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1
Patel, Sunil Kumar, Shital Adhikari, Basanta Gauli, et al. "ASSOCIATION OF CRP AND D-DIMER WITH CT SEVERITY SCORING IN COVID-19 PATIENTS." Journal of Chitwan Medical College 11, no. 4 (2022): 120–25. http://dx.doi.org/10.54530/jcmc.538.
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Background: Corona virus disease 2019 (COVID-19) has become a global public health issue with significant impacts upon the healthcare delivery systems. Previous studies have consistently found elevated levels of C-Reactive Protein and D-dimer with disease severity. In this study, we aimed to investigate the relationship between C-Reactive Protein, D-dimer level and Computed Tomography severity score in patients with SARS-COV-2 pneumonia. Methods: Our study included 76 patients with COVID-19, admitted in COVID Unit of Chitwan Medical College and Teaching Hospital from June 2020 to December 2020. We included COVID-19 cases confirmed by a RT-PCR test and those undergoing High resolution Computed Tomography of chest and having C-Reactive Protein and D-dimer levels done on admission. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5–25%; 3:26–50%; 4:51–75%; 5, > 75%; range 0–5; global score 0–25. Results: Overall the median CTSS was 15. Mild, moderate and severe CT severity scoring was reported in 5.3%, 60.5% and 34.2% respectively and D-dimer progressively increased across the CTSS severity groups. The difference was significant for CRP, P = 0.007 but not for D-dimer, P = 0.42. Moreover, higher CTSS scores were significantly associated with higher ICU stay, lower recovery rate and higher O2 requirement at discharge. Conclusions: Radiological severity of COVID-19 pneumonia has significant association with elevated C-Reactive Protein level but not with D-dimer level and other routine laboratory parameters.
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Purba, Rohmantuah Trada, Mahendratama Purnama Adhi, Erna Kusumawardhani, Rapto Hardian, and Andri Lumban Tobing. "Potensi Pemberian Tocilizumab pada Pasien COVID-19 Di ICU RSUD Ulin Banjarmasin." JAI (Jurnal Anestesiologi Indonesia) 12, no. 3 (2020): 17–33. http://dx.doi.org/10.14710/jai.v12i3.32905.
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Latar Belakang: Corona Virus Disease 2019 (COVID-19) adalah penyakit pandemi yang menjadi masalah global yang melanda seluruh dunia. Manifestasi klinis dan tingkat keparahan penyakit COVID-19 sangat bervariasi. Pada pasien COVID-19 derajat kritis yang memerlukan perawatan di intensive care unit (ICU) telah ditemukan adanya proses badai sitokin yang meningkatkan mortalitas dan morbiditas. Interleukin-6 (IL-6) berperan dalam terjadinya badai sitokin.Kasus: Berikut kami laporkan serial kasus 5 pasien COVID-19 terkonfirmasi positif derajat sedang-kritis yang diberikan tocilizumab (TCZ) sebagai suatu IL-6 inhibitor yang memiliki potensi terapi menurunkan mortalitas dan morbiditas pasien COVID-19 derajat berat-kritis.Pembahasan: Dari 5 pasien yang diberikan TCZ, didapatkan hasil 3 pasien bisa pulang dan 2 pasien meninggal. Terdapat potensi pemberian IL-6 inhibitor karena dari patofisiologi penyakit COVID-19 yang berkaitan dengan IL-6 dan badai sitokin. IL-6 inhibitor dapat menurunkan mortalitas dan morbiditas dengan mencegah terjadinya badai sitokin. Hal ini diukur menggunakan evaluasi onset penyakit, kadar biomarker inflamasi dan gangguan koagulasi yang sering diteliti pada pasien COVID-19 seperti c-reactive protein (CRP), lactate dehydrogenase (LDH), D-Dimer dan ferritin.Kesimpulan: Pemberian TCZ memiliki potensi efek terapeutik jika diberikan pada onset penyakit <10 hari. Perlu dilakukan penelitian lebih lanjut untuk menilai efek terapeutik dan timing pemberian yang tepat.
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Dr., R. Shivasuvramaniyam M.D. Dr. Minakshi M.D. "Clinical & Biochemical Profile of Covid 19 Patients With and Without Co Morbidities." International Journal of Multidisciplinary Research and Analysis 05, no. 02 (2022): 391–98. https://doi.org/10.5281/zenodo.6155971.
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The pandemic outbreak of noval corona virus disease (covid19) was initially noticed in a seafood market in wuhan city in china in mid-December, 2019, has spreaded to 215 countries worldwide. 2020 january7th and was temporally named 2019 n- co.v Corona virus belongs to a large family of virus that causes illness ranging from the common cold to more severe disease, A noval corona virus is a new strain that has not been previously identified in humans on January 30th 2020 declared the noval corona virus outbreak of public health emergency of international concern (PHEIC). At that time there was 98 cases and no death in 18 countries outside china. The official name covid-19 and SARS –COV2 was issued by the WHO on 11th February 2020 Viruses are named based on their genetic structure to facilitate the development of diagnostic test, Vaccine and medium. Virologist and the wider scientific committee do this work, so virus is are named by the international committee on taxonomy of viruses. A recent review of the survival of human corona virus on surface found large variability ranging from 2 hours to 9 days. The survival time depends on number of factors, including the type of surface, temperature, relative humidity and specific strain of viruses. March 11th 2020, the rapid increase in the number of cases outside china. 118000 cases had been reported in 114 countries and 4291 deaths had been reported. Middle of the March 2020 corona out break could be characterized by “Pandemic” reporting over 40108 globally confirmed cases. As of 28th April 2020, 63% of global mortality from the virus. The impact of the dieses on the world has been staggering both from public health and economic perspective. We evaluated whether prior or active corona virus infection influenced hematological, Biochemical and Clinical parameters of the such patients. But active corona fever resulted in higher hospitalization rate. Our data support the nation that SARS- COV-2 and co morbidity weather affects an important percentage of covid 19 pateints and leads to worse parameters, requiring greater attention from health authorities.
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Baragi, Sunil, and Pavani Mallikarjun Dyavannavar. "Association of Inflammatory Markers with the Severity of COVID-19 in a Tertiary Care Hospital in Bagalkot, India - A Cross-Sectional Study." Journal of Evidence Based Medicine and Healthcare 8, no. 28 (2021): 2520–25. http://dx.doi.org/10.18410/jebmh/2021/466.
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BACKGROUND A novel coronavirus was identified as being responsible for a cluster of pneumonia cases worldwide. With an upward trajectory of (corona virus disease-19) COVID-19 cases and its numerous presentations, there is an urgent requirement of identifying initial signs of decline of quality and an adequate response in order to shift a patient to specialized intensive care units (ICU) for those who progress morbidly to severe or critical categories. It has been reported that various acute phase reactants like erythrocyte sedimentation rate (ESR), ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH) and D-dimer are raised much more in severe and critical patients than in the mild cases. These markers might have a role to predict mortality. The present study was done to assess the relationship of serum ferritin, and CRP levels at admission with in-hospital mortality among patients with COVID-19 infection and to determine cut-off values of the best prediction of mortality. METHODS A cross-sectional study of 109 reverse transcription polymerase chain reaction (RTPCR) confirmed COVID-19 patients admitted in our hospital was done. The outcome of cases was categorized into mild, moderate and severe grades. RESULTS Out of 109, 80(73.4 %) were males and 29 (26.6 %) were females. Majority patients of both genders were having severe disease with 30 males and females 10 (P - value = 0.066). Among 109 patients, mild cases (33), moderate case (36), severe case (40). Serum ferritin value severe group (n = 49) 422.45 ng/mL, moderate group (n = 33) 563.64 ng/mL, mild group (n = 27) 529.63 ng/mL. Mean ESR value in severe group 98.37, moderate group 100, mild group 100. Mean CRP in severe group 242.86 mg/L, moderate group 248.48 mg/L, mild group 307.41 mg/L. Mean d-dimer in severe group 971.43 ng/mL, moderate group 803.03 ng/mL, mild group 811.11 ng/mL. CONCLUSIONS Our study showed higher levels of markers like ferritin, D-dimer, CRP and ESR in severe patients as compared to mild and helped in forecasting the advancement of mild cases to severe. Also, the blood levels of CRP and ferritin and the duration to complete symptomatic relief all demonstrated a substantial statistical link thus aiding for monitoring of patients at home and in hospitals. KEYWORDS Covid-19, Inflammatory Markers
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Hachim, Ibrahim Y., Mahmood Y. Hachim, Haifa Hannawi, Kashif Bin Naeem, Abdulla Salah, and Suad Hannawi. "The inflammatory biomarkers profile of hospitalized patients with COVID-19 and its association with patient’s outcome: A single centered study." PLOS ONE 16, no. 12 (2021): e0260537. http://dx.doi.org/10.1371/journal.pone.0260537.
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Several reports highlighted the central role of inflammation in the pathogenesis of corona virus disease-19 (COVID-19) disease. Also, the hyper-inflammatory response that is triggered by severe acute respiratory syndrom-Covid-2 (SARS-CoV-2) infection was believed to play an essential role in disease severity and adverse clinical course. For that reason, the classical inflammatory markers were proposed as a possible indicator for COVID-19 severity. However, an extensive analysis of the predictive value of inflammatory biomarkers in large patients’ cohorts is still limited and critically needed. In this study we investigated the predictive value of the classical inflammatory biomarkers in a patient cohort consists of 541 COVID-19 patients admitted to Al Kuwait Hospital, Dubai, UAE. A detailed analysis of the association between the essential inflammatory markers and clinical characteristics as well as clinical outcome of the patients were made. In addition, the correlation between those markers and a wide range of laboratory biomarkers and incidence of acute organs injury were investigated. Our results showed a significant elevation of many inflammatory markers including white cell count (WBC) count, neutrophils count, C-reactive protein (CRP), D-Dimer, ferritin, procalcitonin (PCT), and lactate dehydrogenase (LDH) levels in patients with more severe illness. Also, our results highlighted that higher levels of those markers can predict worse patient outcome including the need of ventilation, intensive care unit (ICU) admission, multiple organs dysfunction as well as death. In addition, Our results showed that the presence of lymphopenia and lower absolute lymphocyte count (ALC) at the time of admission were associated with severe to critical COVID-19 illness (P<0.0001), presence of acute respiratory distress syndrome (ARDS) (P<0.0001) and the need for ventilation and ICU admission., Moreover, our results showed a strong association between lower ALC count and multiple organs dysfunction and patient’s death (P<0.0001). In conclusion, our results highlighted the possible use of classical inflammatory biomarkers at time of admission as a potential predictive marker for more severe clinical course in COVID-19 patients that might need more aggressive therapeutic approach including the need of ventilators and ICU admission. The presence of such predictive markers might improve patient’s stratification and help in the direction of the available resources to patients in need, which in turn help in improving our response to the disease pandemic.
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Islam, Asif, Malik M. Atif, Summaya Shabbir, et al. "Deranged Liver Enzymes in COVID-19 Patients; and its Impacts on Prognosis." Pakistan Journal of Medical and Health Sciences 16, no. 8 (2022): 558–61. http://dx.doi.org/10.53350/pjmhs22168558.
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Objectives: The objective of this study was to investigate derangement of liver enzymes in COVID-19 patients. The prevalence of deranged hepatic enzymes with COVID-19 infection, its association with other co-morbidities and any changes in its prognosis were investigated. Methodology: This study was conducted in Mayo hospital from 1st June 2021 till 31st September 2021. A number of 224 patients were included in this study. Both male and female patients of varying age groups were included in the study. Laboratory tests were conducted to collect data related to liver enzyme values of each patient. Liver function test (LFT) was performed twice, first on day 1 and then on day 7 to observe any further changes in liver enzymes values in COVID-19 patients. The LFTs of the patients told us Bilirubin, Alanine aminotransferase (ALT), Alkaline Phosphatase (ALP), C-reactive protein (CRP), Ferritin and D-dimer levels in the body. The data were analyzed by SPSS analysis. The t-test used was for the comparison of standard features in both groups. The P value less than 0.05 was regarded significant. Data about co-morbidities, autoimmune disease and its treatment, and outcome was also collected. Gender, autoimmune disease and COVID-19 PCR data was analyzed using descriptive analysis. Prevalence of deranged liver enzymes in COVID-19 patients was analyzed using paired sample test. Association with co-morbidities and prognosis was also analyzed by frequency analysis. Results: Sample consists of 224 individuals among them the ratio of male and female was 50:50 with age ranging 17-90 years. There were 220 COVID-19 PCR positive patients, 1 negative and 3 suspected patients with about 89.7 per cent patients having no autoimmune disease. The results showed that bilirubin, ALT and D-dimer show significant derangement in COVID-19 patients while ALP, CRP and Ferritin did not. The patients with both diabetes mellitus and hypertension showed the highest percentage of association with the value being 25 percent. Other co-morbidities like asthma, chronic liver disease and hepatitis C among many other also showed association with corona virus disease. And the results of prognosis showed that 33 percent, of the patients were shifted to the ICU. 18.8 percent of the patients were admitted in the hospital. 20.5 percent of the patients died. 18.8 percent were discharged and 6.3 percent shifted to the HDU. Conclusion: As the results show liver enzyme ALT, D-dimer and bilirubin show significant derangement in COVID-19 patients. This concludes that some, but not all, of the liver enzyme derangement is prevalent in COVID-19 patients. The patients with both diabetes mellitus and hypertension showed highest association with COVID-19. The patients being shifted to the ICU was the highest prognosis of disease. Other than that a large number of patients died, some were admitted to the hospital due to worsening condition, some discharged and others shifted to the HDU. Keywords: Deranged liver enzymes, Liver enzymes, COVID-19, Patients, Prevalence, Association, Prognosis, Outcome.
