scholarly journals Diagnostic and early prognostic value of serum CRP and LDH levels in patients with possible COVID-19 at the first admission

2021 ◽  
Vol 15 (06) ◽  
pp. 766-772
Author(s):  
Dogan Akdogan ◽  
Mustafa Guzel ◽  
Dervis Tosun ◽  
Orhan Akpinar
Keyword(s):  
Pulmonary Function ◽  
Disease Severity ◽  
Prognostic Value ◽  
Severe Disease ◽  
Specific Treatment ◽  
Close Monitoring ◽  
Test Results ◽  
Arterial Blood ◽  
Laboratory Test Results ◽  
First Admission

Introduction: COVID-19 is the infection caused by the new coronavirus. Specific treatment for COVID-19 has not been established, yet. It is important to determine the disease severity of the patients at the first admission. Therefore, the exploration of biomarkers is deemed necessary. We aimed to assess the diagnostic and early prognostic value of CRP and LDH levels in possible COVID-19 patients presenting with a severe clinical picture. Methodology: We evaluated the correlations of relevant routine laboratory test results with disease severity in COVID-19 patients admitted to our infectious diseases clinic. Patients were divided into severe and non-severe disease groups based on clinical findings, oxygen saturation levels in the arterial blood, biochemical test results, and radiological findings. Differences in the findings between the two disease severity groups were examined to determine potential biomarkers. Results: Median age and the CRP and LDH levels in the severe disease group were statistically significantly higher compared to the nonsevere group (p < 0.0001). No other parameters statistically significant differences have been observed between the two groups (P > 0.05). Conclusions: CRP and LDH levels were positively correlated with lung lesions in early-stage COVID-19, potentially reflecting disease severity. Because LDH and CRP levels can potentially reflect the pulmonary function, they can be potential predictors of COVID-19- related respiratory failure. For avoiding poor prognosis; LDH and CRP should be considered as potential predictors for identifying the need for thoracic CT scans, close monitoring of pulmonary function, and aggressive supportive therapy early in the course of COVID-19.

scholarly journals Comparative Analysis of Anxiety/Depression Scores in COVID-19 Patients with Disease Severity, Sleep Patterns, and Certain Laboratory Test Results

2021 ◽  
Author(s):  
Zi-Qiang Meng ◽  
Qi Leng ◽  
Xu Wang ◽  
Chun-Hai Xu ◽  
Jing Xu ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Medical History ◽  
Disease Severity ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Test Results ◽  
Past Medical History ◽  
Hospital Anxiety ◽  
Laboratory Test Results ◽  
Lung Infections

IntroductionCoronavirus disease 2019 (COVID-19) is associated with severe emotional changes. This research aims to investigate the prevalence of anxiety and depression in COVID-19 patients and its relationship with disease severity, sleep patterns, lifestyle, and specific laboratory test results.Material and methodsAn observational study of 52 Chinese patients with COVID-19 was conducted to assess the relation between anxiety and depression (evaluated with the Hospital Anxiety and Depression Scale) and laboratory findings (lymphocytes, C-reactive proteins, leukocytes, alanine aminotransferase, aspartate aminotransferase). The relationships between the severity of COVID-19 in patients, the Insomnia Severity Index (ISI) score, and the Hospital Anxiety and Depression Scale (HADS) score were also investigated.ResultsThere was a significant statistical difference between the disease, smoking, and HADS-A scores (P = 0.011 / 0.020). The HADS-D score of patients with the disease was higher than in those without the past medical history (P = 0.008). The difference in C-reactive protein (CRP) between different lung infections, the HADS-A and HADS-D scores between different ages and ISI groups, and the correlation between the two scores were statistically significant.ConclusionsAnxiety and depression are associated with poor sleep quality, smoking, and past medical history in patients with COVID-19. Additionally, anxiety and depression were seen to coexist, and there was a positive correlation between them. Further, the inflammatory index CRP was significantly increased in bilateral lung infections.

