scholarly journals Diagnostic utility of a Ferritin-to-Procalcitonin Ratio to differentiate patients with COVID-19 from those with Bacterial Pneumonia: A multicenter study

2021 ◽  
Author(s):  
Amal A Gharamti ◽  
Fei Mei ◽  
Katherine C Jankousky ◽  
Jin Huang ◽  
Peter Hyson ◽  
...  
Keyword(s):  
Bacterial Pneumonia ◽  
Operating Characteristic ◽  
Case Control Study ◽  
Receiver Operating Characteristic Analysis ◽  
Similar Proportion ◽  
Characteristic Analysis ◽  
Multivariable Analyses ◽  
Prevalence Of Diabetes Mellitus ◽  
Control Study

Abstract Background There is an urgent need for accurate, rapid, inexpensive biomarkers that can differentiate COVID-19 from bacterial pneumonia. We assess the role of the ferritin-to-procalcitonin (F/P) ratio to classify pneumonia cases into those due to COVID-19 or due to bacterial pathogens. Methods This multicenter case-control study compared patients with either COVID-19 and bacterial pneumonia, admitted between March 1 and May 31, 2020. Patients with COVID-19 and bacterial pneumonia co-infection were excluded. The F/P in patients with COVID-19 or with bacterial pneumonia were compared. Receiver operating characteristic analysis determined the sensitivity and specificity of various cut-off F/P values for COVID-19 versus bacterial pneumonia. Results A total of 242 COVID-19 pneumonia cases and 34 bacterial pneumonia controls were included. Patients with COVID-19 pneumonia had a lower mean age (57.11 vs 64.4 years, p=0.02) and a higher BMI (30.74 vs 27.15 kg/m 2, p=0.02) compared to patients with bacterial pneumonia. Cases and controls had a similar proportion of women (47% vs 53%, p=0.5) and COVID-19 patients had a higher prevalence of diabetes mellitus (32.6% vs 12%, p=0.01). The median F/P was significantly higher in patients with COVID-19 (4037.5) compared to the F/P in bacterial pneumonia (802, p<0.001). An F/P ≥ 877 used to diagnose COVID-19 resulted in a sensitivity of 85% and a specificity of 56%, with a positive predictive value of 93.2%, and a likelihood ratio of 1.92. In multivariable analyses, an F/P ≥ 877 was associated with greater odds of identifying a COVID-19 case (OR: 11.27, CI: 4-31.2, p<0.001). Conclusion An F/P ≥ 877 increases the likelihood of COVID-19 pneumonia compared to bacterial pneumonia.

scholarly journals Diagnostic utility of a Ferritin-to-Procalcitonin Ratio to differentiate patients with COVID-19 from those with Bacterial Pneumonia: A multicenter study

2020 ◽  
Author(s):  
Amal A. Gharamti ◽  
Fei Mei ◽  
Katherine C. Jankousky ◽  
Jin Huang ◽  
Peter Hyson ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Bacterial Pneumonia ◽  
Clinical Presentation ◽  
Diagnostic Testing ◽  
The United States ◽  
Diagnostic Value ◽  
Similar Proportion ◽  
Characteristic Analysis ◽  
Multivariable Analyses ◽  
Prevalence Of Diabetes Mellitus

AbstractImportanceThere is a need to develop tools to differentiate COVID-19 from bacterial pneumonia at the time of clinical presentation before diagnostic testing is available.ObjectiveTo determine if the Ferritin-to-Procalcitonin ratio (F/P) can be used to differentiate COVID-19 from bacterial pneumonia.DesignThis case-control study compared patients with either COVID-19 or bacterial pneumonia, admitted between March 1 and May 31, 2020. Patients with COVID-19 and bacterial pneumonia co-infection were excluded.SettingA multicenter study conducted at three hospitals that included UCHealth and Phoebe Putney Memorial Hospital in the United States, and Yichang Central People’s Hospital in China.ParticipantsA total of 242 cases with COVID-19 infection and 34 controls with bacterial pneumonia.Main Outcomes and MeasuresThe F/P in patients with COVID-19 or with bacterial pneumonia were compared. Receiver operating characteristic analysis determined the sensitivity and specificity of various cut-off F/P values for the diagnosis of COVID-19 versus bacterial pneumonia.ResultsPatients with COVID-19 pneumonia had a lower mean age (57.11 vs 64.4 years, p=0.02) and a higher BMI (30.74 vs 27.15 kg/m2, p=0.02) compared to patients with bacterial pneumonia. Cases and controls had a similar proportion of women (47% vs 53%, p=0.5) and COVID-19 patients had a higher prevalence of diabetes mellitus (32.6% vs 12%, p=0.01). The median F/P was significantly higher in patients with COVID-19 (4037.5) compared to the F/P in bacterial pneumonia (802, p<0.001). An F/P ≥ 877 used to diagnose COVID-19 resulted in a sensitivity of 85% and a specificity of 56%, with a positive predictive value of 93.2%, and a likelihood ratio of 1.92. In multivariable analyses, an F/P ≥ 877 was associated with greater odds of identifying a COVID-19 case (OR: 11.27, CI: 4-31.2, p<0.001).Conclusions and RelevanceAn F/P ≥ 877 increases the likelihood of COVID-19 pneumonia compared to bacterial pneumonia. Further research is needed to determine if obtaining ferritin and procalcitonin simultaneously at the time of clinical presentation has improved diagnostic value. Additional questions include whether an increased F/P and/or serial F/P associates with COVID-19 disease severity or outcomes.