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Gul, Samina, and Muhammad Ajmal Khan. "Association of Vitamin D with CRP as A Diagnostic Marker of Cytokine Storm in COVID-19 Patients." International Journal of Human and Health Sciences (IJHHS) 6, no. 4 (2022): 355. http://dx.doi.org/10.31344/ijhhs.v6i4.473.
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The novel corona virus disease (COVID-19) outbreak imposed the catastrophic impact on the communities worldwide. Recentevidence suggests that vitamin D is one of the important factors that affects the COVID-19 disease severity and the mortality increased in the vitamin D deficient COVID-19 patients. Since C- reactive protein (CRP)is an indicator of inflammation, an increase in levels of Vitamin D hence leads to the decrease in cytokines which ultimately affects the degree of C reactive proteins in the patients. In this review, we have focusedhere on the association between vitamin D and surrogate marker C- reactive protein (CRP)in cytokine storms in COVID-19 patients.International Journal of Human and Health Sciences Vol. 06 No. 04 Oct’22 Page: 355-361
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Saputro, Tri Ade, Nur Vita Purwaningsih, Ainutajriani Ainutajriani, and Tony Watoyani. "Correlation between Corona Viruses Disease (Covid-19) and C-Reactive Protein (CRP) in Patients at Haji Hospital Surabaya." Medicra (Journal of Medical Laboratory Science/Technology) 5, no. 1 (2022): 11–16. http://dx.doi.org/10.21070/medicra.v5i1.1631.
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Coronavirus Disease (Covid-19) is a new type of virus that has never been previously identified in humans. Common signs and symptoms of Covid-19 infection include symptoms of acute respiratory distress such as fever, cough and shortness of breath. C-Reactive Protein (CRP) is a protein in serum that causes inflammation in the body. The presence of this inflammatory response causes the levels of CRP in the body to increase significantly. To determine the severity of Covid-19 disease, one of the screening tests used is the CRP examination, starting when clinical symptoms appear, becoming high levels of CRP indicating inflammation or inflammation. This study aims to determine CRP levels in patients who were confirmed positive for Covid-19 at RSU Haji Surabaya. The research method used is descriptive research with secondary data. The sample in the study was 60 patients who had confirmed Covid-19 and performed a CRP test from February to June 2021. The sampling technique used a total sampling technique at the Haji General Hospital Surabaya. The results showed that from 60 confirmed Covid-19 inpatients, 58 patients (96.6%) had CRP levels with high risk criteria or CRP levels > 5 mg/L and 2 patients (3.4%) had CRP levels. with normal criteria or CRP levels < 5 mg/L. Based on the results, it can be concluded that CRP levels are positively correlated with the development and severity of Covid-19 disease.
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Renowati, Renowati, Waslaini Waslaini, and Fitra Wahyuni. "HUBUNGAN BIOMARKER INFLAMASI C-REAKTIF PROTEIN DENGAN LAJU ENDAP DARAH PADA PASIEN TERKONFIRMASI COVID-19." Ensiklopedia of Journal 4, no. 3 (2022): 187–90. http://dx.doi.org/10.33559/eoj.v1i4.176.
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Abstract: China country. It spreads very quickly, namely through physical contact through the nose, mouth, and eyes, and develops in the lungs (C-Reactive Protein). CRP is an acute phase protein synthesized in the liver for non-specific monitoring of local and systemic disease. The erythrocyte sedimentation rate is the rate at which erythrocytes settle in a vertical tube. Research has been carried out to determine the title of the relationship between C-Reactive Protein Levels and Blood Sedimentation Rates in Covid-19 Confirmed Patients. Samples in this study were 60 samples. Then it was found that there were 45 men with a percentage (58.3 %) and a female sex with a percentage of 25 people (41.7 %), and the average c-reactive protein level 477.63 mg/dl and the sedimentation rate was 3.258,33 mm /hour. Then the results of statistical tests obtained results of 0.001 < 0.05. the conclusion is that there is a relationship between levels of c-reactive protein and levels of erythrocyte sedimentation rate in patients suspected of covid-19 with sufficient correlation criteria.Keywords: Corona virus, CRP levels, LED
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Shannak, Qader Abdullah, Thaar Mohammed Najim, and Dhamer Ismail Madab. "Evaluation of the level of vitamin D3 in the blood serum of patients infected with COVID-19 in Al-Amiriya city." Technium BioChemMed 3, no. 2 (2022): 127–35. http://dx.doi.org/10.47577/biochemmed.v3i2.7179.
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The researchers used 60 samples, 35 of which were infected with the developing corona virus and 25 of which were healthy and disease-free. Their ages ranged from 30 to 55, and the samples were taken from their homes. Al-Amiriya Hospital in An bare Governorate. After that, blood was collected from healthy and sick people and separated by centrifugation. The biochemical variables were Determination, including (CRP ,ferritin, Vit.D3) .In comparison to healthy people, people infected with the developing corona virus had significantly higher levels of C-reactive protein and ferritin in their blood serum, according to the findings of the current study. Also When compared to healthy people, Vit.D3 levels in blood serum of people infected with the developing corona virus were shown to be significantly lower.
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Gandhi, Chitra Siva Sankari, Amuthavalli Vasudevan, Ramya Subramani, and Ramadevi Kanaka Sabapathi. "C-Reactive Protein - A Promising Marker for Patients with Ischemic Heart Disease along with Covid-19 among South Indian Population." Journal of Evidence Based Medicine and Healthcare 8, no. 38 (2021): 3378–83. http://dx.doi.org/10.18410/jebmh/2021/613.
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BACKGROUND New corona virus respiratory syndrome is a health emergency due to high infectivity and high case fatality in patients with comorbid conditions like ischemic heart disease. The diagnostic methods of corona virus disease (Covid-19) are still in experimental stage. Hence, a sensitive and specific disease progression marker of Covid-19 is needed. CRP (C-reactive protein) is synthesised by liver. It is elevated in infection and inflammatory conditions as it is an acute phase protein. The purpose of this study was to evaluate CRP as a promising marker for predicting severity of Covid-19 in ischemic heart disease patients and to correlate the impact of CRP with other circulating cardiac biomarkers in different age groups and both sexes. METHODS This is a cross sectional study done among south Indian population mostly from Tamil Nadu and Andhra Pradesh. 232 cases were selected and divided into two groups based on age, sex and confirmed Covid-19 positive cases by RT-PCR (Reverse transcription-polymerase chain reaction), admitted and treated in Rajiv Gandhi Government General Hospital, Chennai. RESULTS In this study, CRP levels were elevated in the age group of 50 - 70 years (66.96 ± 70.09 mg/dL) than CRP levels of age group 30 - 50 years (82.31 ± 90.23 mg/dL) and P value was found to be significant in the age group of 50 - 70 years. Lactate dehydrogenase (LDH) levels were elevated in the age group of 30 - 50 years (380.77 ± 252.23 U/L) than the LDH levels of age group 50 - 70 years (393.53 ± 206.83 U/L) and P value was found to be significant in the age group of 30 - 50 years. Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) levels are the additional cardiac enzymes found to be elevated in this study. CRP showed a positive correlation with LDH (r = 0.221 P < 0.001) in both males (r = 0.06 and P < 0.001) and females (r = 0.45 and P < 0.001) with a significant P value. Receiver operating characteristics (ROC) curves for CRP Vs age group shows a sensitivity of 91.15 % and specificity of 92.52 % and area under curve of 0.556. CONCLUSIONS CRP can be used as a promising marker for early detection and timely intervention of ischemic heart disease in Covid-19 patients especially in the age group of 50 - 70 years and thereby reduces the mortality. KEYWORDS Biomarkers, Heart Disease, Mortality, Prognosis
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Aditi, Sneha, Roushni Kumari, and Abdul Aziz. "The role of hematological biomarkers, coagulation profile and CRP (c-reactive protein) in COVID-19 patients in private health care sector." Indian Journal of Pathology and Oncology 9, no. 3 (2022): 216–19. http://dx.doi.org/10.18231/j.ijpo.2022.052.
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SARS-CoV-2 causing corona virus disease 2019 (COVID-19) is the most common infection in recent days worldwide. Rapidly evolving from the epidemic outbreak in Wuhan, China on 29 December 2019, SARS-CoV-2 is the third known corona virus that causes fatal respiratory diseases in humans. The roles of biomarkers from a blood sample in the diagnosis of COVID-19 patients who have visited the hospital with history of fever has been evaluated.A retrospective study was carried out in a private sector hospital at Panipat where the patients having history of fever were admitted during 1st May 2020 to 15th August 2020. A total of 100 patients were included who were suspected cases of corona. All the blood parameters, systemic inflammatory index (SII), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) Coagulation factor (prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR) and C-Reactive protein (CRP) are compared between negative and positive COVID-19 cases according to RT-PCR. Result: Out of 100 patients, 65% were RTPCR covid positive. In patient with RTPCR negative test results, it was found that total leukocyte count, neutrophils, platelet, NLR and SII values were higher. However, haemoglobin, lymphocytes and PLR was found to be elevated in patients with positive test results.COVID-19 positive patients presented with leukopenia, neutropenia, thrombocytopenia and lymphocytosis. SII and NLR were reduced. PLR and CRP were increased. PT and APTT were within normal limits. Lymphocyte count and PLR showed strong significance in this study.The definitive diagnosis of COVID-19 was made by RT-PCR analysis, but this is a time-consuming and less accessible test. Low values of NLR and SII and high value of PLR and CRP are indicative of COVID-19 and can be used in its diagnosis.
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Khalid, Bassam, Hassam Anjum Mir, Taimoor Saleem, Umer Naseer, Asif Hashmat, and Khurshid Muhammad Uttra. "Comparison of Diagnostic Accuracy of CRP Versus Ferritin in COVID Patients as a Marker of Severity of Disease Taking who Severity Classification as Gold Standard." Pakistan Journal of Medical and Health Sciences 17, no. 2 (2023): 573–76. http://dx.doi.org/10.53350/pjmhs2023172573.
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Objective: To determine the diagnostic accuracy of elevated C reactive protein (CRP) and ferritin in predicting severe Covid-19 infection using the World Health Organization’s (WHO) Covid-19 severity classification as gold standard. Study Design: Descriptive study. Place and Duration of Study: This study was conducted at the Pak Emirates Military Hospital, Rawalpindi, from January 1st 2021 till April 30th 2021. Ethical review committee’s (ERC) approval was taken and good clinical practice guidelines were followed. Material and Methods: Baseline blood samples were sent to the hospital laboratory for the measurement of C reactive protein and ferritin levels. PCR was taken as gold standard for the diagnosis of Corona virus disease. Patients were classified into severe and non-severe categories using WHO classification of severity. Sensitivity, specificity, diagnostic accuracy, negative predictive value and positive predictive value were calculated for elevated CRP and ferritin. Results: There were 65 (57.5%) patients who had severe Covid-19 disease and 48 (42.5%) patients who had non-severe Covid-19 disease. Among the patients with severe Covid-19, 57 (87.7%) had elevated CRP levels, and 50 (76.9%) patients had elevated ferritin levels. Testing ferritin levels, against the severity of Covid-19 patients, there was a sensitivity of 76.9%, specificity of 79.2%, positive predictive value (PPV) of 83.3%, negative predictive value (NPV) of 71.7% and diagnostic accuracy of 77.8%. Testing CRP levels, there was a sensitivity of 87.7%, specificity of 85.4%, PPV of 89.1%, NPV of 83.6% and diagnostic accuracy of 86.7%. Conclusion: The results from our study show that CRP has a slightly improved diagnostic accuracy as compared to ferritin. However, both these markers have value in the prediction of severity of Covid-19 infection. Keywords: Covid-19, elevated C reactive protein and ferritin.
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Schaefer, Ernst J., Latha Dulipsingh, Florence Comite, et al. "Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging." PLOS ONE 16, no. 6 (2021): e0252818. http://dx.doi.org/10.1371/journal.pone.0252818.