Evaluation of Platelet Activity Markers in Prognostic Value of Children with Crimean-Congo Hemorrhagic Fever

2020 ◽  
Vol 15 (03) ◽  
pp. 123-128
Author(s):  
Ahmet Sami Güven ◽  
Fatma Duksal ◽  
Özge Metin Akcan ◽  
Utku Aygüneş ◽  
Mehmet Burhan Oflaz
Keyword(s):  
Disease Severity ◽  
Prognostic Value ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Prognostic Index ◽  
Hemorrhagic Fever ◽  
Healthy Children ◽  
Distribution Width ◽  
Crimean Congo Hemorrhagic Fever ◽  
Significant Difference

Abstract Objective The aim of this study is to investigate the prognostic value of platelet (PLT) activity markers in children with Crimean-Congo hemorrhagic fever (CCHF) and compare results with healthy controls. Materials and Methods A total of 135 patients with CCHF and 100 healthy children were included in this retrospective study. Mean age was 12.4 ± 3.3 years in CCHF group, and 92 patients were male. We measured PLT count, mean platelet volume (MPV), platelet distribution width (PDW), and mean platelet mass (MPM) as PLT activity markers. Results A statistically significant decrease in MPM and PLT, and significantly higher levels of PDW and activated partial thromboplastin time (aPTT) and no significant difference in MPV were observed in patients with CCHF compared with controls. Although there were no significant differences between the severe and nonsevere CCHF groups in term of MPV and PDW, the MPM value was significantly decreased in severe patients (p < 0.001). Furthermore, MPM values were inversely correlated with aPTT (r = −0.617, p = 0.015), and positively correlated with PLT (r = 0.703, p < 0.001) which are considered likely to be indicators of disease severity. Multivariate logistic regression analysis revealed MPM as an independent risk factor for severe disease. Conclusion Our study demonstrated that MPM values were decreased in severe cases compared with nonsevere in children with CCHF. The MPM as an indicator of PLT activation at the time of diagnosis in children with CCHF can be used as a prognostic index for disease severity.

The utility of clinical findings to predict laboratory values in hypertensive disorders of pregnancy

2016 ◽  
Vol 44 (3) ◽  
Author(s):  
Jane So ◽  
Elizabeth Young ◽  
Natalie Crnosija ◽  
Joseph Chappelle
Keyword(s):  
Severe Disease ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Bivariate Analysis ◽  
Test Results ◽  
Quadrant Pain ◽  
Laboratory Findings ◽  
Abnormal Laboratory ◽  
Laboratory Test Results

AbstractPreeclampsia is the 2A retrospective chart review of women who presented for evaluation of hypertension in pregnancy during 2010. Demographic information, medical history, symptoms, vital signs, and laboratory results were collected. Bivariate analysis was used to investigate associations between predictors and the outcome.Of the 481 women in the sample, 22 were identified as having abnormal laboratory test results (4.6%). Women who reported right upper quadrant pain or tenderness had significantly increased likelihood of having laboratory abnormalities compared to those without the complaint.Only a small percentage of women evaluated were determined to have abnormal laboratory findings, predominantly among women with severe preeclampsia. Right upper quadrant pain or tenderness was positively correlated with laboratory abnormalities. The restriction of laboratory analysis in women with clinical evidence of severe disease may be warranted – a broader study should, however, first be used to confirm our findings.

scholarly journals Changes in liver function in patients with covid-19 and the demographics of the disease in a mid-sized city of Turkey: A retrospective analysis

2020 ◽  
Vol 7 (12) ◽  
pp. 739-744
Author(s):  
Huseyin Avni Demir
Keyword(s):  
Liver Function ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Close Monitoring ◽  
Test Results ◽  
Laboratory Findings ◽  
Icu Patients ◽  
Mortality And Morbidity ◽  
The Mean ◽  
Significant Mortality

Objective:  To define the clinical characteristics of patients hospitalized with COVID-19 in ICU and ward and to evaluate the significance of liver function test results. A new disease caused by SARS-CoV-2 has been devastating the world affecting millions of patients worldwide and leading the significant mortality and morbidity. Material and Methods: The demographic features of a cohort of 125 hospitalized patients between March 2020 and May 2020 were recorded. The clinical characteristics, laboratory findings, and mortality rates were analyzed. Results: A total of 125 patients hospitalized for COVID-19 diagnosis where 113 (90.4%) were followed-up in the ward and 12 (9.6%) were in ICU were included in the study. The mean age of the patients was 44.05±16.95 and 88 (70.4%) of the patients were male. The most common symptoms were in the following order: cough in 80 patients (64%), dyspnea in 40 (32%) and fever in 33 (26.4%). The leukocyte and neutrophil counts were significantly higher in ICU patients with COVID-19 compared to patients in the ward (p=0.002, p<0.05; respectively). The CRP and D-Dimer levels were found elevated in ICU patients with COVID-19 than in the ward (p<0.05; p<0.05, respectively). The AST level of patients with COVID-19 in ICU was significantly heightened than patients in the ward. Conclusion: The present study revealed that patients with elevated AST level were at great risk of progressing to severe disease those require close monitoring.