scholarly journals 419. Diagnostic Utility of a Ferritin to Procalcitonin Ratio to Differentiate Patients with COVID-19 from Those with Bacterial Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S277-S277
Author(s):  
Katherine C Jankousky ◽  
Peter Hyson ◽  
Jin Huang ◽  
Daniel B Chastain ◽  
Carlos Franco-Paredes ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Host Response ◽  
Bacterial Pneumonia ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
University Hospital ◽  
Characteristic Analysis ◽  
The Us ◽  
Test Probability ◽  
Receiver Operating

Abstract Background Accurate, rapid, inexpensive biomarkers are needed to differentiate COVID-19 from bacterial pneumonia, allowing effective treatment and antibiotic stewardship. We hypothesized that the ratio of ferritin to procalcitonin (F/P) reflects greater viral activity and host response with COVID-19 pneumonia, while bacterial pneumonia would be associated with less cytolysis (lower ferritin) and more inflammation (higher procalcitonin), thus a lower F/P ratio. Methods We conducted a retrospective study of adult patients admitted to a single University hospital in the US through May 2020, during the COVID-19 pandemic. We compared F/P ratio of patients diagnosed with COVID-19 or bacterial pneumonia, excluding patients with COVID-19 and bacterial co-infections. In a logistic regression, we controlled for age, sex, body mass index (BMI), diabetes (DM), and hypertension (HTN). We used a receiver operating characteristic analysis to calculate the sensitivity and specificity of F/P values for the diagnosis of COVID-19 versus bacterial pneumonia. Results Of 218 patients with COVID-19 and 17 with bacterial pneumonia, COVID-19 patients were younger (56 vs 66 years, p=0.04), male (66% vs 24%, p=0.009), had higher BMI (31 vs 27 kg/m2, p=0.03), and similar rates of HTN (59% vs 45%, p=0.3) and DM (32% vs 18%, p=0.2). The median F/P ratio was significantly higher in patients with COVID-19 (3195 vs 860, p=0.0003, Figure 1). An F/P ratio cut-off of ≥ 1250 generated a sensitivity of 78% and a specificity of 59% to correctly classify a COVID-19 case (Figure 2). When adjusted for age, gender, BMI, DM, and HTN, a ratio ≥ of 1250 was associated with significantly greater odds of COVID-19 versus bacterial pneumonia (OR: 4.9, CI: 1.5, 16.1, p=0.009). Figure 1. Ferritin to Procalcitonin Ratios of patients with COVID-19 and patients with Bacterial Pneumonia (controls). Figure 2. Receiver Operating Characteristic Analysis of Ferritin to Procalcitonin Ratio Cut-off Values Predicting COVID-19 Diagnosis. Conclusion We observed an elevated F/P ratio in patients with COVID-19 compared to those with bacterial pneumonia. A F/P ratio ≥ 1250 provides a clinically relevant increase in pre-test probability of COVID-19. Prospective studies evaluating the discriminatory characteristics of F/P ratio in larger cohorts is warranted. Disclosures All Authors: No reported disclosures

scholarly journals Invasive Monitoring of Intracranial Pressure After Decompressive Craniectomy in Malignant Stroke

