scholarly journals HGF, IL-1α, and IL-27 Are Robust Biomarkers in Early Severity Stratification of COVID-19 Patients

2021 ◽  
Vol 10 (9) ◽  
pp. 2017
Author(s):  
Álvaro Tamayo-Velasco ◽  
Pedro Martínez-Paz ◽  
María Jesús Peñarrubia-Ponce ◽  
Ignacio de la Fuente ◽  
Sonia Pérez-González ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Hospital Admission ◽  
Healthy Volunteers ◽  
Respiratory Symptoms ◽  
Critical Group ◽  
Lung Damage ◽  
Severe Group ◽  
Critical Patients

Pneumonia is the leading cause of hospital admission and mortality in coronavirus disease 2019 (COVID-19). We aimed to identify the cytokines responsible for lung damage and mortality. We prospectively recruited 108 COVID-19 patients between March and April 2020 and divided them into four groups according to the severity of respiratory symptoms. Twenty-eight healthy volunteers were used for normalization of the results. Multiple cytokines showed statistically significant differences between mild and critical patients. High HGF levels were associated with the critical group (OR = 3.51; p < 0.001; 95%CI = 1.95–6.33). Moreover, high IL-1α (OR = 1.36; p = 0.01; 95%CI = 1.07–1.73) and low IL-27 (OR = 0.58; p < 0.005; 95%CI = 0.39–0.85) greatly increased the risk of ending up in the severe group. This model was especially sensitive in order to predict critical status (AUC = 0.794; specificity = 69.74%; sensitivity = 81.25%). Furthermore, high levels of HGF and IL-1α showed significant results in the survival analysis (p = 0.033 and p = 0.011, respectively). HGF, IL-1α, and IL 27 at hospital admission were strongly associated with severe/critical COVID-19 patients and therefore are excellent predictors of bad prognosis. HGF and IL-1α were also mortality biomarkers.

scholarly journals HGF, IL-1α and IL-27 are Robust Biomarkers in Early Severity Stratification of COVID-19 Patients

2021 ◽  
Author(s):  
Alvaro Tamayo-Velasco ◽  
Pedro Martinez-Paz ◽  
María Jesús Peñarrubia ◽  
Ignacio De la Fuente ◽  
Sonia Pérez-González ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Respiratory Symptoms ◽  
Plasma Sample ◽  
Lung Damage ◽  
Plasma Samples ◽  
Cytokine Storm ◽  
Multivariable Model ◽  
Low Oxygen ◽  
Severe Group ◽  
Critical Patients

Abstract Background: Pneumonia is the leading cause of hospital admission and mortality in coronavirus disease 2019 (COVID-19), attributed to a cytokine storm. The objective of our study is to characterize this profile to identify the cytokines responsible for lung damage and mortality.Methods: Plasma samples of 108 prospectively recruited COVID-19 patients were collected between March and April 2020. Patients were divided into four groups according to the severity of respiratory symptoms: 34 mild (no oxygen support), 26 moderate (low oxygen support using nasal cannula), 16 severe (high oxygen support) and 32 critical (mechanical ventilation). A 45-plex Human XL Cytokine Luminex Performance Panel kit was used in duplicate for each plasma sample. Twenty-eight healthy volunteers were used for normalization of the results.Results: Multiple cytokines showed statistically significant differences when comparing mild and critical patients (HGF, PDGFBB, PIGF-1, IL-1α, MCP-1, VEGFA, IL-15 and IL-2). The best multivariable model included HGF, IL-1α, IL-2 and IL-27. High HGF levels were associated with the critical group (OR = 3.51; p < 0.001; 95%CI = 1.95–6.33). Moreover, high IL-1α (OR = 1.36; p = 0.01; 95%CI = 1.07–1.73) and low IL-27 (OR = 0.58; p < 0.005; 95%CI = 0.39–0.85) greatly increased the risk of ending up in the severe group. This model was especially sensitive in order to predict critical status (AUC = 0.794; specificity = 69.74%; sensitivity = 81.25%). Furthermore, high levels of HGF and IL-1α showed significant results in the survival analysis (p = 0.033 and p = 0.011, respectively).Conclusions: Our study showed that HGF, IL-1α and IL 27 at hospital admission were strongly associated with severe/critical COVID-19 patients and therefore are excellent predictors of bad prognosis. Indeed, HGF and IL-1α were also mortality biomarkers.

