scholarly journals Is the Urine Analysis, a Diagnostic Value in COVID-19 Patients?

Author(s):  
Sonti Sulochana ◽  
Lakshmi Priya Asokan ◽  
. Mathesh ◽  
Chitra Srinivasan

Background: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), a novel coronavirus causing Coronavirus disease 19 (COVID-19) in December 2019, is now a pandemic infectious disease, primarily affecting the respiratory tract. To date, many investigations are available for the diagnosis of SARS-CoV-2. A viral nucleic acid test has been used for the diagnosis of COVID-19, and some hematological indicators have been used in the auxiliary diagnosis and identification of the severity of COVID-19. There are very few studies available in routine urine biochemical parameters and their relation with Covid-19 patients. Aim: This study is aimed to study the changes in urine parameter values in COVID-19 disease and to predict the severity of the disease with the changes in urine parameters. Materials and Methods: A total of 150 patients with COVID-19 were admitted at Saveetha Medical College and Hospital during the study period. All cases tested positive for SARS-CoV-2 by RT-PCR test done on nasopharyngeal swabs during the study period were included. Patients who tested negative by RT-PCR test were considered as controls. The relationship between the results of urine biochemical parameters and the severity of COVID-19 were analysed by Descriptive statistics, Chi-squared test. Results: The positive rates of proteinuria (PRO) and leucocytes were more significant in COVID-19 patients than in healthy controls. The urine specific gravity (SG) value was highly significant (p <0.001) while the blood, nitrites in urine, and  potential of hydrogen (pH) value was insignificant. Conclusion: There were some considerable changes in few urine biochemical parameters between patients with the SARS-CoV-2 and healthy controls. So from this study we conclude, proteinuria is helpful for predicting COVID-19 severity and kidney function.

2020 ◽  
Vol 58 (7) ◽  
pp. 1121-1124 ◽  
Author(s):  
Rui Liu ◽  
Qingfeng Ma ◽  
Huan Han ◽  
Hanwen Su ◽  
Fang Liu ◽  
...  

AbstractBackgroundAmong patients with coronavirus disease 2019 (COVID-19), the cases of a significant proportion of patients are severe. A viral nucleic acid test is used for the diagnosis of COVID-19, and some hematological indicators have been used in the auxiliary diagnosis and identification of the severity of COVID-19. Regarding body fluid samples, except for being used for nucleic acid testing, the relationship between COVID-19 and routine body fluid parameters is not known. Our aim was to investigate the value of urine biochemical parameters in the prediction of the severity of COVID-19.MethodsA total of 119 patients with COVID-19 were enrolled at Renmin Hospital of Wuhan University. According to the severity of COVID-19, the patients were divided into three groups (moderate 67, severe 42 and critical 10), and 45 healthy persons were enrolled in the same period as healthy controls. The relationship between the results of urine biochemical parameters and the severity of COVID-19 was analyzed.ResultsThe positive rates of urine occult blood (BLOOD) and proteinuria (PRO) were higher in COVID-19 patients than in healthy controls (p < 0.05); the urine specific gravity (SG) value was lower in patients than in healthy controls (p < 0.05), and the urine potential of hydrogen (pH) value was higher in patients than in healthy controls (p < 0.01). The positive rates of urine glucose (GLU-U) and PRO in the severe and critical groups were higher than those in the moderate group (p < 0.01 and p < 0.05, respectively); other biochemical parameters of urine were not associated with the severity of COVID-19.ConclusionsSome urine biochemical parameters are different between patients with severe acute respiratory syndrome (SARS)-CoV-2 and healthy controls, and GLU-U and PRO may be helpful for the differentiation of COVID-19 severity.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weiping Lu ◽  
Jianguo Wei ◽  
Tingting Xu ◽  
Miao Ding ◽  
Xiaoyan Li ◽  
...  