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Most deaths from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection occur in older subjects. We assessed the utility of serum inflammatory markers interleukin-6 (IL-6), C reactive protein (CRP), and ferritin (Roche, Indianapolis, IN), and SARS-CoV-2 immunoglobulin G (IgG), immunoglobulin M (IgM), and neutralizing antibodies (Diazyme, Poway, CA). In controls, non-hospitalized subjects, and hospitalized subjects assessed for SARS-CoV-2 RNA (n = 278), median IgG levels in arbitrary units (AU)/mL were 0.05 in negative subjects, 14.83 in positive outpatients, and 30.61 in positive hospitalized patients (P<0.0001). Neutralizing antibody levels correlated significantly with IgG (r = 0.875; P<0.0001). Having combined values of IL-6 ≥10 pg/mL and CRP ≥10 mg/L occurred in 97.7% of inpatients versus 1.8% of outpatients (odds ratio 3,861, C statistic 0.976, P = 1.00 x 10−12). Antibody or ferritin levels did not add significantly to predicting hospitalization. Antibody testing in family members and contacts of SARS-CoV-2 RNA positive cases (n = 759) was invaluable for case finding. Persistent IgM levels were associated with chronic COVID-19 symptoms. In 81,624 screened subjects, IgG levels were positive (≥1.0 AU/mL) in 5.21%, while IgM levels were positive in 2.96% of subjects. In positive subjects median IgG levels in AU/mL were 3.14 if <30 years of age, 4.38 if 30–44 years of age, 7.89 if 45–54 years of age, 9.52 if 55–64 years of age, and 10.64 if ≥65 years of age (P = 2.96 x 10−38). Our data indicate that: 1) combined IL-6 ≥10 pg/mL and CRP ≥10 mg/L identify SARS-CoV-2 positive subjects requiring hospitalization; 2) IgG levels were significantly correlated with neutralizing antibody levels with a wide range of responses; 3) IgG levels have significant utility for case finding in exposed subjects; 4) persistently elevated IgM levels are associated with chronic symptoms; and 5) IgG levels are significantly higher in positive older subjects than their younger counterparts.
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Safitri, Meta, and Lisyani Budipradigda Suromo. "Correlation between C-Reactive Protein Level and Blood Urea Nitrogen-Creatinine Ratio in COVID-19 Patients." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 28, no. 1 (2021): 10–13. http://dx.doi.org/10.24293/ijcpml.v28i1.1756.
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Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2).C-Reactive Protein (CRP) is an inflammation marker that increases significantly in COVID-19 patients. SARS-CoV-2 can affectkidney function and increase the Blood Urea Nitrogen (BUN)-creatinine ratio. The previous study showed that CRP andBUN-creatinine ratios could be used as predictors of the severity and survival of COVID-19 patients. This study aimed todetermine the correlation between CRP levels and the BUN-creatinine ratio in COVID-19 patients. A retrospectivecross-sectional study was conducted on 34 COVID-19 patients who were diagnosed by PCR test at Dr. Kariadi Hospital,Semarang from March to September 2020. The Spearman correlation test was used for statistical analysis. The median CRPvalue was 4.59 (0.36-27.48) mg/L and BUN-creatinine ratio was 15.06 (5.79-37.04), while the correlation between CRP andBUN-creatinine ratio showed p=0.003 and r=0.502. There was a moderate positive correlation between CRP level andBUN-creatinine ratio. C-reactive protein plays a role in the infiltration process of inflammatory cells and increases adhesionmolecules, which can directly or indirectly damage kidney function. SARS-CoV-2 can enter the kidney directly through theACE-2 receptor and activate the renin-angiotensin-aldosterone system, which will increase water and sodium absorption inthe renal tubules, passive reabsorption of BUN, and creatinine filtration in the glomerulus resulting in increasedBUN-creatinine ratio.
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Alharris, Esraah, and Dina Saleh. "The Pathological Basis for Severe Corona Virus Disease-19 in Diabetic Patients." INTERNATIONAL JOURNAL OF DRUG DELIVERY TECHNOLOGY 12, no. 02 (2022): 873–77. http://dx.doi.org/10.25258/ijddt.12.2.74.
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Background: It has been documented that the mortality rate in diabetic persons can reach 10%. In addition, it has been shown that the rate of mortality and the need for respiratory support are higher among newly diagnosed cases of diabetes mellitus compared with patients known to have diabetes mellitus for a relatively long duration. In the setting of the pandemic of COVID-19, glycemic control for the patients admitted to hospitals is critical, as is diabetes screening to uncover undiagnosed cases.Aim of the study: To explore the possible link between diabetes mellitus and COVID-19 in Iraq Patients and methods: The current research was carried out in Al-Diwaniyah Province, Iraq, in Al-Diwaniyah Teaching Hospital, including the word of medicine, respiratory unit, and intensive care unit. The study started on Sept 15, 2021 and ended on Apr 15, 2022. The study was cross-sectional and included 100 patients with a diagnosis of COVID-19 evidenced by polymerase chain reaction (PCR) test and CT-scan “computed tomography scan of the chest. Those patients were chosen randomly from the pool of patients visiting the teaching hospital. The age range of patients was between 18 and 94 years, with 45 males and 55 females. Laboratory investigation results were retrieved from patients’ records and included random blood sugar, lactate dehydrogenase, d-dimer, HbA1c%, and “C-reactive protein (CRP).” Results: The mean values of age, random blood sugar (RBS), lactate dehydrogenase (LDH), d-dimer, HbA1c, and HS-CRP were comparable between males and females (p > 0.05). Patients with high HbA1c levels (HbA1c ≥ 6.5%) were older and had significantly higher levels of random blood sugar and d-dimer than patients with HbA1c is less than 6.5%. The d-dimer level showed a significant positive correlation to RBS, LDH, HbA1c, and HS-CRP (p is less than 0.05). Conclusion: Higher levels of markers of inflammation were associated with HbA1c levels in the diabetic range, indicating a bi-directional relation between diabetes mellitus and the severity of COVID-19.
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Bogarapu, Kiranmayi. "Serum Total Bilirubin and Aminotransferases in Patients with COVID-19 in Nellore District of South Andhra Pradesh." Journal of Evolution of Medical and Dental Sciences 10, no. 45 (2021): 3925–30. http://dx.doi.org/10.14260/jemds/2021/793.
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BACKGROUND Corona virus disease - 19 (COVID -19) infection is an acute infectious disease caused by a newly discovered beta corona virus, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). While the primary target organ is the lungs, involvement of many other organs is often evident in patients with COVID - 19. There is emerging evidence to suggest association of SARS-CoV-2 infection with development of many liver abnormalities. The purpose of this study was to evaluate the prevalence of abnormal liver parameters in COVID - 19 patients and their variation in moderate and severe cases. METHODS This is a retrospective study. All patients with COVID -19, between the ages 20 - 75 years, encountered between April and May 2021, were included for the study and compared with age-matched controls. Severity of infection was defined based on the presence of symptoms, oxygen saturation, need for respiratory and intensive care support. Liver parameters such as serum total bilirubin (TBIL), serum aminotransferases, alanine aminotransaminase (ALT) and aspartate aminotransaminase (AST) were analysed. Inflammatory markers such as C-reactive protein (CRP) and D-dimer were also included for assay. RESULTS A total of 52 patients were encountered during the study period. Of these, 29 % (15/52) required intensive care. Abnormal liver parameters were observed in 14 (27 %) patients, and were significantly elevated compared to healthy controls. Liver dysfunction was markedly profound in severe infection than those with moderate disease. Higher levels of CRP and D-dimer were noted in severe patients of COVID - 19. CONCLUSIONS Mild liver abnormalities in the form of elevated ALT and AST are seen in COVID - 19 patients suggesting mild or no liver injury. These abnormal parameters do not generally lead to significant liver function impairment/failure and no specific treatment is required. KEY WORDS COVID - 19, Corona Virus, Liver Injury, Intensive Care Support.
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Pramana, Komang Ardiana, Reza Widianto Sudjud, and Ardi Zulfariansyah. "Comparison of total lymphocytes, neutrophils to lymphocytes ratio, and C-reactive protein in vaccinated and non-vaccinated severe COVID-19 patients." Anaesthesia, Pain & Intensive Care 26, no. 5 (2022): 656–62. http://dx.doi.org/10.35975/apic.v26i5.2018.
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Background & objective: SARS-CoV-2 virus caused acute respiratory illness called COVID-19 with rising case mortality rates. One of the preventive measures to arrest the spread of a contagious disease is the use of vaccines. We assessed the effectiveness of the inactivated vaccine (Coronavac) through three inflammatory parameters e.g., total lymphocyte count, neutrophil-lymphocyte ratio, and C-reactive protein (CRP), in severe COVID-19 patients.
 Methodology: This study was an observational study with a retrospective cross-sectional design. The study was conducted in the Intensive Care Unit (ICU) of Hasan Sadikin Hospital Bandung, from January 2021 to December 2021. The data of total lymphocyte count, neutrophil-lymphocyte ratio, and C-reactive protein, was collected retrospectively from the medical record documents of 54 patients of COVID-19. The assessment was performed on severe COVID-19 subjects on the 7th day of illness. Data normality test was done using the Shapiro Wilk test. Study data were not normally distributed, and statistical analyses were performed using the Mann-Whitney test for numerical data and the Chi-Square test for categorical data.
 Results: There were significant differences in inflammation parameters, e.g., total lymphocyte count, neutrophil-lymphocyte ratio, and CRP, between the two groups (P < 0.0001) and the subject outcome between two groups (P < 0.0001). Total lymphocyte count in severe vaccinated COVID-19 patients was higher than in non-vaccinated patients, while neutrophil-lymphocyte ratio and CRP were lower in vaccinated subjects. Mortality was also lower in the vaccinated patients compared to unvaccinated patients.
 Conclusion: The inactivated vaccine (Coronavac) effectively reduces the mortality rate of severe COVID-19 patients based on inflammatory parameters including total lymphocyte count, neutrophil-lymphocyte ratio, and C-reactive protein.
 Abbreviations: ACE: Angiotensin Converting Enzyme; ARB: Angiotensin Receptor Blocker; ARDS: Acute Respiratory Distress Syndrome; BMI: Body Mass Index; CFR: Case Fatality Rate; COVID-19: Coronaviruses Disease 2019; CRP: C-Reactive Protein; IL: Interleukin; NLR: Neutrophil Lymphocyte Ratio; SPSS: Statistical Product Service Solution; TLC: Total Lymphocyte Count; TNF: Tumor Necrosis Factor; VEGF: Vascular Endothelial Growth Factor
 Citation: Sudjud RW, Zulfariansyah A, Ardiana K. Comparison of total lymphocytes, neutrophils to lymphocytes ratio, and C-reactive protein in vaccinated and unvaccinated severe COVID-19 patients. Anaesth. pain intensive care 2022;26(5):656-662; DOI: 10.35975/apic.v26i5.2018
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Arushi Mohan, Padmini SN, Brunda MS, Abhinaya Shekhar, Paul Matthew, and G.R. Lingeshwaran. "Role of biomarkers in predicting prognosis of Coronavirus disease 2019 (COVID-19): A retrospective cross-sectional study: Perspective of a tertiary care hospital in India." World Journal of Advanced Research and Reviews 11, no. 1 (2021): 081–90. http://dx.doi.org/10.30574/wjarr.2021.11.1.0300.
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Background: COVID-19 is a novel disease triggered by the SARS-CoV-2 virus, a beta coronavirus similar to MERS-CoV and SARS CoV. Inflammatory markers have a vital role in the pathogenesis of nCOVID 19; understanding the importance of these inflammatory markers in determining disease status is essential given the impact of the disease on healthcare. Thus, being able to triage cases with minimal tests is momentous to capture, which we have investigated as per our study guidelines of the role of inflammatory markers such as D-dimer, CRP (C - reactive protein), Ferritin, LDH (Lactate Dehydrogenase) in patients with COVID 19. In addition, limited data is available comparing the utility of these inflammatory markers to predict the following parameters as the need for ICU, oxygen support requirement, and duration of in-hospital stay, which can help guide the management protocol. Aim: This study aims to determine markers associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). Objectives: 1) To assess the inflammatory markers that are routinely investigated in COVID- 19 patients. 2) To determine the most probable factor to estimate severity in COVID- 19 and thus predict prognosis. Methods: This is a retrospective cross-sectional observational study of patients who tested SARS COV 2 positive by RT PCR. The laboratory inflammatory markers, namely Lactate Dehydrogenase, C reactive protein, D-dimer, Ferritin, were assessed in the selected patients, and their clinical data and demographic details were taken into account. The parameters considered for contributing to the severity included the number of days of stay in the hospital, oxygen requirement, and ICU needs. Analyses relied upon analysis of variance for cross-sectional study design and a P< 0.05 statistical significance criterion. Results: There was a statistically significant difference found between oxygen requirement and D dimer (p<0.001), LDH (p= 0.002), and CRP (p= 0.024). There was a statistically significant difference found between admission to ICU and D Dimer (p= 0.001). Conclusion: A statistically significant association between the increasing D-dimer levels and all the outcome measures considered was found. The D-dimer, LDH, and CRP help predict oxygen requirement, and all the inflammatory markers can predict the number of days of stay in the hospital.