Reduction of Laboratory Utilization in the Intensive Care Unit

2016 ◽  
Vol 32 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Samih Raad ◽  
Rachel Elliott ◽  
Evan Dickerson ◽  
Babar Khan ◽  
Khalil Diab
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Laboratory Test ◽  
Laboratory Tests ◽  
Routine Laboratory ◽  
Test Results ◽  
Staff Education ◽  
Arterial Blood ◽  
Laboratory Test Results ◽  
Order Sets

Objective: In our academic intensive care unit (ICU), there is excess ordering of routine laboratory tests. This is partially due to a lack of transparency of laboratory-processing costs and to the admission order plans that favor daily laboratory test orders. We hypothesized that a program that involves physician and staff education and alters the current ICU order sets will lead to a sustained decrease in routine laboratory test ordering. Design: Prospective cohort study. Setting: Academic closed medical ICU (MICU). Patients: All patients admitted to the MICU. Methods: We consistently educated residents, faculty, and staff about laboratory test costs. We removed the daily laboratory test option from the admission order sets and asked residents to order needed laboratory test results every day. We only allowed the G3+I-STAT (arterial blood gas only) cartridges in the MICU in hopes of decreasing duplicative laboratory test results. We added laboratory review to the daily rounding checklist. Measurement and Main Results: Total number of laboratory tests per patient-day decreased from 39.43 to an average of 26.74 ( P <.001) over a 9-month period. The number of iSTAT laboratory tests per patient-day decreased from 7.37 to an average of 1.16 ( P < .001) over the same time period. The number of iSTAT/central laboratory processing duplicative laboratory tests per patient-day decreased from 0.17 to an average of 0.01 ( P < .001). The percentage of patients who have daily laboratory test orders decreased from 100% to an average of 11.94% ( P <. 001). US$123 436 in direct savings and US$258 035 dollars in indirect savings could be achieved with these trends. Intensive care unit morbidity and mortality were not impacted. Conclusion: A simple technique of resident, nursing, and ancillary staff education, combined with alterations in order sets using electronic medical records, can lead to a sustained reduction in laboratory test utilization over time and to significant cost savings without affecting patient safety.

scholarly journals Liver Chemistries in Patients with Severe or Non-severe COVID-19: A Meta-Analysis

2020 ◽  
Author(s):  
Xuan Dong ◽  
Dan-Yi Zeng ◽  
Yan-Yan Cai ◽  
Wei-Ming Chen ◽  
Qing-Qing Xing ◽  
...  
Keyword(s):  
Disease Progression ◽  
Early Warning ◽  
Meta Analysis ◽  
Severe Disease ◽  
Close Monitoring ◽  
Test Results ◽  
Liver Impairment ◽  
Liver Test ◽  
Risk Of Progression ◽  
Abnormal Liver Test

ABSTRACTBackground and AimsCumulating observations have indicated that patients with coronavirus disease (COVID-19) undergo different patterns of liver impairment. We performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19.MethodsWe searched PubMed, Google Scholar, Embase, Cochrane Library, medRxiv, bioRxiv, and three Chinese electronic databases through April 18, 2020, in accordance with the Preferred Reporting Items for Meta-Analyses. We analyzed pooled data on liver chemistries stratified by COVID-19 severity using a fixed or random-effects model.ResultsIn the meta-analysis of 37 studies, which included a total of 6,235 patients, the pooled mean alanine aminotransferase (ALT) was 36.4 IU/L in the severe COVID-19 cases and 27.8 IU/L in the non-severe cases (95% confidence interval [CI]: − 9.4 to − 5.1, p < 0.0001). The pooled mean aspartate aminotransferase (AST) was 46.8 IU/L in the severe cases and 30.4 IU/L in the non-severe cases (95% CI: − 15.1 to − 10.4, p < 0.0001). Furthermore, regardless of disease severity, the AST level is often higher than the ALT level. Compared with the non-severe cases, the severe cases tended to have higher γ-glutamyltransferase levels but lower albumin levels.ConclusionsIn this meta-analysis, we comprehensively described three patterns of liver impairment related to COVID-19, namely hepatocellular injury, cholestasis, and hepatocellular disfunction, according to COVID-19 severity. Patients with abnormal liver test results are at higher risk of progression to severe disease. Close monitoring of liver chemistries provides an early warning against disease progression.Lay SummaryData on abnormal liver chemistries related to coronavirus disease (COVID-19) are cumulating but are potentially confusing. We performed a meta-analysis of 37 studies that included a total of 6,235 patients with COVID-19. We noted that patients with abnormal liver test results are at higher risk of progression to severe disease and close monitoring of liver chemistries provides early warning against disease progression.