Abstract Background Corona Virus Disease 2019 (COVID-19) is currently a worldwide pandemic and has a huge impact on public health and socio-economic development. The purpose of this study is to explore the diagnostic value of the quantitative computed tomography (CT) method by using different threshold segmentation techniques to distinguish between patients with or without COVID-19 pneumonia. Methods A total of 47 patients with suspected COVID-19 were retrospectively analyzed, including nine patients with positive real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR) test (confirmed case group) and 38 patients with negative RT-PCR test (excluded case group). An improved 3D convolutional neural network (VB-Net) was used to automatically extract lung lesions. Eight different threshold segmentation methods were used to define the ground glass opacity (GGO) and consolidation. The receiver operating characteristic (ROC) curves were used to compare the performance of various parameters with different thresholds for diagnosing COVID-19 pneumonia. Results The volume of GGO (VOGGO) and GGO percentage in the whole lung (GGOPITWL) were the most effective values for diagnosing COVID-19 at a threshold of − 300 HU, with areas under the curve (AUCs) of 0.769 and 0.769, sensitivity of 66.67 and 66.67%, specificity of 94.74 and 86.84%. Compared with VOGGO or GGOPITWL at a threshold of − 300 Hounsfield units (HU), the consolidation percentage in the whole lung (CPITWL) with thresholds at − 400 HU, − 350 HU, and − 250 HU were statistically different. There were statistical differences in the infection volume and percentage of the whole lung, right lung, and lobes between the two groups. VOGGO, GGOPITWL, and volume of consolidation (VOC) were also statistically different at the threshold of − 300 HU. Conclusions Quantitative CT provides an image quantification method for the auxiliary diagnosis of COVID-19 and is expected to assist in confirming patients with COVID-19 pneumonia in suspected cases.


2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Ugur Kostakoglu ◽  
Aydın Kant ◽  
Serhat Atalar ◽  
Barış Ertunç ◽  
Şükrü Erensoy ◽  
...  

Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19. Methods: The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II). Results: The mean age of the patients in Group-I was 49.7±18.0 years and the time between the onset of symptoms and admission to the hospital was 3.6±2.0 days; whereas the same values for the patients in Group-II were 58.1±19.9 and 5.3±4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-PCR positivity correlated positively with headache. Presence of CT findings was positively correlated with age, comorbidity, shortness of breath, fever, and the symptom duration. Conclusions: It should be noted that a negative result in the rtRT-PCR test does not rule out the possibility of COVID-19 diagnosis in patients whose symptom duration is longer than five days, who are elderly with comorbidities and in particular who present with fever and shortness of breath. In these patients, typical CT findings are diagnostic for COVID-19. A normal chest CT is no reason to loosen up measures of isolation in patients with newly beginning symptoms until the results are obtained from the PCR test. doi: https://doi.org/10.12669/pjms.37.1.2956 How to cite this:Kostakoglu U, Kant A, Atalar S, Ertunc B, Erensoy S, Dalmanoglu E, et al. Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection. Pak J Med Sci. 2021;37(1):-234-238. doi: https://doi.org/10.12669/pjms.37.1.2956 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Mohammadhossein Zamanian ◽  
Zohre Foroozanfar ◽  
Zhila Izadi ◽  
Samira Jafari ◽  
Hossein Derakhshankhah ◽  
...  

Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kermanshah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mortality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137; 55.9%), cough (n = 93; 38.0%), and fever (n = 78; 31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09; 95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07; 95% CI: 1.46 to 17.58), hypertension (OR = 5.82; 95% CI: 1.13 to 30.04), smoking (OR = 11.44; 95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31; 95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23; 95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383; 95% CI: 0.17 to 0.88) and fever (OR = 0.278; 95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.


Author(s):  
Ishani Bora ◽  
Sanjib Gogoi ◽  
Vaishnavi Venkatasubramanian ◽  
Roshan Mathew ◽  
Ritin Mohindra

The novel Coronavirus COVID-19 is wrecking a havoc across the globe and has been declared as a pandemic by WHO. Apart from transmission and shedding of the virus through respiratory secretions in the form of droplets (mainly), several studies have shown the presence of the virus in various samples such as stool, urine and occasionally in blood, semen, tears and breastmilk. Whereas government authority guidelines consider a person as cured from COVID-19 when along with clinical improvement no more virus can be detected primarily on respiratory samples along with clinical improvement; the persistence of the virus in these body fluids even after clinical recovery and negative RT-PCR test results on respiratory samples, has raised many questions about the elusive nature of this novel virus along with the possibility of other routes of transmission of this virus in the community. Although studies performed till now across the globe on persistence of SARSCOV-2 in various body fluids are sparse, in this review we would like to present and analyse the results of those studies performed globally on the aforesaid topic to get a better insight of this side of the COVID-19 story.