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Scarcella, Marialaura, Emidio Scarpellini, Alessandra Ascani, et al. "Effect of Whey Proteins on Malnutrition and Extubating Time of Critically Ill COVID-19 Patients." Nutrients 14, no. 3 (2022): 437. http://dx.doi.org/10.3390/nu14030437.
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The novel SARS-CoV-2 virus has led to a severe pandemic, starting from early 2020. Intensive care (ICU) management of the COVID-19 disease is difficult with high morbidity and mortality. Early nutritional support, especially with whey protein, seems to be crucial in this medical case. Thus, we aimed to assess the effects of an adequate nutritional protocol rich in whey protein on nutritional and inflammatory status, extubating time, and mortality of critically ill COVID-19 patients (CICP). Methods: A prospective single-center exploratory observational study was undertaken on 32 consecutive CICP admitted to the ICU of Santa Maria Hospital, Terni, Italy, and treated with whey protein-enriched formula. Patients’ demographics, nutritional status, indexes of inflammation, daily pre-albumin serum levels, duration of mechanical ventilation, and mortality were recorded. Results: Thirty-two patients were enrolled. Ninety-five percent of them showed a gradual reduction in C-reactive protein (CRP) values and increase in pre-albumin levels after the whey protein-enriched formula. Prealbumin levels were not correlated with a better nutritional status but with a shorter extubating time and better survival. Conclusions: An adequate administration of whey protein during COVID-19 patients’ ICU stays can provide fast achievement of protein targets, reducing the duration of mechanical ventilation, and improving inflammatory status and ICU survival. Further prospective and large-scale, controlled studies are needed to confirm these results.
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Kalikotay, Bhagawaty. "Corona Virus Disease 2019 (COVID-19) Prevention and Control Measures in Community: A Literature Review." Rupantaran: A Multidisciplinary Journal 4, no. 1 (2020): 44–51. http://dx.doi.org/10.3126/rupantaran.v4i1.34016.
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 There is a new public health crises threatening the world with the emergence and spread of 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There have been around 25,300,975 reported cases of coronavirus disease 2019 (COVID-2019) and 848,673 reported deaths to date (30/08/2020). Extensive literature review of publicly available information to summarize sign and symptoms as well as prevention of COVID-19 was carried out. The disease is transmitted by inhalation or contact with infected droplets and the incubation period ranges from 2 to 14 days. The symptoms are usually fever, cough, sore throat, breathlessness, fatigue, malaise among others. The disease is mild in most people; in some (usually the elderly and those with comorbidities), it may progress to pneumonia, acute respiratory distress syndrome (ARDS) and multi organ dysfunction. Many people are asymptomatic. The case fatality rate is estimated to range from 2 to 3%. Diagnosis is by demonstration of the virus in respiratory secretions by special molecular tests. Common laboratory findings include elevated C-reactive protein (CRP). Prevention entails home isolation of suspected cases and those with mild illnesses and strict infection control measures at hospitals that include contact and droplet precautions.
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Arushi, Mohan, SN Padmini, MS Brunda, Shekhar Abhinaya, Matthew Paul, and Lingeshwaran G.R. "Role of biomarkers in predicting prognosis of Coronavirus disease 2019 (COVID-19): A retrospective cross-sectional study: Perspective of a tertiary care hospital in India." World Journal of Advanced Research and Reviews 11, no. 1 (2021): 081–90. https://doi.org/10.5281/zenodo.5169042.
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<strong>Background</strong>: COVID-19 is a novel disease triggered by the SARS-CoV-2 virus, a beta coronavirus similar to MERS-CoV and SARS CoV. Inflammatory markers have a vital role in the pathogenesis of nCOVID 19; understanding the importance of these inflammatory markers in determining disease status is essential given the impact of the disease on healthcare. Thus, being able to triage cases with minimal tests is momentous to capture, which we have investigated as per our study guidelines of the role of inflammatory markers such as D-dimer, CRP (C - reactive protein), Ferritin, LDH (Lactate Dehydrogenase) in patients with COVID 19. In addition, limited data is available comparing the utility of these inflammatory markers to predict the following parameters as the need for ICU, oxygen support requirement, and duration of in-hospital stay, which can help guide the management protocol. <strong>Aim: </strong>This study aims to determine markers associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). <strong>Objectives: </strong>1) To assess the inflammatory markers that are routinely investigated in COVID- 19 patients. 2) To determine the most probable factor to estimate severity in COVID- 19 and thus predict prognosis. <strong>Methods</strong>: This is a retrospective cross-sectional observational study of patients who tested SARS COV 2 positive by RT PCR. The laboratory inflammatory markers, namely Lactate Dehydrogenase, C reactive protein, D-dimer, Ferritin, were assessed in the selected patients, and their clinical data and demographic details were taken into account. The parameters considered for contributing to the severity included the number of days of stay in the hospital, oxygen requirement, and ICU needs. Analyses relied upon analysis of variance for cross-sectional study design and a P< 0.05 statistical significance criterion. <strong>Results:</strong> There was a statistically significant difference found between oxygen requirement and D dimer (p<0.001), LDH (p= 0.002), and CRP (p= 0.024). There was a statistically significant difference found between admission to ICU and D Dimer (p= 0.001). <strong>Conclusion:</strong> A statistically significant association between the increasing D-dimer levels and all the outcome measures considered was found. The D-dimer, LDH, and CRP help predict oxygen requirement, and all the inflammatory markers can predict the number of days of stay in the hospital.
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Rani, Anju, Varuna Gupta, Kandhakumari Gandhi, and Ashok Kumar Dhanvijay. "Microbiological profile of COVID-19 patients admitted in a tertiary care hospital Mathura, Uttar Pradesh, India." International Journal of Research in Medical Sciences 9, no. 5 (2021): 1403. http://dx.doi.org/10.18203/2320-6012.ijrms20211876.
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Background: The pandemic due to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) has drawn worldwide worst effect with diagnostic challenge. Every investigation has its own importance for diagnosis, care, treatment and for management of corona virus disease-2019 (COVID-19) patients. Here this prospective study aimed to investigate the microbiological profile, prevalence of co-infection, and antibiotic susceptibility pattern of patients with confirmed SARS-CoV-2.Methods: A total of 336 samples were processed in COVID laboratory, Department of Microbiology. An array of serological investigations was done by rapid card screening test. C-Reactive protein (CRP) was analyzed by nephelometer. Blood culture was done by automated system and urine culture on Cystine-Lactose-Electrolyte-Deficient (CLED) Agar. Antibiotic susceptibility tests were done by Kirby Bauer disc diffusion method.Results: Out of 336 samples tested 76%were male and 24%were female. All samples tested were negative for HIV, HBsAg, HCV, syphilis, malarial parasite. CRP and Typhi -dot with IgM and IgG antibody were positive in 89.28% and 11.42% respectively. About 27% of COVID-19 patients showed bacterial and fungal co-infections. The most prevalent organisms were MR-CoNS (26%), K. pneumoniae (19%) and less prevalent were P. aeruginosa (6%) and A. baumannii (4%). C. albicans (11%) was the only isolated fungi. All gram positive isolates were 100% sensitive to Linezolid and vancomycin, among gram negative isolates, 100% were sensitive to colistin and polymyxin B.Conclusions: Microbiological investigation for presence of other co-infecting agents among patients with COVID-19 infection should be considered, and prompt treatment should be carried out accordingly.
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Gessler, Nele, Melanie A. Gunawardene, Peter Wohlmuth, et al. "Clinical outcome, risk assessment, and seasonal variation in hospitalized COVID-19 patients—Results from the CORONA Germany study." PLOS ONE 16, no. 6 (2021): e0252867. http://dx.doi.org/10.1371/journal.pone.0252867.
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Background After one year of the pandemic and hints of seasonal patterns, temporal variations of in-hospital mortality in COVID-19 are widely unknown. Additionally, heterogeneous data regarding clinical indicators predicting disease severity has been published. However, there is a need for a risk stratification model integrating the effects on disease severity and mortality to support clinical decision-making. Methods We conducted a multicenter, observational, prospective, epidemiological cohort study at 45 hospitals in Germany. Until 1 January 2021, all hospitalized SARS CoV-2 positive patients were included. A comprehensive data set was collected in a cohort of seven hospitals. The primary objective was disease severity and prediction of mild, severe, and fatal cases. Ancillary analyses included a temporal analysis of all hospitalized COVID-19 patients for the entire year 2020. Findings A total of 4704 COVID-19 patients were hospitalized with a mortality rate of 19% (890/4704). Rates of mortality, need for ventilation, pneumonia, and respiratory insufficiency showed temporal variations, whereas age had a strong influence on the course of mortality. In cohort conducting analyses, prognostic factors for fatal/severe disease were: age (odds ratio (OR) 1.704, CI:[1.221–2.377]), respiratory rate (OR 1.688, CI:[1.222–2.333]), lactate dehydrogenase (LDH) (OR 1.312, CI:[1.015–1.695]), C-reactive protein (CRP) (OR 2.132, CI:[1.533–2.965]), and creatinine values (OR 2.573, CI:[1.593–4.154]. Conclusions Age, respiratory rate, LDH, CRP, and creatinine at baseline are associated with all cause death, and need for ventilation/ICU treatment in a nationwide series of COVID 19 hospitalized patients. Especially age plays an important prognostic role. In-hospital mortality showed temporal variation during the year 2020, influenced by age. Trial registration number NCT04659187.
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Raghute, Latesh B., Sujata Dudhgaonkar, Pravin S. Uike, and Kavita M. Jaiswal. "Haematological abnormalities and pharmacotherapy in severe acute respiratory syndrome corona virus 2." International Journal of Basic & Clinical Pharmacology 10, no. 7 (2021): 855. http://dx.doi.org/10.18203/2319-2003.ijbcp20212386.
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The first case of SARS-CoV-2 (severe acute respiratory syndrome corona virus 2) was reported in Wuhan, China at the end of year 2019. It shows flu-like symptoms, but anosmia, fatigue, persistent cough and loss of appetite, that collectively might spot individuals with COVID-19. The aim of writing this review was to gather the information about blood abnormalities and pharmacotherapy for COVID-19 as a resource for healthcare professionals. A blood workup as well as continuous tracking hematological changes could divulge the risks of disease progression. The indirect indicators such as C-reactive protein (CRP), D-dimer, albumin, ferritin and LDH levels which are used as markers to estimate the severity of COVID-19 infection and prognosis. The most common hematological findings include lymphocytopenia, neutrophilia, eosinopenia, mild thrombocytopenia and less frequently, thrombocytosis. Clinical management includes prophylactic and therapeutic measures. Supportive care including supplemental oxygen and mechanical ventilatory support as and when indicated. Several class of drugs like anti-malarial, anti-viral, anti-inflammatory drugs are being used for the treatment and prevention of COVID-19. The target for development of most of the vaccine for COVID-19 is S protein of the corona virus. Various vaccines available for use across the globe are COVAX, Covishield, Moderna, Johnson and Johnson, Sputnik V, Novavax, Sinopharm, SinoVac. Serial monitoring of hematological manifestations is recommended and the treating doctor should stay vigilant and consider proper screening. The therapeutic intention is to decrease viral load and pharmacological thrombo-prophylaxis in high risk patients.
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Ceci, Flavio Maria, Marco Fiore, Francesca Gavaruzzi, et al. "Early Routine Biomarkers of SARS-CoV-2 Morbidity and Mortality: Outcomes from an Emergency Section." Diagnostics 12, no. 1 (2022): 176. http://dx.doi.org/10.3390/diagnostics12010176.