Stroke ◽  
2020 ◽  
Author(s):  
Silvia Hernández-Durán ◽  
Leonie Meinen ◽  
Veit Rohde ◽  
Christian von der Brelie
Keyword(s):  
Intracranial Pressure ◽  
Mortality Rate ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
High Specificity ◽  
Invasive Monitoring ◽  
Icp Monitoring ◽  
Characteristic Analysis ◽  
Decompressive Hemicraniectomy

Background and Purpose: The role of decompressive hemicraniectomy (DC) in malignant cerebral infarction (MCI) has clearly been established, but little is known about the course of intracranial pressure (ICP) in patients undergoing this surgical measure. In this study, we investigated the role of invasive ICP monitoring in patients after DC for MCI, postulating that postoperative ICP predicts mortality. Methods: In this retrospective observational study of MCI patients undergoing DC, ICP were recorded continuously in hourly intervals for the first 72 hours after DC. For every hour, mean ICP was calculated, pooling ICP of every patient. A receiver operating characteristic analysis was performed for hourly mean ICP. A subgroup analysis by age (≥60 years and <60 years) was also performed. Results: A total of 111 patients were analyzed, with 29% mortality rate in patients <60 years, and 41% in patients ≥60 years. A threshold of 10 mm Hg within the first 72 postoperative hours was a reliable predictor of mortality in MCI, with an acceptable sensitivity of 70% and high specificity of 97%. Established predictors of mortality failed to predict mortality. Conclusions: Our study suggests the need to reevaluate postoperative ICP after DC in MCI and calls for a redefinition of ICP thresholds in these patients to indicate further therapy.

Quantification of photophobia in visual snow syndrome: A case-control study

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Ozan E Eren ◽  
Ruth Ruscheweyh ◽  
Andreas Straube ◽  
Christoph J Schankin
Keyword(s):  
Visual Processing ◽  
Operating Characteristic ◽  
Case Control Study ◽  
Visual Disturbance ◽  
Visual Sensitivity ◽  
Characteristic Analysis ◽  
Main Effect ◽  
Entire Visual Field ◽  
Chronic Migraineurs ◽  
Control Study

Objective To quantify photophobia in visual snow syndrome (VSS), a debilitating migraine-associated visual disturbance manifesting with continuous “TV snow-like” flickering dots in the entire visual field and additional visual symptoms, such as photophobia. Methods Photophobia was compared between 19 patients with VSS and 19 controls matched for age, sex, migraine and aura using the Leiden Visual Sensitivity Scale (L-VISS). Results Patients with VSS had an increased L-VISS-score compared to matched controls [(22.2 ± 5.9 vs. 4.4 ± 4.8; ANOVA, factors VSS and comorbid migraine: Main effect for VSS (F = 100.70; p < 0.001), but not for migraine (F < 0.01; p = 1.00) or the interaction (F = 1.93; p = 0.16)]. An L-VISS-score of 14 identified VSS with a sensitivity and specificity of 95% (Receiver Operating Characteristic analysis, 0.986 ± 0.014, p ≤ 0.001). Conclusion Patients with VSS suffer continuously from photophobia at a level similar to chronic migraineurs during attacks. Although migraine and VSS share dysfunctional visual processing, patients with VSS might be more severely affected.

The Role of Occlusal Factors in the Presence of Noncarious Cervical Lesions in Young People: A Case-Control Study

2019 ◽  
Vol 44 (1) ◽  
pp. E12-E22
Author(s):  
A Alvarez-Arenal ◽  
L Alvarez-Menendez ◽  
I Gonzalez-Gonzalez ◽  
E Jiménez-Castellanos ◽  
M Garcia-Gonzalez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Operating Characteristic ◽  
Case Control Study ◽  
Characteristic Curve ◽  
Case Control ◽  
Cervical Lesions ◽  
Retrospective Case ◽  
Occlusal Wear ◽  
Control Study

