  
Abraham Attah ◽  
...  
Keyword(s):  
Critically Ill ◽  
Major Bleeding ◽  
Bleeding Complications ◽  
P Value ◽  
Bleeding Events ◽  
Coagulation Parameters ◽  
Therapeutic Anticoagulation ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Prophylactic Anticoagulation

Introduction: Thrombosis and bleeding are recognized complications of the novel coronavirus infection (COVID-19), with a higher incidence described particularly in the critically ill. Methods: A retrospective review of COVID-19 patients admitted to our intensive care units (ICU) between 1 January 2020 and 31 December 2020 was performed. Primary outcomes included clinically significant thrombotic and bleeding events (according to the ISTH definition) in the ICU. Secondary outcomes included mortality vis-a-vis the type of anticoagulation. Results: The cohort included 144 consecutive COVID-19 patients with a median age of 64 years (IQR 54.5–75). The majority were male (85 (59.0%)) and Caucasian (90 (62.5%)) with a median BMI of 30.5 kg/m2 (IQR 25.7–36.1). The median APACHE score at admission to the ICU was 12.5 (IQR 9.5–22). The coagulation parameters at admission were a d-dimer level of 109.2 mg/mL, a platelet count of 217.5 k/mcl, and an INR of 1.4. The anticoagulation strategy at admission included prophylactic anticoagulation for 97 (67.4%) patients and therapeutic anticoagulation for 35 (24.3%) patients, while 12 (8.3%) patients received no anticoagulation. A total of 29 patients (20.1%) suffered from thrombotic or major bleeding complications. These included 17 thrombus events (11.8%)—8 while on prophylactic anticoagulation (7 regular dose and 1 intermediate dose) and 9 while on therapeutic anticoagulation (p-value = 0.02)—and 19 major bleeding events (13.2%) (4 on no anticoagulation, 7 on prophylactic (6 regular dose and 1 intermediate dose), and 8 on therapeutic anticoagulation (p-value = 0.02)). A higher thrombosis risk among patients who received remdesivir (18.8% vs. 5.3% (p-value = 0.01)) and convalescent serum (17.3% vs. 5.8% (p-value = 0.03%)) was noted, but no association with baseline characteristics (age, sex, race, comorbidity), coagulation parameters, or treatments (steroids, mechanical ventilation) could be identified. There were 10 pulmonary embolism cases (6.9%). A total of 99 (68.8%) patients were intubated, and 66 patients (45.8%) died. Mortality was higher, but not statistically significant, in patients with thrombotic or bleeding complications—58.6% vs. 42.6% (p-value = 0.12)—and higher in the bleeding (21.2%) vs. thrombus group (12.1%), p-value = 0.06. It did not significantly differ according to the type of anticoagulation used or the coagulation parameters. Conclusions: This study describes a high incidence of thrombotic and bleeding complications among critically ill COVID-19 patients. The findings of thrombotic events in patients on anticoagulation and major bleeding events in patients on no or prophylactic anticoagulation pose a challenging clinical dilemma in the issue of anticoagulation for COVID-19 patients. The questions raised by this study and previous literature on this subject demonstrate that the role of anticoagulation in COVID-19 patients is worthy of further investigation.

Large retroperitoneal lymph nodes (RPLN) as a predictor for venous thromboembolism (VTE) in patients (pts) with germ cell tumor (GCT) receiving first-line chemotherapy (chemo).

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 332-332
Author(s):  
Ben Tran ◽  
Malcolm J. Moore ◽  
Eitan Amir ◽  
Michael A Jewett ◽  
Lynn Anson-Cartwright ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Predictive Model ◽  
Roc Curve ◽  
White Cell Count ◽  
Univariate Analysis ◽  
High Rate ◽  
Venous Stasis ◽  
Maximal Diameter ◽  
Increased Risk ◽  
Prophylactic Anticoagulation

332 Background: VTE causes significant morbidity and mortality in GCT pts. While an existing and validated predictive model identifies VTE risk in chemo pts with any cancer (Khorana model), a predictive model specific to GCT does not exist. Many GCT pts present with bulky RPLN that produce venous stasis in the lower extremities. The objective of this study was to explore the association between large RPLN and VTE in GCT pts receiving chemo and compare large RPLN as a predictor for VTE in GCT pts to the non-GCT specific Khorana model. Methods: Clinical data from our institutional GCT database was complemented by review of radiology, pharmacy and medical records. All GCT pts receiving 1st line chemo between 1-Jan-00 and 31-Dec-10 were included. Large RPLN were defined as ≥5cm in maximal diameter. Factors used in the Khorana model (baseline BMI, hemoglobin, white cell count and platelets) were collected. We compared the predictive accuracy of large RPLN versus Khorana score ≥3 using receiver operator characteristic (ROC) curve statistical analyses. Results: The cohort consisted of 260 GCT pts, median age 31.5 years, predominantly testis primary (235, 90%) and good risk (171, 66%). 17 (7%) developed VTE prior to the start of chemo. 19 (7%) were given prophylactic anticoagulation, none of whom developed VTE. Of the remaining 224 pts, 20 (9%) developed VTE during chemo. In a univariate analysis, large RPLN was strongly associated with VTE (OR 7.74, p<0.001), as were Khorana score ≥3 (OR 9.81, p<0.001) and hospital admission during chemo (OR 3.96, p=0.004). ROC curve analyses demonstrated large RPLN was a significant individual predictor for VTE (AUC 0.588, p=0.03), however, Khorana score ≥3 was a better predictor (AUC 0.664, p=0.02). Adding large RPLN to create a modified Khorana score provided marginal gains (AUC 0.682, p=0.02). Conclusions: Although large RPLN at diagnosis predicts for VTE in GCT pts, the Khorana predictive model is superior. Given the high rate of VTE in GCT pts receiving chemo, we recommend prophylactic anticoagulation for pts at increased risk, including pts with Khorana score ≥3, pts requiring hospital admission or pts with large RPLN.