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Background. COVID-19 is a severe acute respiratory disease caused by SARS-CoV-2, a virus belonging to the Coronaviridae family. This disease has spread rapidly around the world and soon became an international public health emergency leading to an unpredicted pressure on the hospital emergency units. Early routine blood biomarkers could be key predicting factors of COVID-19 morbidity and mortality as suggested for C-reactive protein (CRP), IL-6, prothrombin and D-dimer. This study aims to identify other early routine blood biomarkers for COVID-19 severity prediction disclosed directly into the emergency section. Methods. Our research was conducted on 156 COVID-19 patients hospitalized at the Sapienza University Hospital “Policlinico Umberto I” of Rome, Italy, between March 2020 and April 2020 during the paroxysm’s initial phase of the pandemic. In this retrospective study, patients were divided into three groups according to their outcome: (1) emergency group (patients who entered the emergency room and were discharged shortly after because they did not show severe symptoms); (2) intensive care unit (ICU) group (patients who attended the ICU after admission to the emergency unit); (3) the deceased group (patients with a fatal outcome who attended the emergency and, afterward, the ICU units). Routine laboratory tests from medical records were collected when patients were admitted to the emergency unit. We focused on Aspartate transaminase (AST), Alanine transaminase (ALT), Lactate dehydrogenase (LDH), Creatine kinase (CK), Myoglobin (MGB), Ferritin, CRP, and D-dimer. Results. As expected, ANOVA data show an age morbidity increase in both ICU and deceased groups compared with the emergency group. A main effect of morbidity was revealed by ANOVA for all the analyzed parameters with an elevation between the emergency group and the deceased group. Furthermore, a significant increase in LDH, Ferritin, CRP, and D-dimer was also observed between the ICU group and the emergency group and between the deceased group and ICU group. Receiver operating characteristic (ROC) analyses confirmed and extended these findings. Conclusions. This study suggests that the contemporaneous presence of high levels of LDH, Ferritin, and as expected, CRP, and D-dimer could be considered as potential predictors of COVID-19 severity and death.
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Jatoi, Saima, Muhammad Adnan Bawany, Sunil Dat Maheshwari, Muhammad Akbar Memon, Sheeza Saleem Qureshi, and Hasham Masood Qureshi. "Inflammatory Markers as Predictors of Severity and Mortality in Coronavirus Disease: A Cross-sectional Study." International Journal of Current Research and Review 14, no. 13 (2022): 30–35. http://dx.doi.org/10.31782/ijcrr.2022.141306.
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Introduction: COVID-19 is a pandemic that demands swift, in-depth, and well-grounded research work. WHO (World Health Organization) has declared around 1 million deaths and confirmed about 35 million cases worldwide. Aim: To predict the role of three inflammatory markers (serum ferritin, C-reactive protein and lactate dehydrogenase) in severity and mortality in patients with corona virus disease patients admitted in the hospital. Methodology: Patients with traceable SARS-CoV-2 by polymerase chain reaction (PCR) were inducted into this study by simple random sampling. Patients with potential radiological scans but without positive SARS were not included in this study. The nasopharyngeal sample technique was used to check the presence of the virus. This viral load’s severity was checked via World Health Organization recommendations. All the information including the sociodemographic data, severity of disease and laboratory values of three inflammatory markers gathered on a semi structured proforma designed for the study. Study Design: A Cross-Sectional study. Place and Duration: Isra University Hospital from 1st June 2021 to 31st December 2021. Results: A 240 patients were included in the study; aged between 20 and 60 years. The values of the three inflammatory markers were found raised in the group of patients being studied (more frequently within the moderate and severe disease groups). C - reactive protein was raised in 122 patients, ferritin was raised in 83 patients and Lactate dehydrogenase was raised in 184 patients Conclusion: Measuring the values of CRP, LDH, and Ferritin at admission can be a reliable predictor of severity and mortality in SARs-CoV-2. Out of the three, ferritin is the best indicator and should be considered essential.
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Rahman, Tasnim, Nursarat Ahmed, Baishakhi Islam, et al. "Association Between Serum C-Reactive Protein (CRP) And D-Dimer Levels In Covid-19 Patients In A Tertiary Level Hospital, Khulna." Journal of Dhaka Medical College 32, no. 1 (2024): 57–62. http://dx.doi.org/10.3329/jdmc.v32i1.76448.
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Background: The novel corona virus disease 2019 (COVID-19) is major public health issue. It is the most significant global health challenge in the world. Biomarkers play a significant role to detect the severity of COVID-19 infection in the perspective of management of the patients. Aim and objective: We aimed to assess the association between the levels of C-Reactive Protein and D-dimer in COVID-19 patients. Methods: This cross-sectional study was conducted in the department of Pathology and department of Microbiology GMCH, Khulna. 152 patients with SARS-CoV-2 (COVID -19) positive patients were enrolled in this study. C-reactive protein and D-dimer levels are measured in the laboratory of Pathology department, GMCH, Khulna. All statistical computations were performed by using window-based computer software devised with Statistical Packages for Social Sciences (IBM SPSS Statistics 21 version). Results: In this study CRP level was found of mean value of 62.84± 44.64 mg/L with a range of 1.40-195.20 mg/L. It was normal in 21 (13.8%) patients and increased in in 131 patients (86.2 %). The mean value of D-dimer was 2.48 ± 02.20 mg/L with a range of 0.10-9.35 mg/L. D-dimer was normal in 26 (17.1%) patients, whereas it was increased in 126 patients (82.9 %). We performed Pearson’s correlation-coefficient (r) test to compare the association between the levels of CRP with D-dimer in COVID-19 positive patients. There was moderately positive and significant correlation (r = +0.647, p <0.05) between the levels of CRP and D-dimer. Conclusion: There was statistically significant correlation between the levels of serum CRP with D-dimer in COVID-19 positive patients. These two biomarkers can be used to assess the severity in patients with COVID-19 positive with thrombotic disorder for reduction of morbidity and mortality of COVID positive patients. J Dhaka Med Coll. 2023; 32(1) : 57-62
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Buchhorn, Reiner, Carlotta Meyer, Kai Schulze-Forster, Juliane Junker, and Harald Heidecke. "Autoantibody Release in Children after Corona Virus mRNA Vaccination: A Risk Factor of Multisystem Inflammatory Syndrome?" Vaccines 9, no. 11 (2021): 1353. http://dx.doi.org/10.3390/vaccines9111353.
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Multisystem inflammatory syndrome (MIS) is a new systemic inflammatory acute onset disease that mainly affects children (MIS-C) and, at a lesser frequency, adults (MIS-A); it typically occurs 3–6 weeks after acute SARS-CoV infection. It has been postulated and shown in adults that MIS may occur after SARS-CoV-2 vaccination (MIS-V). Our current case is one of the first published cases with a multisystem inflammatory syndrome in an 18-year-old adolescent after the SARS-CoV-2 vaccine from Pfizer/BionTech (BNT162b2), who fulfills the published level 1 criteria for a definitive disease: age < 21 years, fever > 3 consecutive days, pericardial effusion, elevated CRP/NT-BNP/Troponin T/D-dimeres, cardiac involvement, and positive SARS-CoV-2 antibodies. The disease starts 10 weeks after the second vaccination, with a fever (up to 40 °C) and was treated with amoxicillin for suspected pneumonia. The SARS CoV-2-PCR and several antigen tests were negative. With an ongoing fever, he was hospitalized 14 days later. A pericardial effusion (10 mm) was diagnosed by echocardiography. The C-reactive protein (174 mg/L), NT-BNP (280 pg/mL), and Troponin T (28 pg/mL) values were elevated. Due to highly elevated D-dimeres (>35,000 μg/L), a pulmonary embolism was excluded by thoracal computer tomography. If the boy did not improve with intravenous antibiotics, he was treated with intravenous immunoglobulins; however, the therapy was discontinued after 230 mg/kg if he developed high fever and hypotension. A further specialized clinic treated him with colchicine and ibuprofen. The MIS-V was discovered late, 4 months after the onset of the disease. As recently shown in four children with MIS-C after SARS-CoV-2 infection and a girl with Hashimoto thyroiditis after BNT162b2 vaccination, we found elevated functional autoantibodies against G-protein-coupled receptors that may be important for pathophysiology but are not conclusive for the diagnosis of MIS-C. Conclusion: We are aware that a misattribution of MIS-V as a severe complication of coronavirus vaccination can lead to increased vaccine hesitancy and blunt the global COVID-19 vaccination drive. However, the pediatric population is at a higher risk for MIS-C and a very low risk for COVID-19 mortality. The publication of such cases is very important to make doctors aware of this complication of the vaccination, so that therapy with intravenous immunoglobulins can be initiated at an early stage.
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Rajeswari, G., P. Satya Gopal, and G. B. V. V. S. V. Prasad. "Prognostic significance of various biochemical markers in Corona virus disease (COVID)-19: A tertiary care hospital study in Kakinada East Godavari district, Andhra Pradesh." International Journal of Clinical Biochemistry and Research 8, no. 3 (2021): 226–29. http://dx.doi.org/10.18231/j.ijcbr.2021.047.
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This study was conducted on covid 19 patients who admitted in various wards in tertiary care centre (Government general hospital, Kakinada) E.G, Dt, Andhra Pradesh, from the 1st November 2020 to 15th January 2021 before Immunization. And divided in to two groups male and female cases. This study involves estimation of Biochemical profile in all the admitted patients to predict the severity of the covid 19 disease at the time of admission in to the Hospital. To analyse and estimate the serum inflammatory markers like D dimer, Ferritin, C-Reactive Protein, LFT and RFT in Covid 19 patients and evaluate the relationship of inflammatory marker se D-Dimer with other inflammatory markers like Ferritin, CRP and biochemical markers like Creatinine and liver enzymes (OT, PT). We retrospectively analysed the Clinical features and lab parameters of 393 cases of Covid-19 admitted to tertiary care hospital GGH Kakinada. Plasma d dimer, serum CRP and ferritin were significantly raised in total covid 19 patients and more increased in males when compared with females. Biochemical parameters like creatinine and liver enzymes also elevated in total cases and more increased in males as compared with females suggest organ dysfunction and systemic inflammation. The most typical finding in patients with COVID-19 coagulopathy is an increased D dimer concentration, and the relationship between D-dimer levels and the other markers of inflammation like Ferritin, CRP in COVID-19 shows disease progression. We conclude that biochemical monitoring of Covid-19 patients helps in identifying critically ill patients even earlier, aiming to reduce mortality and improve the recovery rate.
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Canak, Grozdana, Nadica Kovacevic, Jovan Vukadinov, et al. "Clinical features, treatments and outcomes of influenza A (H1N1) 2009 among the hospitalized patients in the clinic for infectious diseases in Novi Sad." Vojnosanitetski pregled 70, no. 2 (2013): 155–62. http://dx.doi.org/10.2298/vsp1302155c.
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Background/Aim. Most infections caused by influenza A (H1N1) 2009 virus are presented by mild respiratory symptoms. However, some patients required admission to the intensive care unit (ICU). In this article we aimed to describe the clinical and laboratory characteristics of the patients with influenza A (H1N1) 2009, antiviral therapy use, the disease outcome and risk factors associated with the severe disease. Methods. The patients with the signs and symptoms of novel influenza A (H1N1) 2009, admitted to the Clinic for Infectious Disease in Novi Sad, were evaluated. The study included 293 patients hospitalized between October 2009 and February 2010. Basic demographic data, underlying medical conditions, clinical signs and symptoms, duration of the disease before the admission, laboratory tests, radiographic findings, treatment, and the final outcome (survived, died) were all noted. Factors associated with severe disease requiring ICU admission were determined by comparing the ICU cases with control groups of the patients admitted to the hospital but not to ICU. Results. The average age of the patients was 32.72 years. A total of 114 (38.9%) of the patients had an underlying medical condition. Asthma and chronic obstructive pulmonary disease were present in 44 (15.01%) of the patients, chronic cardiovascular diseases in 28 (9.56%), diabetes mellitus in 16 (5.46%), malignity in 15 (4.44%) of the patients and 11 (3.75%) of the patients were pregnant. Fever was registered in 282 (96.24%), myalgias in 119 (40.61%), headache in 48 (16.38%), cough in 240 (81.91%), sore throat in 25 (8.53%), runny nose and sneezing in 17 (5.8%) and dyspnea in 110 (37.54%) of the patients. A total of 192 (65.53%) had radiological findings that were consistent with pneumonia. A total of 154 (56.61%) of the patients received antiviral therapy within 48 h. A total of 280 (96.24%) patients were discharged and 13 (4.44%) were transferred to ICU. Fatal outcome was noticed in 2/13 (15.3%) ICU treated patients and 11/13 (84.7%) patients survived. The median time from the onset of illness to the initiation of antiviral treatment was 7.1 days for the patients admitted to ICU and 3.2 days for non-ICU patients (p < 0.05). Low blood oxygen saturation (SaO2 ? 92%) was more common in ICU admitted patients, 10/13 (76,92%), compared to 28/280 (10%) non-ICU admitted ones (p < 0.01). Serum C-reactive protein (CRP) levels > 200 mg/L were noticed in 9/13 (69.23%) patients admitted to ICU and 85/280 (30.35%) patients who were not (p < 0.05). Conclusion. Most novel influenza A (H1N1) 2009 infections presented mild respiratory disease. Prompt antiviral therapy in patients with A (H1N1) virus infection seem to be the best approach to avoid serious form of the disease. Special attention should be payed to patients having low level of peripheral oxygen saturation and raised CRP serum level.