Author(s):  
Afshin Ostovar ◽  
Elham Ehsani-Chimeh ◽  
Zeinab Fakoorfard

Background: Coronavirus disease (COVID-19) has spread around the world since the beginning of 2020. The definitive diagnosis of COVID-19 is the RT-PCR laboratory test. However, because of low sensitivity, the chest CT scan has become important for the rapid diagnosis and clinical decision-making. Objectives: This study aims to define CT scan’ diagnostic value in diagnosing COVID-19 in medical centers. Methods: This study is a rapid health technology assessment (HTA) and had two major phases. In phase 1, a rapid review was done for defining the sensitivity and specificity rate of CT. During this phase, studies related to the diagnostic and technical data on the use of CT in the diagnosis of COVID-19 were reviewed, and the sensitivity and specificity of CT in these studies were extracted. In phase 2, sequential testing was run to evaluate the diagnostic value of chest CT to diagnose COVID-19 according to two scenarios before and after adding RT-PCR test results. Results: CT scan has a high sensitivity for diagnosing cases of COVID-19. Due to its low specificity, relying on CT scans to diagnose COVID-19 alone in medical centers can lead to a significant proportion of false-positive cases. This study showed that if the probability of COVID-19 before the CT scan were about 50%, with a positive CT scan, this probability would be between 60 and 70% depending on the CT specificity. Conclusions: With the available evidence, the use of a CT scan alone is not sufficient for diagnosis. The RT-PCR test is also necessary to improve the diagnosis and continue the treatment and isolation of patients.


2021 ◽  
pp. 1-3
Author(s):  
Anjan Jyoti Talukdar ◽  
Raj Pratim Das ◽  
Basanta Hazarika ◽  
Priyam Saikia ◽  
Tirtha Chaliha ◽  
...  

BACKGROUD:Covid-19hasemergedhasanalarmingpublichealthcrisis,puttingthehealthcarefacilitiesacross theglobeat strain.Even after almost ten months of its identification,there exists only a few specific approved therapeutic agents for novel coronavirus disease.In this observational study,we have looked for any clinical benefits of convalescent plasma therapy in moderately severe cases of Covid-19,when added to a regimen consisting of Remdesivir,Dexamethasone and Heparin. METHODOLOGY: 528 moderately severe patients confirmed by RT-PCR test were enrolled. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to 268 patients as an addition to maximal supportive care and Remdesivir with steroid and heparin while 260 receivedRemdesivir with steroid and heparin. RESULTS:Theprimaryendpointwasmortalitybenefit.Thesecondendpointswerethereductionindaysofhospitalization,viral clearanceandimprovementofclinical symptoms.Themediantimefromonsetofillness toplasmatransfusionwas9.55d(range 6-24d).Nosevereadverseeffectswereobserved. CONCLUSION:Our studyshowedthatCPTcouldimprovesurvivalinpatientswhenaddedtothestandardtherapyinpatients with moderate Covid-19 infection. The add on therapy also significantly reduced the need for supplemental oxygen in the survivorsItcouldpotentiallyimprovetheclinicaloutcomesbesidesbeingawell-toleratedmodalityoftreatment.


Author(s):  
Jinwei Ai ◽  
Junyan Gong ◽  
Limin Xing ◽  
Renjiao He ◽  
Fangtao Tian ◽  
...  