scholarly journals Comparison of Liver Biomarkers in 288 COVID-19 Patients: A Mono-Centric Study in the Early Phase of Pandemic

2021 ◽  
Vol 7 ◽  
Author(s):  
Haozhi Fan ◽  
Jinyuan Cai ◽  
Anran Tian ◽  
Yuwen Li ◽  
Hui Yuan ◽  
...  
Keyword(s):  
Hepatic Dysfunction ◽  
Treatment Protocol ◽  
Critical Group ◽  
Critical Groups ◽  
Normal Range ◽  
Upward Trend ◽  
Factors Affecting ◽  
Severe Group ◽  
Critical Patients ◽  
Novel Coronavirus

Background and Aims: Recent reports have indicated that hepatic dysfunction occurred in a proportion of patients with coronavirus disease 2019 (COVID-19). We aimed to compare and describe the liver biomarkers in different subtypes of COVID-19 patients.Methods: This study enrolled 288 COVID-19 patients in Huangshi Hospital of Traditional Chinese Medicine. All patients were divided into ordinary, severe, and critical groups according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7). Demographic, clinical characteristics and liver biomarkers were compared among the three groups.Results: During hospitalization, AST, TBiL, and ALP levels in ordinary and severe patients fluctuated within the normal range with a rising trend in critical patients except AST. ALT and GGT levels fluctuated within the normal range showing an upward trend, while LDH levels in the critical group exceeded the normal range. Prealbumin showed an upward trend, especially in the severe group. At discharge, AST and LDH levels in ordinary and severe groups were lower than their baselines but increased in the critical group. In contrast to albumin, TBiL levels were increased in ordinary and critical groups while decreased in the severe group. The stratified analysis revealed factors affecting liver function in critical cases included highest temperature ≥38.0°C, age ≥60 and symptom of hypoxemia.Conclusions: COVID-19 can cause severe hepatic dysfunction in critical patients, requiring early monitoring and intervention. LDH, ALP, GGT, TBiL, prealbumin, and albumin may be helpful for evaluating and predicting disease prognosis due to their correlation with disease severity in COVID-19.

scholarly journals Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

2021 ◽  
Vol 18 ◽  
pp. 147997312110022
Author(s):  
Kevin Cares-Marambio ◽  
Yessenia Montenegro-Jiménez ◽  
Rodrigo Torres-Castro ◽  
Roberto Vera-Uribe ◽  
Yolanda Torralba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chest Pain ◽  
Hospital Admission ◽  
Respiratory Symptoms ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Data Synthesis ◽  
Recent Onset ◽  
Persistent Symptoms

Knowledge on the sequelae of Coronavirus Disease 2019 (COVID-19) remains limited due to the relatively recent onset of this pathology. However, the literature on other types of coronavirus infections prior to COVID-19 reports that patients may experience persistent symptoms after discharge. To determine the prevalence of respiratory symptoms in survivors of hospital admission after COVID-19 infection. A living systematic review of five databases was performed in order to identify studies which reported the persistence of respiratory symptoms in COVID-19 patients after discharge. Two independent researchers reviewed and analysed the available literature, and then extracted and assessed the quality of those articles. Of the 1,154 reports returned by the initial search nine articles were found, in which 1,816 patients were included in the data synthesis. In the pooled analysis, we found a prevalence of 0.52 (CI 0.38–0.66, p < 0.01, I 2 = 97%), 0.37 (CI 0.28–0.48, p < 0.01, I 2 = 93%), 0.16 (CI 0.10–0.23, p < 0.01, I 2 = 90%) and 0.14 (CI 0.06–0.24, p < 0.01, I 2 = 96%) for fatigue, dyspnoea, chest pain, and cough, respectively. Fatigue, dyspnoea, chest pain, and cough were the most prevalent respiratory symptoms found in 52%, 37%, 16% and 14% of patients between 3 weeks and 3 months, after discharge in survivors of hospital admission by COVID-19, respectively.