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Mehboob, Saima, Syed Hamid Hussein Banori, and Zahir Ullah. "Clinical Features, Laboratory Characteristics, and Outcome of Patients Admitted With COVID-19 Infection; A Single-Center Experience." ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 27, no. 03 (2022): 109–15. http://dx.doi.org/10.58397/ashkmdc.v27i03.479.
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Objective: To determine the clinical features, laboratory variants, and outcome of patients with Corona virus Dis- ease-2019 (COVID-19) infection.
 Methods: A descriptive, single-center case series was conducted between October to December 2020. It included patients diagnosed with COVID-19 infection via Polymerase Chain Reaction (PCR). Patients were recruited through non-probability convenience-based sampling. After history and detailed examination of the patients, their demographic and clinical characteristics, including complete blood count (CBC), renal & electrolytes profile, inflammatory markers like C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimers were recorded using a structured questionnaire. Patients were managed according to the severity of the disease and disease progression was monitored regularly. Treatment offered to these patients was based on their presentation and severity of the disease.
 Results: Out of 1092 patients, 77% were males. Most of them were diabetic (71.0%) and aged between 51-70 years (58.97%). Furthermore, 1051 of the total enrolled cases were symptomatic and had shortness of breath (94.32%), dry cough (91.20%), anorexia (91.20%), fatigue (90.65%), and etc. Among the laboratory parameters, raised C-reactive protein (CRP) was found in 96.24% of patients while leukocyte count, Alkaline phosphatase (ALP), D-dimers, ferritin and lactate dehydrogenase (LDH) levels were elevated in 89.37%, 71.61%, 68.77%, 56.86%, and 44.04% respectively. Hyponatremia was also observed in 53.75% patients. Most patients (32.60%) had oxygen saturation between 80 to 89%, while it was 80% among 20.42% patients. Moreover, 31.05% patients were categorized as having mild disease, 23.68% had moderate severity, and 24.84% had severe disease on the basis of clinical criteria. About 20.42% were critical and had respiratory failure. The recovery rate was high (96.0%), and the mortality rate was only 4.0%.
 Conclusion: We observed dynamic changes in the clinical and laboratory features of the COVID-19 patient’s ad- mitted at District Health Quarter in Charsada, highlighting the significance of each of these parameters for individual patient’s recovery and survival.
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Begum, Momtaz, Bidith Ranjan Deb, Shantanu Das, et al. "Clinical Characteristics of the Patients with Corona Virus Disease 2019 in Sylhet District of Bangladesh." Bangladesh Journal of Infectious Diseases 11, no. 1 (2024): 45–51. http://dx.doi.org/10.3329/bjid.v11i1.73295.
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Background: Bangladesh has suffered a lot corona virus disease 2019 (COVID 19), but clinical data on COVID 19 is fewer still. Objective: The purpose of the present study was to determine the patterns of clinical characteristics of confirmed COVID 19 patients in Sylhet to contribute as information resource of our country. Methodology: This cross sectional study was conducted in the inpatient Department of Medicine of Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet, Bangladesh to evaluate the clinical characteristics among the COVID 19 patients from July 2020 to December 2020 by purposive sampling technique. For the purpose a total 75 RT PCR positive COVID 19 patients were included in the study and data were collected with a semi-structured questionnaire. Results: The results showed that,85.3%% patients presented with fever, 46.7% with cough and 38.7.0% with dyspnoea. On examination 85.3% had fever, 38.7% had tacypnea, 38.7% had low SpO2 at room temperature, 57.3% had vesicular breath sound. Lab investigations (biochemical) mostly needed at admission for management of the patients were complete blood count (CBC) in 93.3% case, c reactive protein (CRP) in 76.0% case, D-dimer in 68.0% case, random blood sugar (RBS) in 56.0% case, serum creatinine in 54.7%, serum ferritin in 42.7%, serum electrolytes in 42.7%, electro cardiogram (ECG) in 38.7%. According to clinical classification for case management of COVID 19 58.7%, 21.3%, 16%, 2.7%, 1.3% were successively diagnosed as mild, moderate, severe, asymptomatic and critical COVID 19 infection. Among the study population 80.0% patient was in need of antibiotic, 60.0% anti coagulant, 48.0% steroid, 38.7% oxygen, 2.7% antiviral drugs, 1.3% mechanical ventilation during their treatment. Conclusion: The results obtained from this study could urge more study on it to provide updated knowledge as well as find potential treatment strategies for this pandemic disease. Bangladesh Journal of Infectious Diseases, June 2024;11(1):45-51
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Blomberg, Bonnie, Lisa Reidy, Maria Romero, et al. "Obesity effects serum levels of SARS-CoV-2-specific antibodies in COVID-19 patients." Journal of Immunology 206, no. 1_Supplement (2021): 62.10. http://dx.doi.org/10.4049/jimmunol.206.supp.62.10.
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Abstract SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-2), cause of COVID-19 (Coronavirus Disease of 2019), represents a significant risk to people living with pre-existing conditions including increased inflammatory responses and consequent dysfunctional immunity. In these studies we evaluated the effects of obesity, a condition associated with chronic systemic inflammation, on the secretion of SARS-CoV-2-specific IgG antibodies in the blood of COVID-19 patients. Results showed that SARS-CoV-2 IgG antibodies are negatively associated with Body Mass Index (BMI) in COVID-19 obese patients, as expected based on the known effects of obesity on humoral immunity, as we have previously published for the response to the influenza vaccine. Antibodies in COVID-19 obese patients are also negatively associated with serum levels of pro-inflammatory and metabolic markers of inflammaging and pulmonary inflammation, such as SAA (serum amyloid A protein), CRP (C-reactive protein) and ferritin, but positively associated with NEFA (nonesterified fatty acids). These results altogether help to identify an inflammatory signature with strong predictive value for immune dysfunction that could be targeted to improve humoral immunity in individuals with obesity as well as with other chronic inflammatory conditions.
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Tire, Yasin, Mehmet Akif Yazar, and Said Sami Erdem. "Can changes in platelet count, mean platelet volume, and platelet distribution width be used to determine the severity of COVID-19?" Medical Science and Discovery 8, no. 10 (2021): 581–85. http://dx.doi.org/10.36472/msd.v8i10.611.
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Objective: We aimed to investigate the relation of platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) with other acute phase reactants in COVID-19 new corona virus.
 Material and Methods: Thirty one patients with COVID-19 were included in to study. There were three groups as outpatient (Group 1, OP)(n=6), hospital (Group 2, H)(n=16) and intensive care unit (Group 3, IC)(n=9) in this analytic study.
 Results: WBC (White Blood Cell), CRP (C-Reactive Protein) values were significantly different in all groups. PDW values were significantly lower in Group 3 than Group 1, 2. The result of ROC analysis was 10.9 as a cut-off value (Area under the curve, AUC)=0.407)
 Conclusions: This study indicates that lower PDW may frequently develop in COVID-19 cases and there is a relation between thrombocytosis and acute phase reactants, that is, the inflammatory response. So we can offer that PDW should be used as a marker of Covid-19 disease severity, but it needs more studies in the future.
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Wang, Ye, Bo Yi, Shujun Wang, Xiaolin Chen, and Zhongyuan Wen. "Effect of hyperglycemia on the immune function of COVID-19 patients with type 2 diabetes mellitus: a retrospective study." PeerJ 10 (December 16, 2022): e14570. http://dx.doi.org/10.7717/peerj.14570.
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Purpose To analyze the clinical characteristics and immune function parameters and to explore the effect of hyperglycemia on the immune function in patients with Corona Virus Disease 2019 (COVID-19) with type 2 diabetes mellitus (T2DM). Methods This retrospective study included patients with COVID-19 with T2DM hospitalized in Renmin Hospital of Wuhan University between January 31, 2020, and February 10, 2020. The clinical data were collected and patients were divided into a well-controlled group (blood glucose 3.9–10.0 mmol/L) and a poorly-controlled group (blood glucose >10.0 mmol/L). The differences in routine blood tests, peripheral lymphocyte subsets, humoral immune components, C-reactive protein (CRP) level, and cytokines were compared, and the correlation between blood glucose and immune parameters as well as the severity of the disease was analyzed. Results A total of 65 patients with COVID-19 and T2DM were included in the final analysis. Compared with the well-controlled group, patients in the poorly-controlled group had decreased lymphocytes, CD16+ 56+ NK cells, CD3+ T cells, CD8+ T cells and increased neutrophil percentage, IL-6 levels, CRP levels and serum concentration of IgA. Blood glucose was inversely correlated with CD16+ 56+ NK cells, CD3+ T cells, CD4+ T cells, and CD8+ T cells and positively correlated with IL-6 and CRP levels. There was a positive correlation between blood glucose and the severity of the COVID-19. Conclusion Hyperglycemia will aggravate the immune dysfunction of COVID-19 patients with T2DM and affect the severity of COVID-19.
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Frasca, Daniela, Lisa Reidy, Carolyn Cray, et al. "Influence of obesity on serum levels of SARS-CoV-2-specific antibodies in COVID-19 patients." PLOS ONE 16, no. 3 (2021): e0245424. http://dx.doi.org/10.1371/journal.pone.0245424.
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SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-2), cause of COVID-19 (Coronavirus Disease of 2019), represents a significant risk to people living with pre-existing conditions associated with exacerbated inflammatory responses and consequent dysfunctional immunity. In this paper, we have evaluated the influence of obesity, a condition associated with chronic systemic inflammation, on the secretion of SARS-CoV-2-specific IgG antibodies in the blood of COVID-19 patients. Our hypothesis is that obesity is associated with reduced amounts of specific IgG antibodies. Results have confirmed our hypothesis and have shown that SARS-CoV-2 IgG antibodies are negatively associated with Body Mass Index (BMI) in COVID-19 obese patients, as expected based on the known influence of obesity on humoral immunity. Antibodies in COVID-19 obese patients are also negatively associated with serum levels of pro-inflammatory and metabolic markers of inflammaging and pulmonary inflammation, such as SAA (serum amyloid A protein), CRP (C-reactive protein), and ferritin, but positively associated with NEFA (nonesterified fatty acids). These results altogether could help to identify an inflammatory signature with strong predictive value for immune dysfunction. Inflammatory markers identified may subsequently be targeted to improve humoral immunity in individuals with obesity and in individuals with other chronic inflammatory conditions.
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Hutagalung, Albert Frido, and Fania Debora. "Pemakaian Toculizumab Anti IL-6 pada Tatalaksana COVID-19: Sebuah Serial Kasus." Majalah Anestesia & Critical Care 40, no. 1 (2022): 45–50. http://dx.doi.org/10.55497/majanestcricar.v40i1.232.
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Pendahuluan: Angka kematian pada pasien Corona Virus Disease (COVID-19) masih tinggi di Indonesia, tetapi belum ada terapi baku emas yang bisa digunakan untuk mengobati pasien COVID-19. Salah satu pilihan terapi yang dapat digunakan adalah Anti IL-6 Tocilizumab (TCZ).
 Ilustrasi Kasus: Pada laporan kasus ini, dilakukan pengamatan sejak Mei hingga Juli 2020 terhadap tujuh pasien terkonfirmasi COVID-19 dengan onset sakit bervariasi, yang baru dirawat setelah 3-7 hari dari timbulnya gejala. Terapi yang diberikan adalah terapi standar COVID-19 sesuai pedoman gugus tugas COVID-19 ditambah dengan anti-IL-6 Tocilizumab 80 mg intravena, dengan waktu mulai pemberian bervariasi antara hari ke 1-9 hari perawatan di rumah sakit. Fase perjalanan penyakit COVID-19 sebelum diterapi mulai dari fase II sampai fase III, dengan jumlah pasien meninggal 3 orang dan selamat 4 orang.
 Simpulan: TCZ memberikan hasil perubahan klinis dan laboratorium penurunan kadar C-Reactive Protein (CRP) pada beberapa pasien tetapi angka luaran untuk selamat masih perlu ditingkatkan lagi dan juga dipengaruhi oleh waktu yang tepat untuk pemberian TCZ, dukungan organ seperti oksigenasi, bantuan ventilator, dan terapi standar COVID-19 lainnya.
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Muti, Abdullah Al. "The Clinical and Laboratory Profile of RT-PCR Positive Covid-19 Patients in District Hospital in Bangladesh." Scholars Journal of Applied Medical Sciences 11, no. 05 (2023): 879–84. http://dx.doi.org/10.36347/sjams.2023.v11i05.012.
