Simple predictive models identify patients with COVID-19 pneumonia and poor prognosis

Background and aims Identification of SARS-CoV-2-infected patients at high-risk of poor prognosis is crucial. We aimed to establish predictive models for COVID-19 pneumonia severity in hospitalized patients. Methods Retrospective study of 430 patients admitted in Vall d’Hebron Hospital (Barcelona) between 03-12-2020 and 04-28-2020 due to COVID-19 pneumonia. Two models to identify the patients who required high-flow-oxygen-support were generated, one using baseline data and another with also follow-up analytical results. Calibration was performed by a 1000-bootstrap replication model. Results 249 were male, mean age 57.9 years. Overall, 135 (31.4%) required high-flow-oxygen-support. The baseline predictive model showed a ROC of 0.800 based on: SpO2/FiO2 (adjusted Hazard Ratio-aHR = 8), chest x-ray (aHR = 4), prior immunosuppressive therapy (aHR = 4), obesity (aHR = 2), IL-6 (aHR = 2), platelets (aHR = 0.5). The cut-off of 11 presented a specificity of 94.8%. The second model included changes on the analytical parameters: ferritin (aHR = 7.5 if ≥200ng/mL) and IL-6 (aHR = 18 if ≥64pg/mL) plus chest x-ray (aHR = 2) showing a ROC of 0.877. The cut-off of 12 exhibited a negative predictive value of 92%. Conclusions SpO2/FiO2 and chest x-ray on admission or changes on inflammatory parameters as IL-6 and ferritin allow us early identification of COVID-19 patients at risk of high-flow-oxygen-support that may benefit from a more intensive disease management.

Morphology and Molecular Biology of Benthic Java Sea Shark Ray Rhina ancylostoma Bloch and Scheider 1801 (Elasmobranchia: Rhinidae)

Aims: Morphology and molecular biology of a rare shark-rays Rhina ancylostoma caught from Java sea.Indonesia. Study Design: Morphology, morphometry and DNA analysis of the fish specimen. Place and Duration of Study: Sample wascollected from fish auction hall at north Java, specimen now stored in Lab of Ichtiology. Department of Fisheries. Faculty of Fisheries and Marine Science. Diponegoro University, between March to December 2019. Methodology: DNA extraction, amplification and molecular identification of fish sample.Yield of DNA supernatant transferred in an eppendeorf tube and stored in 4°C for further process. PCR amplification. Part of Mithocondrial DNA COI (Cytochrome Oxidase subunit-I) gen was amplified using Polymerase Chain Reaction (PCR) method. Then matched up with GenBank database at NCBI using Basic Local Alignment Search Tool (BLAST) analysis. Philogenetic tree was set using Neighbor-Joining method, Kimura-2 parameter model and 1,000 bootstrap replication. Some sequence from NCBI GenBank were inputted into philogenetic tree as comparison. Results: Rhina ancylostoma as one of demersal shark rays catch from tropical shallow Java sea. Range of Total Length 73 – 200 cm and dominant Total Length catch 125 cm. Morphologyis characterised with three lines of spine thorn on the head, morphometry characteriswide of head to TL ratio 0.77. DNA analysis had confirmed the specimen of AH2 as Rhina ancylostoma based on homological match up of sequence of Gen Bank database with reference accesion number KU721837.1 with length sequence of 665 bpand identical similarity of 99.84% for specimen Accession number LC 505461. Conclusion: Rhina ancylostoma as one of demersal shark rays catch from Java sea. Range Total Length (TL) of catch 73 – 200 cm and dominant TL catch range 101 – 125 cm. Morphologically character of wide head ratio with three lines of spine thorn on the head. Nearest genetic distance of 0.02 to Rhincobatushorkelii and 0.017 to R. australiae. Longest genetic distance of 0.243 to Potamotrygon motoro.