AbstractBackgroundThe pandemic of coronavirus disease 2019 (COVID-19) has become the first concern in international affairs as the novel coronavirus (SARS-CoV-2) is spreading all over the world at a terrific speed. The accuracy of early diagnosis is critical in the control of the spread of the virus. Although the real-time RT-PCR detection of the virus nucleic acid is the current golden diagnostic standard, it has high false negative rate when only apply single test.ObjectiveSummarize the baseline characteristics and laboratory examination results of hospitalized COVID-19 patients. Analyze the factors that could interfere with the early diagnosis quantitatively to support the timely confirmation of the disease.MethodsAll suspected patients with COVID-19 were included in our study until Feb 9th, 2020. The last day of follow-up was Mar 20th, 2020. Throat swab real-time RT-PCR test was used to confirm SARS-CoV-2 infection. The difference between the epidemiological profile and first laboratory examination results of COVID-19 patients and non-COVID-19 patients were compared and analyzed by multiple logistic regression. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to assess the potential diagnostic value in factors, which had statistical differences in regression analysis.ResultsIn total, 315 hospitalized patients were included. Among them, 108 were confirmed as COVID-19 patients and 207 were non-COVID-19 patients. Two groups of patients have significance in comparing age, contact history, leukocyte count, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate (p<0.10). Multiple logistic regression analysis showed age, contact history and decreasing lymphocyte count could be used as individual factor that has diagnostic value (p<0.05). The AUC of first RT-PCR test was 0.84 (95% CI 0.73-0.89), AUC of cumulative two times of RT-PCR tests was 0.92 (95% CI 0.88-0.96) and 0.96 (95% CI 0.93-0.99) for cumulative three times of RT-PCR tests. Ninety-six patients showed typical pneumonia radiological features in first CT scan, AUC was 0.74 (95% CI 0.60-0.73). The AUC of patients’ age, contact history with confirmed people and the decreased lymphocytes were 0.66 (95% CI 0.60-0.73), 0.67 (95% CI 0.61-0.73), 0.62 (95% CI 0.56-0.69), respectively. Taking chest CT scan diagnosis together with patients age and decreasing lymphocytes, AUC would be 0.86 (95% CI 0.82-0.90). The age threshold to predict COVID-19 was 41.5 years, with a diagnostic sensitivity of 0.70 (95% CI 0.61-0.79) and a specificity of 0.59 (95% CI 0.52-0.66). Positive and negative likelihood ratios were 1.71 and 0.50, respectively. Threshold of lymphocyte count to diagnose COVID-19 was 1.53×109/L, with a diagnostic sensitivity of 0.82 (95% CI 0.73-0.88) and a specificity of 0.50 (95% CI 0.43-0.57). Positive and negative likelihood ratios were 1.64 and 0.37, respectively.ConclusionSingle RT-PCR test has relatively high false negative rate. When first RT-PCR test show negative result in suspected patients, the chest CT scan, contact history, age and lymphocyte count should be used combinedly to assess the possibility of SARS-CoV-2 infection.


Cells ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2332
Author(s):  
Iwona Kwiecień ◽  
Elżbieta Rutkowska ◽  
Katarzyna Kulik ◽  
Krzysztof Kłos ◽  
Katarzyna Plewka ◽  
...  

Studying the dynamics changes of neutrophils during innate immune response in coronavirus 2019 (COVID-19) can help understand the pathogenesis of this disease. The aim of the study was to assess the usefulness of new neutrophil activation parameters: Immature Granulocyte (IG), Neutrophil Reactivity Intensity (NEUT-RI), Neutrophil Granularity Intensity (NEUT-GI), and data relating to granularity, activity, and neutrophil volume (NE-WX, NE-WY, NE-WZ) available in hematology analyzers to distinguish convalescent patients from patients with active SARS-CoV-2 infection and healthy controls (HC). The study group consisted of 79 patients with a confirmed positive RT-PCR test for SARS-CoV2 infection, 71 convalescent patients, and 20 HC. We observed leukopenia with neutrophilia in patients with active infection compared to convalescents and HC. The IG median absolute count was higher in convalescent patients than in COVID-19 and HC (respectively, 0.08 vs. 0.03 vs. 0.02, p < 0.0001). The value of the NEUT-RI parameter was the highest in HC and the lowest in convalescents (48.3 vs. 43.7, p < 0.0001). We observed the highest proportion of NE-WX, NE-WY, and NE-WZ parameters in HC, without differences between the COVID-19 and convalescent groups. New neutrophil parameters can be useful tools to assess neutrophils’ activity and functionalities in the immune response during infection and recovery from COVID-19 disease.


In December 2019, a new virus, also named a novel coronavirus, started as an emerging pathogen for humans and resulted in a pandemic. World Health Organization (WHO) called this novel coronavirus as COVID-19 on 11 February 2020, and the virus responsible for causing COVID-19 is SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is a positive-stranded RNA virus. This paper proposed an artificial neural network model in a grid computing system to identify COVID-19 patients. It can help us to identify the suspected patients and shortlist those patients who need to check by the RT-PCR test kit. The purpose of this research is to increase the time efficiency to test those patients, which has a higher chance of getting affected by COVID-19. Increasing the time efficiency in this type of pandemic situation can make a huge impact on reducing the fatality rate. This is because, according to ICMR, 1,191,946 samples have been tested as of 5 May, and 46,433 individuals have been confirmed positive. It means that only 3.85% of persons get positive results and 96.15% persons with a negative result. It implies that the time to test this 96.15% of cases is wasted. Hence we aim to detect the COVID-19 patients in less time and utilize this large amount of time to test those at higher risk of being affected by this epidemic (COVID-19). This model will also help those countries to overcome the problem of the shortage of this type of test kits such as - RT-PCR.


Sign in / Sign up

Export Citation Format

Share Document