COGNITIVE IMPAIRMENT IN PATIENTS WITH CORONAVIRUS INFECTION

2021 ◽  
Vol 2 (1) ◽  
pp. 5-8
Author(s):  
Gulnoza Urinova ◽  
◽  
Nargiza Nasirtdinova ◽  
Janna Nazarova
Keyword(s):  
Cognitive Impairment ◽  
Neurological Disorders ◽  
Sinus Thrombosis ◽  
The Novel ◽  
Altered Level ◽  
Wide Range ◽  
Level Of Consciousness ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
The Brain

Thisarticle discusses cognitive impairment in patients with coronavirus infection and explains that observations have been made on this topic. The novel coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus poses a global health threat. Neurological disordersfound in patients with coronavirus infection have a wide range of clinical neurological signs: headache, dizziness, altered level of consciousness, acute cerebrovascular accident (ACVE), venous sinus thrombosis the brain [12].Keywords:coronavirus infection, cognitive impairment, neurological disorders, headache, dizziness, muscle weakness, encephalopathy, encephalitis

Relationship between morphometrics and trophic levels in deep-sea fishes

2020 ◽  
Vol 637 ◽  
pp. 225-235 ◽  
Author(s):  
MA Ladds ◽  
MH Pinkerton ◽  
E Jones ◽  
LM Durante ◽  
MR Dunn
Keyword(s):  
Stable Isotopes ◽  
Trophic Level ◽  
Deep Sea ◽  
Strong Relationship ◽  
Ecosystem Model ◽  
Trophic Levels ◽  
Fish Size ◽  
Wide Range ◽  
Gape Size ◽  
Morphological Variables

Marine food webs are structured, in part, by predator gape size. Species found in deep-sea environments may have evolved such that they can consume prey of a wide range of sizes, to maximise resource intake in a low-productivity ecosystem. Estimates of gape size are central to some types of ecosystem model that determine which prey are available to predators, but cannot always be measured directly. Deep-sea species are hypothesized to have larger gape sizes than shallower-water species relative to their body size and, because of pronounced adaptive foraging behaviour, show only a weak relationship between gape size and trophic level. Here we present new data describing selective morphological measurements and gape sizes of 134 osteichthyan and chondrichthyan species from the deep sea (200-1300 m) off New Zealand. We describe how gape size (height, width and area) varied with factors including fish size, taxonomy (class and order within a class) and trophic level estimated from stable isotopes. For deep-sea species, there was a strong relationship between gape size and fish size, better predicted by body mass than total length, which varied by taxonomic group. Results show that predictions of gape size can be made from commonly measured morphological variables. No relationship between gape size and trophic level was found, likely a reflection of using trophic level estimates from stable isotopes as opposed to the commonly used estimates from FishBase. These results support the hypothesis that deep-sea fish are generalists within their environment, including suspected scavenging, even at the highest trophic levels.

Experience in Applying Hyperbaric Oxygen Therapy Using Portable Pressure Chambers for the Treatment of Patients with the Novel Coronavirus Infection COVID-19

Biomeditsina ◽  
2020 ◽  
pp. 39-46
Author(s):  
A. S. Samoilov ◽  
Yu. D. Udalov ◽  
M. V. Sheyanov ◽  
A. V. Gholinsky ◽  
A. B. Litvinenko
Keyword(s):  
Oxygen Saturation ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Capillary Blood ◽  
Blood Hemoglobin ◽  
Patient Groups ◽  
Radiological Changes ◽  
Coronavirus Infection ◽  
Novel Coronavirus

This communication presents the experience of using mobile pressure chambers in patients with the confi rmed novel coronavirus infection in hospital settings. The obtained preliminary results indicate positive antihypoxic effects of hyperbaric oxygen therapy (HBO) applied in the form of increased saturation. After a session of HBO, patients demonstrated an increase in the oxygen saturation of capillary blood hemoglobin at the average level of 3.71 points. Differences between SatO2 levels prior to and following HBO treatment were signifi cant in the CT2, CT3 and CT4 groups (p0.05). As expected, the effi cacy of HBO in terms of the oxygen saturation of capillary blood hemoglobin was the greatest in the patient groups showing pronounced clinical and radiological changes in the lungs.

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