SUMMARY Objective: The aim of this retrospective case-control study was to evaluate the influence of different occlusal characteristics and self-referred bruxism in the presence of noncarious cervical lesions (NCCLs). Methods and Materials: The participants were 280 students (140 cases and 140 controls), with an average age of 24.5 years, from six schools of dentistry in Spain. Clinical examination was carried out to record the NCCLs and the static and dynamic occlusal characteristics. The side of mastication and bruxism was collected by questionnaire. Data variables were analyzed by means of univariate and multivariate logistic regression. Odds ratios and the respective 95% confidence intervals were calculated (p&lt;0.05). Results: The presence of NCCLs was significantly more likely in subjects with protrusive interferences (odds ratio [OR]=1.82); with lateral interferences, especially on the nonworking side (OR= 1.77); or who were self-reported bruxists (OR=1.72). In the multivariate analysis, protrusive interferences, bruxism, age, and the presence of attrition were risk factors for the development of NCCLs. These factors resulted in a model with an area under the receiver-operating characteristic curve of 0.667 and a positive predictive value of 61.43%. Conclusions: There was no significant relationship between most occlusal factors and the presence of NCCLs. Only bruxism, protrusive interferences, age, and occlusal wear were risk factors. The predictive model was not sufficiently explanatory. Occlusal factors alone do not appear to be sufficient to explain the presence of NCCLs.

scholarly journals Complements C3 and C4 in serum and stimulatedsaliva of patients suffer oral erosive lichen planus

2021 ◽  
Vol 25 (2) ◽  
pp. 102-107
Author(s):  
Mohammad-Hossein Mirzaii-Dizgah ◽  
◽  
Bita Rohani ◽  
Iraj Mirzaii-Dizgah ◽  
◽  
...  
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Operating Characteristic ◽  
Case Control Study ◽  
Characteristic Analysis ◽  
Control Groups ◽  
Erosive Lichen Planus ◽  
Saliva Level ◽  
Oral Lichen ◽  
Control Study

Introduction: The objective of this study was to compare the level of complements C3 and C4 in serum, and stimulated saliva between oral lichen planus (OLP) and healthy individuals. Methods: A case-control study was performed on 31 healthy and 31 who suffer the erosive type of OLP. Serum and saliva level of C3 and C4 were measured by immunoturbidimetry method. Results: C3 and C4 were expressed at a lower level in serum and saliva of OLP patients compared to control groups. Serum C3 and C4 levels did not correlate with their saliva levels. The receiver operating characteristic analysis showed significantly diagnostic abilities for serum and saliva C3 and C4 to discrimination of OLP patients from controls (cutoff [mg/dl] for C3 were 83 in serum and 3.45 in saliva and for C4 were 9.5 in serum and 0.9 in saliva). Conclusion: Serum and salivary levels of total C3 and C4 were lower in patients with OLP than in healthy controls. Therefore, they may able to discriminate OLP from healthy.

scholarly journals Gly972Arg Variant of Insulin Receptor Substrate 1 Gene and Colorectal Cancer Risk in Overweight/Obese Subjects

2016 ◽  
Vol 31 (1) ◽  
pp. 68-72 ◽  
Author(s):  
Touraj Mahmoudi ◽  
Keivan Majidzadeh-A ◽  
Khatoon Karimi ◽  
Hamid Farahani ◽  
Reza Dabiri ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Insulin Receptor ◽  
Case Control Study ◽  
Insulin Receptor Substrate ◽  
Protective Effects ◽  
Insulin Receptor Substrate 1 ◽  
Pcr Rflp ◽  
Obese Subjects ◽  
Control Study

Background Given the major role of obesity and insulin resistance (IR) in colorectal cancer (CRC), we investigated whether genetic variants in ghrelin ( GHRL), resistin ( RETN) and insulin receptor substrate 1 ( IRS1) were associated with CRC risk. Methods This study was conducted as a case-control study, and 750 subjects, including 438 controls and 312 patients with CRC, were enrolled and genotyped using the PCR-RFLP method. Results No significant differences were observed for GHRL (rs696217), RETN (rs3745367) and IRS1 (rs1801278, Gly972Arg or G972R) gene variants between the cases and controls. However, the IRS1 G972R R allele compared with the G allele and the G972R RR+GR genotype compared with the GG genotype appeared to be markers of decreased CRC susceptibility in the overweight/obese subjects (p = 0.024; odds ratio [OR] = 0.42, 95% confidence interval [95% CI], 0.20-0.91; and p = 0.048; OR = 0.42, 95% CI, 0.17-0.99, respectively). Furthermore, the R allele and RR+GR genotype were also associated with decreased risks for obesity in the patients with CRC (p = 0.007; OR = 0.35, 95% CI, 0.15-0.77; and p = 0.015; OR = 0.35, 95% CI, 0.15-0.72, respectively). Conclusions In accordance with previous studies, our findings suggest that the IRS1 G972R R allele and RR+GR genotype have protective effects for CRC in overweight/obese patients and for obesity in patients with CRC. Nevertheless, further studies are required to confirm these findings.

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