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Objective: To assess the clinical and laboratory profile of RT-PCR positive covid-19 patients in district hospital in Bangladesh. Method: This cross-sectional study was done in 250 Bed General Hospital, Tangail, Bangladesh from January 2021 to Dec 2021. We included 95 patients having clinical symptoms and signs of COVID-19, above the age of 18 years, irrespective of sex. We defined probable and confirmed COVID-19 case according to ‘National Guidelines on Clinical Management of Corona Virus Disease 2019 (COVID-19) Version 7.0, published on 28 May 2020.10 Data were collected in structured questionnaire from patients and hospital records. All laboratory tests were performed according to the clinical judgement. Laboratory assessments consisted of RTPCR for COVID-19, complete blood count, coagulation tests, assessment of liver and renal function, C-reactive protein, procalcitonin, lactate dehydrogenase (LDH) and ferreting. Radiological assessments included chest x-ray and high resolution computed tomography (HRCT) scan. Results: During the study, majority were belong to >56 years age group, 43.6% were female and 56.4% were male. Plus, majority didn’t get their vaccination, 89.60%. In addition to that, 42.1% had DM followed by HTN cases was 36.8%, 8.4% had previously history of stroke, 10.5% had CKD. 69.5% had anorexia followed by 58.9% had nausea, 28.4% had vomiting, 14.7% had Abdominal pain. On laboratory investigations, we found most of the patients had elevated levels of C-reactive protein and D-dimer was positive in 99% cases. Plus,75% patient presents emergency signs with SpO2 <90% or respiratory rate >24. Conclusion: Considering the data of this investigation, it can be stated that, COVID-19 impacted mostly senior male patients. Most of them were diabetic and hypertensive. Common symptoms anorexia sore throat, diarrhea, vomiting, nausea, stomach ache. Key test results included lymphopenia, elevated CRP, positive D-dimer. Notwithstanding that most didn’t take ......
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Turan, Yasemin. "A retrospective evaluation of the effects of COVID-19 vaccines on the CRP, IL-6, ferritin, and D-dimer levels of patients admitted to the COVID intensive care unit." Medicine Science | International Medical Journal 14, no. 1 (2025): 74. https://doi.org/10.5455/medscience.2024.10.129.
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With its elevated mortality and morbidity rates and various complications, the highly contagious Corona Virus Disease - 2019 (COVID-19) infection that developed in association with the agent severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) led to the world’s most deadly pandemic. However, COVID-19-related mortality declined with the development of vaccines. Elevated D-dimer, C-reactive protein (CRP), ferritin, interleukin-6 (IL-6) values in patients with COVID-19 pneumonia are markers that need to be monitored in terms of both severity of infection and prognosis. This article investigates the relationship between COVID-19 vaccination and these parameters. This retrospective, cross-sectional study involved patients aged over 18 diagnosed with COVID-19 pneumonia and admitted to a tertiary COVID intensive care unit. These were assigned to vaccinated or unvaccinated groups, as applicable. The vaccinated patient group was also divided into two subgroups, those who had been given the inactive COVID-19 vaccine and those administered the messenger RNA (mRNA) COVID-19 vaccine. Median age and the proportion of female patients (54.1%) were both higher in the vaccinated patient group. Higher rates of chronic obstructive pulmonary disease and hypertension were also observed in the vaccinated group. Median length of hospital stay and mortality rates (85.5%) were higher in the unvaccinated patient group. The median length of stay was lower in both the group given twin doses of mRNA COVID-19 vaccine and in the patients given the inactive COVID-19 vaccine. Significantly lower median D-dimer levels were determined in the vaccinated patient group (1.3 mg/L) and in the patients administered two doses of inactive COVID-19 vaccine (1.1 mg/L). D-dimer levels among patients admitted to the COVID intensive care unit were higher in the unvaccinated group and in those who had been given a single dose of inactive COVID-19 vaccine, and this represented a risk in terms of mortality.
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Elango, Karthick, Sathya Selvarajan, and Sowmya Krishnamurthy. "Comparative analysis of various laboratory biomarkers based on the severity of COVID-19 in a tertiary care hospital in South India." Indonesian Journal of Medical Laboratory Science and Technology 6, no. 1 (2024): 35–43. http://dx.doi.org/10.33086/ijmlst.v6i1.5389.
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COVID-19 (Corona Virus Disease 2019) was a life-changing pandemic with impact on social, environmental, health, and economic issues. Various inflammatory and hematological biomarkers studied individually or in combination in the literature have shown significant results with regard to COVID-19 pathology, severity, and prognosis. Yet the question of interest is how covid-19 inflammatory cascade impacts the interlink between the biomarkers during different stages. This study aims to retrospectively analyse ferritin, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin, blood urea nitrogen (BUN), creatinine, D-dimer, Lactate Dehydrogenase (LDH), C Reactive Protein (CRP) and Interleukin-6 (IL-6) levels between two groups based on COVID-19 severity. A retrospective cross-sectional study was conducted with laboratory data of COVID-19 patients admitted at Sri Ramachandra Medical College Hospital, India. The sample size was 104 [Group1: severe disease, n=52; Group-2: mild disease, n=52]. After normality testing, data were compared between the two groups followed by correlation analysis between the variables. A p<0.05 was considered statistically significant. On comparison, Group 2 (severe COVID-19 disease) showed significant difference in the levels of all the biomarkers (p<0.005) except Creatinine (p<0.128) when compared with Group 1 (mild COVID-19 disease). Significant correlation was obtained between all biomarkers (p<0.005) except creatinine. The correlation analysis primarily explains the inflammatory cascade involved in disease. Ferritin appears to have a standalone effect on disease severity, progression, organ dysfunction. This understanding can be used to provide better and more timely care.
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Sadhwani, Nisha, Nupur Shah, Mahir Modi, et al. "Study of Characteristics of COVID-19 Patients with Fatal Outcome during Wave-2 from a Tertiary Care Center in Western India." Journal of the Association of Physicians of India 71, no. 03 (2023): 30–34. http://dx.doi.org/10.5005/japi-11001-0196.
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Background: A large surge of intensive care unit (ICU) admissions leading to mortal outcome was observed in wave-2 of coronavirus disease 2019 (COVID-19) due to the higher virulence of the Delta variant of the COVID-19 virus, which led to the scarcity of resources in hospitals. This study was done to observe the clinical characteristics of COVID-19 patients with fatal outcome. Materials and methods: We conducted a retrospective cross-sectional study in adults with COVID-19 pneumonia having fatal outcome during wave-2 of COVID-19, and their clinical characteristics were studied. Results: Out of 136 patients included in the study, the most common risk factors leading to adverse outcome were in the male gender, age (middle and elderly), with hypertension and diabetes mellitus (DM) as predominant comorbidities, early onset dyspnea, high C-reactive protein (CRP), high neutrophil to lymphocyte ratio (NLR), high D-dimer, bilateral lower zone involvement of lungs in chest X-ray (CXR), and development of acute kidney injury (AKI). Conclusion: The characteristics of the severely ill COVID-19 patients highlighted in the study could help clinicians in the early identification and management of high-risk patients. This study would help with resource planning and preparation for further COVID-19 waves and future pandemics
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Alsaeed, Gihad, Taqwa Ahmed, Faith Moore, et al. "Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2." American Journal of Health, Medicine and Nursing Practice 6, no. 1 (2021): 51–58. http://dx.doi.org/10.47672/ajhmn.674.
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Second wave of the new coronavirus (SARS-CoV-2) has been declared throughout the world. It has been always thought that children are the least affected group. A new childhood disease, referred to as MIS-C (Multisystem Inflammation Syndrome) or PIMS-TS (Pediatric Inflammatory Multiorgan Syndrome Temporally related to SARS-CoV-2) was first recognized in April 2020. Shock and multiorgan failure affected some of those children that required intensive care; others were clinically similar to Kawasaki disease or toxic shock. The clinical evidence suggests that this inflammatory multisystem syndrome is temporally associated with severe acute respiratory syndrome corona virus 2. Many clinical uncertainties regarding this new disease rapidly became apparent in prevalence, clinical phenotypes, variable severity, clinical course, and optimal management. We aim to increase awareness of this syndrome regarding the diagnosis and management of children with suspected PIMS-TS by presenting two clinical cases and illustrating the available medical literature in regards to establishing the diagnosis and the appropriate therapeutic interventions. SARS-Cov-2 related medical impacts on children seem not well clarified yet. When a PIMS-TS case is suspected then full investigations should be done, children who have persistent fever associated with abdominal pain, diarrhea ,vomiting ,cough, neurologic symptoms should have primary blood tests to identify PIMS-TS: full blood count, CRP: C-reactive protein, BUN: Blood Urea Nitrogen, Cr: Creatinine, Electrolytes and liver function. Multidisciplinary team approach seems mandatory from the very beginning. Despite the use of IVIG in the treatment of all diagnosed cases, steroids in regular doses could be a good alternative and requires further investigative evaluations.
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Khushbun, Nahar Layla, Yeasmin Shahanara, Ahmed Khan Sharif, Uddin Chowdhury Masba, Binte Azad Afrina, and Yeasmin Mukta Farzana. "Biochemical parameters of mild, moderate & severe COVID-19 patients." World Journal of Advanced Research and Reviews 11, no. 2 (2021): 031–39. https://doi.org/10.5281/zenodo.5202893.
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<strong>Background and objectives</strong>: Coronavirus disease 2019 (COVID-19) is affecting millions of people world-wide. It is caused by the severe acute respiratory syndrome corona virus 2(SARS-CoV-2). The laboratory findings are very important to assess the progress of the disease. The present study is aimed to discuss the biochemical parameters among mild, moderate and severe COVID-19 patients. <strong>Materials and methods:</strong> A cross sectional study were conducted in the Department of Physiology, Dhaka Medical College, Dhaka from January 2020 to December 2020. After obtaining ethical clearance, a total of 100 real time-polymerase chain reaction (RT-PCR) COVID-19 positive patients were selected from Dhaka Medical College Hospital. With all aseptic precautions, 10 ml of venous blood was collected from ante-cubital vein. D-dimer, prothrombin time, C-reactive protein (CRP), lactate dehydrogenase (LDH), serum ferritin, random blood glucose (RBG), serum creatinine, serum glutamic-pyruvic-transaminase (SGPT) and serum albumin measured in the Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. CRP was measured by Immunoturbidimetric method, serum ferritin was estimated by Chemiluminescent microparticle immunoassay. STA-neoplastine CI plus used with STA-R analyzer was used for determination of prothrombin time. D-dimer was estimated by Immunofluorescence Assay method. Serum LDH is measured by Dimention clinical chemistry system, serum albumin is measured by bromocresol purple dye binding method, serum creatinine is measured by Jaffe alkaline picrate method and serum SGPT is measured by colourmetric (IFCC 1980) method and RBG is measured by enzymatic colorimetric method (GOD-PAP). Data were recorded in a pre-designed structured data collection form. For statistical analysis, ANOVA followed by Bonferroni test, Chi square test, Spearman’s rho correlation coefficient test was performed as applicable using SPSS for windows version 25.0. <strong>Results:</strong> By analyzing biochemical parameters of mild, moderate and severe RT-PCR positive 100 COVID-19 patients revealed evaluation of biochemical parameters shows severity of the disease was significantly associated with CRP, SGPT, S. Creatinine, LDH, Ferritin, D-dimer & Prothrombin time. No significant association was found with RBG & S. Albumin. Bonferroni correction following ANOVA was performed to compare between each group. Spearman’s correlation reveals statistically significant strong positive correlation with CRP, Ferritin & D-dimer, moderate positive correlation with S. Creatinine, LDH and mild positive correlation with SGPT & Prothrombin time. <strong>Conclusion:</strong> This study showed D-dimer, prothrombin time, CRP, LDH, ferritin, serum creatinine and SGPT are significantly associated with the severity of the illness that is higher in severe group in comparison to mild and moderate groups. So, comprehensive analysis of the biochemical parameters will be very helpful for early identification & better management of severe disease<strong>.</strong>
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Mishra, Shubham, Vikas Kumar Gupta, and Romel Tickoo. "Association of Inflammatory Markers with the Severity of COVID-19." CHRISMED Journal of Health and Research 11, no. 3 (2024): 146–51. https://doi.org/10.4103/cjhr.cjhr_87_24.