scholarly journals Visual lung damage CT score at hospital admission of COVID-19 patients and 30-day mortality

2021 ◽  
Author(s):  
Etienne Charpentier ◽  
Gilles Soulat ◽  
Antoine Fayol ◽  
Anne Hernigou ◽  
Marine Livrozet ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Lung Damage

P.4.a.019 Carbon dioxide-induced respiratory symptoms and experimental panic in healthy volunteers

2009 ◽  
Vol 19 ◽  
pp. S596
Author(s):  
A. Colasanti ◽  
K. Schruers ◽  
R. van Diest ◽  
G. Esquivel ◽  
E. den Boer ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Healthy Volunteers ◽  
Respiratory Symptoms

scholarly journals Descriptive characteristics of continuous oximetry measurement in moderate to severe COVID-19 patients

2021 ◽  
Author(s):  
Jonathan Aryeh Sobel ◽  
Jeremy Levy ◽  
Ronit Almog ◽  
Anat Reiner Benaim ◽  
Asaf Miller ◽  
...  
Keyword(s):  
Health Care ◽  
Mechanical Ventilation ◽  
High Resolution ◽  
Oxygen Saturation ◽  
Treatment Response ◽  
Vital Sign ◽  
Critical Group ◽  
Non Invasive ◽  
Critical Patients ◽  
Digital Biomarkers

Background: Non-invasive oxygen saturation (SpO2) measurement is a central vital sign that supports the management of COVID-19 patients. However, reports on SpO2 characteristics (patterns and dynamics) are scarce and none, to our knowledge, has analysed high resolution continuous SpO2 in COVID-19. Methods: SpO2 signal sampled at 1Hz and clinical data were collected from COVID-19 departments at the Rambam Health Care Campus (Haifa, Israel) between May 1st, 2020 and February 1st, 2021. Data from a total of 367 COVID-19 patients, totalling 27K hours of continuous SpO2 recording, could be retrieved, including 205 non-critical and 162 critical cases. Desaturations based on different SpO2 threshold definitions and oximetry derived digital biomarkers (OBMs) were extracted and compared across severity and support levels. Findings: An absolute SpO2 threshold at 93% was the most efficient in discriminating between critical and non-critical patients without support or under oxygen support. Under no support, the non-critical group depicted a fold change (FC) of 1,8 times more frequent desaturations compared to the critical group. However, the hypoxic burden was 1,6 times more important in critical versus non-critical patients. Other OBMs depicted significant differences, notably the percentage of time below 93% SpO2 (CT93) was the most discriminating OBM. Mechanical ventilation depicted a strong effect on SpO2 by significantly reducing the frequency (1,85 FC) and depth (1,21 FC) of desaturations. OBMs related to periodicity and hypoxic burden were markedly affected up to several hours before the initiation of the mechanical ventilation. Interpretation: This is the first report investigating continuous SpO2 measurements in hospitalized patients affected with COVID-19. SpO2 characteristics differ between critical and non-critical patients and are impacted by the level of support. OBMs from high resolution SpO2 signal may enable to anticipate clinically relevant events, monitoring of treatment response and may be indicative of future deterioration.

scholarly journals Digestive Involvement in SARS-CoV-2 Infection: A Retrospective Multi-center Study

2020 ◽  
Author(s):  
Haitao Shang ◽  
Chao Huang ◽  
Yuhua Chen ◽  
Shengyan Zhang ◽  
Pengcheng Yang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Respiratory Symptoms ◽  
Gastrointestinal Symptom ◽  
Total Bilirubin ◽  
Clinical Parameters ◽  
Aspartate Transaminase ◽  
Union Hospital ◽  
Critical Patients ◽  
Multi Center Study ◽  
Clinical Prevention