scholarly journals IL 33 Correlates With COVID-19 Severity, Radiographic and Clinical Finding

2021 ◽  
Vol 8 ◽  
Author(s):  
Sofija Sekulic Markovic ◽  
Marina Jovanovic ◽  
Nevena Gajovic ◽  
Milena Jurisevic ◽  
Nebojsa Arsenijevic ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Blood Gases ◽  
Target Cells ◽  
Monocyte Count ◽  
X Rays ◽  
Positive Correlation ◽  
Arterial Blood ◽  
Tnf Α ◽  
Significant Difference

Objective: The increased level of interleukin (IL)-33 is considered as a predictor of severe coronavirus disease 2019 (COVID-19) infection, but its role at different stages of the disease is still unclear. Our goal was to analyze the correlation of IL-33 and other innate immunity cytokines with disease severity.Methods: In this study, 220 patients with COVID-19 were included and divided into two groups, mild/moderate and severe/critical. The value of the cytokines, clinical, biochemical, radiographic data was collected and their correlation with disease severity was analyzed.Results: Most patients in the severe/critical group were male (81.8%) and older (over 64.5 years). We found a statistically significant difference (p &lt; 0.05) in these two groups between clinical features (dyspnea, dry cough, fatigue, and auscultatory findings); laboratory [(neutrophil count, lymphocyte count, monocyte count, hemoglobin, plasma glucose, urea, creatinine, total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), albumin (ALB), lactate dehydrogenase (LDH), creatinine kinase (CK), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), Fe, and Ferritin)], arterial blood gases (oxygen saturation-Sa02, partial pressure of oxygen -p02), and chest X-rays (CXR) lung findings (p = 0.000). We found a significantly higher serum concentration (p &lt; 0.05) of TNF-α, IL-1β, IL-6, IL-12, IL-23, and IL-33 in patients with COVID-19 with severe disease. In the milder stage of COVID-19, a positive correlation was detected between IL-33 and IL-1β, IL-12 and IL-23, while a stronger positive correlation between the serum values of IL-33 and TNF-α, IL-1β, IL-6, and IL-12 and IL-23 was detected in patients with COVID-19 with severe disease. A weak negative correlation (p &lt; 0.05) between pO2 and serum IL-1β, IL-12, and IL-33 and between SaO2 and serum IL-33 was noted. The positive relation (p &lt; 0.05) between the serum values of IL-33 and IL-12, IL-33 and IL-6, and IL-6 and IL-12 is proven.Conclusion: In a more progressive stage of COVID-19, increased IL-33 facilitates lung inflammation by inducing the production of various innate proinflammatory cytokines (IL-1β, IL-6, TNF-α, IL-12, and IL-23) in several target cells leading to the most severe forms of the disease. IL-33 correlates with clinical parameters of COVID-19 and might represent a promising marker as well as a therapeutic target in COVID-19.

Effect of Ibuprofen on Serum Laboratory Test Results

1983 ◽  
Vol 40 (6) ◽  
pp. 1025-1034
Author(s):  
Carol L. Colvin ◽  
Raymond J. Townsend ◽  
William R. Gillespie ◽  
Kenneth S. Albert
Keyword(s):  
Laboratory Test ◽  
Test Results ◽  
Laboratory Test Results

scholarly journals Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2077
Author(s):  
Yi-Min Huang ◽  
Chiao Lo ◽  
Chiao-Feng Cheng ◽  
Cheng-Hsun Lu ◽  
Song-Chou Hsieh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Serum Biomarkers ◽  
Healthy Controls ◽  
Granulomatous Mastitis ◽  
C Reactive Protein ◽  
Idiopathic Granulomatous Mastitis ◽  
Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

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