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Abstract Introduction: Corona virus disease 2019 (COVID-19) is caused by SARS-CoV-2, a newly emergent corona virus. It was first recognized in Wuhan, China, in December 2019, and was reported to cause severe acute respiratory syndrome. Accumulating evidence has suggested that inflammatory responses play a critical role in the progression of COVID-19. Inflammatory responses triggered by rapid viral replication of SARS-CoV-2 and cellular destruction can recruit macrophages and monocytes and induce the release of cytokines. Inflammatory markers such as serum Ferritin, C-reactive protein (CRP) and Interleukin-6 (IL-6), D-dimer have been reported to be significantly associated with the high risks of the development of severe Covid19. Objective: To find out association of inflammatory markers with the severity of covid-19. Find out association of inflammatory markers with the severity of covid-19.To find out which inflammatory marker is associated more with disease severity. Materials and Methods: The Study was conducted in In-patient Department of Internal Medicine, Respiratory medicine and intensive care unit of Max Super Speciality hospital complex ,Saket,New Delhi. It was a hospital-based, prospective observational, cross sectional study. Patients admitted with COVID-19 in Max Super Specialty Hospital Complex, Saket during this study period, fulfilling the inclusion and exclusion criteria enrolled, Informed consent has been taken from all of them. This study approved by Institutional Ethical committee. The data entered in MS EXCEL spreadsheet and analysis have been done using Statistical Package for Social Sciences (SPSS) version 25.0.P value <0.05 was considered as statistically significant. Results: In the study, we have analyzed data of 425 patients, in which 59% of the patients were male while 40 % were female. Mean age of patients was 57 years. Various markers were taken under study viz;IL-6,with mean and SD as 39.65 pg/ml and 41.12 pg/ml, ferritin, D-dimer with mean 290.56 ng/ml and 421.16 ng/ml respectively. SpO2% level of patients has been measured with mean 93.28% and SD 5.01%. Pearson correlation coefficient were calculated between various markers and Spo2 (%) level of patients. Markers showing negative correlation viz; IL-6 (r = -0.369), CRP (r = -0.460). Mean level of all markers are more in severe group, also showing significant difference from non-severe group except D-dimer. Conclusion: It is feasible that inflammatory markers may still be effective and favorable in future clinical decision criteria. Measurement of inflammatory markers might aid clinicians to guide and evaluate COVID-19 severity, prognosis of disease and potential therapeutic targets.
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Trifonova, Ivelina, Iveta Madzharova, Neli Korsun, et al. "Bacterial and Viral Co-Infections in COVID-19 Patients: Etiology and Clinical Impact." Biomedicines 12, no. 10 (2024): 2210. http://dx.doi.org/10.3390/biomedicines12102210.
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Background: Mixed infections can worsen disease symptoms. This study investigated the impact of mixed infections with viral and bacterial pathogens in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Using the in-house multiplex PCR method, we tested 337 SARS-CoV-2 positive samples for co-infections with three bacterial and 14 other viral pathogens. Results: Between August 2021 and May 2022, 8% of 337 SARS-CoV-2-positive patients had bacterial co-infections, 5.6% had viral co-infections, and 1.4% had triple mixed infections. The most common causes of mixed infections were Haemophilus influenzae (5.93%) and respiratory syncytial virus (RSV) (1.18%). Children < 5 years old had more frequent co-infections than adults < 65 years old (20.8% vs. 16.4%), while adults showed a more severe clinical picture with a higher C-reactive protein (CRP) level (78.1 vs.16.2 mg/L; p = 0.033), a lower oxygen saturation (SpO2) (89.5 vs. 93.2%), and a longer hospital stay (8.1 vs. 3.1 days; p = 0.025) (mean levels). The risk of a fatal outcome was 41% in unvaccinated patients (p = 0.713), which increased by 2.66% with co-infection with two pathogens (p = 0.342) and by 26% with three pathogens (p = 0.005). Additionally, 50% of intensive care unit (ICU) patients had a triple infection, compared with only 1.3% in the inpatient unit (p = 0.0029). The risk of death and/or ICU admission was 12 times higher (p = 0.042) with an additional pathogen and increased by 95% (p = 0.003) with a third concomitant pathogen. Conclusions: Regular multiplex testing is important for prompt treatment and targeted antibiotic use.
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Haryati, Haryati, Mohamad Isa, Ali Assagaf, Ira Nurrasyidah, and Erna Kusumawardhani. "Clinical Characteristics of Hospitalized Individuals Dying with COVID-19 in Ulin Regional Hospital Banjarmasin." Jurnal Respirasi 7, no. 1 (2021): 1. http://dx.doi.org/10.20473/jr.v7-i.1.2021.1-7.
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Background: Corona Virus Disease (COVID-19) has become a global pandemic and has spread to more than 200 countries including Indonesia. South Kalimantan is one of the provinces in Indonesia that has a high COVID-19 mortality rate (case fatality rate 4.1%). Information about characteristic of mortality patients with SARS-CoV-2 infection in Indonesia was limited. The objective of this study to describe clinical characteristics of COVID-19-confirmed deaths at Ulin Regional Hospital Banjarmasin, as a referral hospital in South KalimantanMethods: Medical records of 108 hospitalized patients dying with COVID-19 between March until August 2020 were collected. The recorded information included gender, age, onset and severity of disease, comorbidities, symptoms, signs, and laboratory findingsResults: The 108 confirmed cases of COVID-19 deaths were mostly male (73.1%) aged <65 years old (85.2%). About 84% of the cases had at least one comorbidity or more, like hypertension (44.4%), obesity (38%), and diabetes mellitus (32.4%). Common early symptoms were fever (91.7%) and shortness of breath (89.8%). Laboratory findings included lympocytopenia and eosinophilopenia (80.6% and 72.2%), increased neutrophil lymphocyte ratio (NLR; 86.1%), decreased absolute lymphocyte count (ALC; 72.2%), and hyponatremia (55.6%). Elevated C-reactive protein (CRP; 92.6%), lactate dehydrogenase (LDH; 91.7%), serum glutamic oxaloacetic transaminases (SGOT; 82.4%), and creatinine levels (57.4%). The majority of non survivors were severe-critical stage with severe acute respiratory distress syndrome (ARDS).Conclusion: In this depictive study, patients with comorbidities and severe-critical stage are at risk of death. Laboratory abnormalities were common in non survivors. Shortness of breath may indicate poor prognosis of COVID-19.
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Khushbun Nahar Layla, Shahanara Yeasmin, Sharif Ahmed Khan, Masba Uddin Chowdhury, Afrina Binte Azad, and Farzana Yeasmin Mukta. "Biochemical parameters of mild, moderate & severe COVID-19 patients." World Journal of Advanced Research and Reviews 11, no. 2 (2021): 031–39. http://dx.doi.org/10.30574/wjarr.2021.11.2.0348.
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Background and objectives: Coronavirus disease 2019 (COVID-19) is affecting millions of people world-wide. It is caused by the severe acute respiratory syndrome corona virus 2(SARS-CoV-2). The laboratory findings are very important to assess the progress of the disease. The present study is aimed to discuss the biochemical parameters among mild, moderate and severe COVID-19 patients. Materials and methods: A cross sectional study were conducted in the Department of Physiology, Dhaka Medical College, Dhaka from January 2020 to December 2020. After obtaining ethical clearance, a total of 100 real time-polymerase chain reaction (RT-PCR) COVID-19 positive patients were selected from Dhaka Medical College Hospital. With all aseptic precautions, 10 ml of venous blood was collected from ante-cubital vein. D-dimer, prothrombin time, C-reactive protein (CRP), lactate dehydrogenase (LDH), serum ferritin, random blood glucose (RBG), serum creatinine, serum glutamic-pyruvic-transaminase (SGPT) and serum albumin measured in the Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. CRP was measured by Immunoturbidimetric method, serum ferritin was estimated by Chemiluminescent microparticle immunoassay. STA-neoplastine CI plus used with STA-R analyzer was used for determination of prothrombin time. D-dimer was estimated by Immunofluorescence Assay method. Serum LDH is measured by Dimention clinical chemistry system, serum albumin is measured by bromocresol purple dye binding method, serum creatinine is measured by Jaffe alkaline picrate method and serum SGPT is measured by colourmetric (IFCC 1980) method and RBG is measured by enzymatic colorimetric method (GOD-PAP). Data were recorded in a pre-designed structured data collection form. For statistical analysis, ANOVA followed by Bonferroni test, Chi square test, Spearman’s rho correlation coefficient test was performed as applicable using SPSS for windows version 25.0. Results: By analyzing biochemical parameters of mild, moderate and severe RT-PCR positive 100 COVID-19 patients revealed evaluation of biochemical parameters shows severity of the disease was significantly associated with CRP, SGPT, S. Creatinine, LDH, Ferritin, D-dimer & Prothrombin time. No significant association was found with RBG & S. Albumin. Bonferroni correction following ANOVA was performed to compare between each group. Spearman’s correlation reveals statistically significant strong positive correlation with CRP, Ferritin & D-dimer, moderate positive correlation with S. Creatinine, LDH and mild positive correlation with SGPT & Prothrombin time. Conclusion: This study showed D-dimer, prothrombin time, CRP, LDH, ferritin, serum creatinine and SGPT are significantly associated with the severity of the illness that is higher in severe group in comparison to mild and moderate groups. So, comprehensive analysis of the biochemical parameters will be very helpful for early identification & better management of severe disease.
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Mitra, Sona, Arti Muley, Ashish Bavishi, Geetika Patel, and Amal Bhattacharya. "Characteristics and Outcomes of COVID-19 during the Third Wave of COVID Pandemic: A Single-center Descriptive Study." Journal of The Association of Physicians of India 71, no. 2 (2023): 37–40. http://dx.doi.org/10.5005/japi-11001-0173.
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Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has been causing a global pandemic of Coronavirus (COVID-19) disease in recurring waves. On November 24, 2021, a new SARS-CoV-2 variant (B.1.1.529) was identified in South Africa. We aimed to study the clinical profile, laboratory parameters, complications, and outcomes in patients hospitalized with COVID-19 infection during the third wave in India. Materials and methods: This was a single-center cross-sectional study conducted from 10th January 2022 to 10th February 2022. Data on demographic profile, clinical symptoms, laboratory findings, complications, and clinical outcome was collected and compared between nonsevere and severe cases. Results: A total of 74 patients were included. Four (5.4%) had a severe disease while 70 (94.6%) had a nonsevere disease. The most common symptoms were fever (60.8%), cough (52.7%), and sore throat (45.9%). There was a significant difference between severe and nonsevere groups in terms of vaccination history (p = 0.0412), and time elapsed from symptom onset to hospitalization (p ≤0.001). The severe disease group also had significantly higher levels of leukocyte count, C-reactive protein (CRP), D-dimer, ARDS, sepsis, and a higher need for respiratory support (p < 0.001). A total of 70 (94.6%) patients were discharged while four (5.4%) patients succumbed to complications of COVID-19 infection. Complete vaccination against COVID was associated with significantly lower chances of severe disease [odds ratio (OR) 0.083, 95% confidence interval (CI) 0.0080–0.8632]. Conclusion: As compared to the previous two waves, the current wave of the pandemic had milder symptoms, less severe disease, and fewer ICU admissions and deaths. Successful completion of vaccination against COVID was associated with significantly lower morbidity and mortality.
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Shah, S., R. Jadon, S. Datta, et al. "Effect of general anaesthesia with mechanical ventilation on biomarkers of lung inflammation/injury in COVID-19 survivors – A cohort study." Acta Anaesthesiologica Belgica 76, no. 2 (2025): 87. https://doi.org/10.56126/76.2.13.
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Background: A rise in biomarkers of lung injury with intraoperative mechanical ventilation in patients with healthy lungs may herald postoperative pulmonary complications (POPC). However, perioperative cytokine responses to mechanical ventilation in patients with previous SARS-CoV-2 associated pulmonary involvement are unknown. Objectives: To monitor proinflammatory cytokine responses to intraoperative mechanical ventilation in Corona virus disease-19 (COVID-19) survivors with COVID-associated pulmonary involvement and determine utility of these biomarkers in predicting POPC. Design: A prospective cohort study. Setting: Operating room, postoperative recovery area. Methods: Twenty-four patients with previous COVID-related lung involvement (group 1) and 20 patients with no/presumably no COVID-19 infection (group 2) undergoing various surgeries under general anaesthesia were recruited. General anaesthesia and ventilation were managed similarly in two groups. Bronchoalveolar lavage fluid (BALF) samples were collected at onset of ventilation and at end of surgery. Serum samples were collected at same timepoints and 1-hour postoperatively. Main outcome measures: Concentrations of interleukin-8 (IL-8) and tumour necrosis factor α (TNFα) were measured using Enzyme-linked immunosorbent assay, interleukin-6 (IL-6) by Chemiluminescence immunoassay and C-Reactive protein (CRP) by immunoturbidimetry on automated analyzers. Results: Patient demographics were comparable in both groups except age and American society of Anaesthesiologists classification. Rise of BALF IL-6 and IL-8 was more significant in group 1 (P < 0.001), compared to group 2 (P < 0.05 for IL-6 and P < 0.01 for IL-8). A significant increase in serum IL-6 correlated well with serum CRP at several timepoints in group 1. In both groups, BALF and serum TNF α was below detection limit. Only one patient in group 1 developed POPC. Conclusions: Despite a significant perioperative elevation of IL-6 and IL-8 in BALF, when mechanically ventilated, incidence of POPC did not increase in COVID survivors with prior COVID-associated pulmonary involvement. However, this needs to be validated on a larger sample size.