Abstract BackgroundCoronavirus disease 2019 (COVID-19) is an emerged infection raised wide concerns for the pneumonia and respiratory manifestations. Also, digestive complications are frequently observed in COVID-19 patients but the significance remains undetermined.MethodsA retrospective analysis of alimentary symptoms, liver dysfunctions and other clinical parameters of 514 hospitalized COVID-19 patients (282 mild, 162 severe and 70 critical cases) admitted to the 3 designated medical units of Wuhan Union Hospital from Jan 20 to Feb 29, 2020 was performed.Results1) A series of alimentary symptoms, including poor appetite(50.2%), diarrhea(25.5%), nausea(16.3%), vomit(11.9%) and abdominal pain(3.3%), presented in COVID-19 patients.2) Diarrhea was common gastrointestinal symptom with higher morbidity in the severe and critical patients (32.1% and 27.1% respectively), and 13.2% patients developed diarrhea in the first 3 days after onset of symptoms. Those with diarrhea were reported more apparent systemic inflammation and liver injury in severe and critical cases compared with patients without diarrhea.3) Notably, 31 patients (6.03%) presented with diarrhea in the absence of respiratory symptoms. These patients were observed less systemic inflammatory activity relative to diarrhea patients combined with respiratory symptoms.4) Also, liver injury was high incident in COVID-19 patients with increased alanine aminotransferase (43.3%), aspartate transaminase (36.7%) and decreased albumin (80.9%), but less increased total bilirubin (10.9%) and direct bilirubin(14.2%), which were more serious in the severe to critical patients.ConclusionsOur data favored in the process of novel SARS-CoV-2 infection. There may be a “gut-type” in the clinical prevention and management that differ from the “lung-type” in COVID-19 sufferers.

scholarly journals Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan-Jhen Syue ◽  
Chao-Jui Li ◽  
Wen-Liang Chen ◽  
Tsung-Han Lee ◽  
Cheng-Chieh Huang ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Preschool Age ◽  
Short Term ◽  
Patient Demographics ◽  
Life Threatening ◽  
History Of ◽  
Initial Episode

Abstract Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a retrospective study with 406 children (< 18 years) who presented in the emergency department (ED) with an initial episode of acute angioedema and who had subsequent follow-up visits in the out-patient department from January 2008 to December 2014. The severity of the acute angioedema was categorized as severe (requiring hospital admission), moderate (requiring a stay in the short-term pediatric observation unit [POU]), or mild (discharged directly from the ED). The associations among the disease severity, patient demographics and clinical presentation were analyzed. Result In total, 109 (26.8%) children had severe angioedema, and the majority of those children were male (65.1%). Most of the children were of preschool age (56.4%), and only 6.4% were adolescents. The co-occurrence of pyrexia or urticaria, etiologies of the angioedema related to medications or infections, the presence of respiratory symptoms, and a history of allergies (asthma, allergic rhinitis) were predictors of severe angioedema (all p < 0.05). Finally, the duration of angioedema was significantly shorter in children who had received short-term POU treatment (2.1 ± 1.1 days) than in those who discharged from ED directly (2.3 ± 1.4 days) and admitted to the hospital (3.5 ± 2.0 days) (p < 0.001). Conclusion The co-occurrence of pyrexia or urticaria, etiologies related to medications or infections, the presence of respiratory symptoms, and a history of allergies were predictors of severe angioedema. More importantly, short-term POU observation and prompt treatment might be benefit for patients who did not require hospital admission.

scholarly journals Galectin-3 as a potential prognostic biomarker of severe COVID-19 in SARS-CoV-2 infected patients

2021 ◽  
Author(s):  
Eduardo Cervantes-Alvarez ◽  
Nathaly Limon-de la Rosa ◽  
Moisés Salgado-de la Mora ◽  
Paola Valdez-Sandoval ◽  
Mildred Palacios-Jiménez ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Elevated Serum ◽  
Neutrophil Infiltration ◽  
Lung Damage ◽  
Hospital Death ◽  
Galectin 3 ◽  
Initial Severity ◽  
Critical Patients ◽  
Severity Of The Disease

ABSTRACTBACKGROUNDPrognostic biomarkers are needed to identify patients at high-risk for severe COVID-19. Galectin-3 is known to drive neutrophil infiltration and release of pro-inflammatory cytokines contributing to airway inflammation.METHODSIn this prospective cohort, we assessed galectin-3 levels in 156 hospitalized patients with confirmed COVID-19. COVID-19 patients were diagnosed as either critical (>50% lung damage) or moderate (<50% of lung damage) based on computerized tomography. Patients who required invasive mechanical ventilation (IMV) and/or died during hospitalization were categorized as having a severe outcome, and a non-severe outcome if they were discharged and none of the former occurred.RESULTSElevated serum galectin-3 was significantly higher in critical patients compared to moderate ones (35.91 ± 19.37 ng/mL vs. 25 ± 14.85 ng/mL, p<0.0001). Patients who progressed to a severe outcome including IMV and/or in-hospital death, presented higher galectin-3 levels (41.17 ng/mL [IQR 29.71 – 52.25] vs. 23.76 ng/mL [IQR 15.78 – 33.97] compared to those of a non-severe outcome, p<0.0001). Galectin-3 discriminated well between those with severe and non-severe outcome, with an AUC of 0.75 (95% CI 0.67 – 0.84, p<0.0001) and was found to be an independent predictor of severe outcome regardless of the percentage of lung involvement. Additionally, the combination of galectin-3, CRP and albumin, significantly improved its individual predicting ability with an AUC 0.84 (95% CI 0.77 – 0.91, p<0.0001).CONCLUSIONCirculating galectin-3 levels can be used to predict severe outcomes in COVID-19 patients, including the requirement of mechanical ventilation and/or death, regardless of the initial severity of the disease.

High-Resolution CT Features of the COVID-19 Infection During Short-Term Follow-Up

2021 ◽  
Vol 11 (5) ◽  
pp. 1410-1413
Author(s):  
Jia Cui-Yu ◽  
Zhao Da-Wei ◽  
Feng Ji-Liang ◽  
Li Rui-Li
Keyword(s):  
Pulmonary Fibrosis ◽  
Treatment Protocol ◽  
Lung Damage ◽  
Short Term ◽  
Reticular Pattern ◽  
Day Range ◽  
Evolution Characteristics ◽  
Severe Group ◽  
Medical University

Objective: To estimate the short-term follow-up chest HRCT manifestation in patients with COVID-19 who have left hospitals. Methods: Retrospective analysis was executed on the chest HRCT manifestation of 49 cases with RT-PCR confirmed COVID-19 pneumonia patients diagnosed in Beijing You’An hospital affiliated to capital medical university between 20 January 2020 to April 10, 2020. The study including 21 males and 28 females, and the median age was 59.5 years age ranged from 21 years to 80 years. The evolution characteristics of chest HRCT in short-term follow-up after discharge were analyzed. Results: Forty-nine patients were divided into two groups according to Diagnosis and Treatment Protocol of 2019 New Coronavirus Pneumonia (trial version 7) of National Health Commission of China. Severe group included 23 cases (46.9%) and 26 cases of ordinary (53.1%). The HRCT findings of patients in the 2 groups were analyzed on median follow-up time was 30 day (range, 14 to 46 days) after discharge. The follow-up chest HRCT were normal in 19 of 49 (38.8%) patients, abnormal HRCT findings were detected in 30 of 49 (61.2%) patients. The most frequent abnormality found on follow-up HRCT in COVID-19 patients who recovered from pneumonia was GGO which was seen in 26 of 49 (53.1%) patients, reticular pattern was in 9 of 49 (18.4%), traction bronchiectasis was in 3 of 49 (6.1%), small nodular consolidation was in 6 of 49 (12.2%), other findings including curved line in the subpleural area and irregular linear opacities were in 15 of 49 (30.6%). In the study, 3 of 49 (6.1%) patients were diagnosed with pulmonary fibrosis according to HRCT findings. Three cases were severe patients, aged from 65 to 80 years. Pulmonary fibrosis occurred within 30–50 days of onset. Conclusion: Pulmonary fibrosis may develop in 6.1% of COVID-19 patients, which was lower than that of SARS and MERS, suggesting that the lung damage caused by SARS-COV-2 in the recovered patients was lower than that of SARS and MERS.

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