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Yang H, Wang Z, Zhang Y, Xu M, Wang Y, Zhang Y, Liu X, An Z, Tong Z. Clinical characteristics and factors for serious outcomes among outpatients infected with the Omicron subvariant BF.7. J Med Virol 2023; 95:e28977. [PMID: 37635385 DOI: 10.1002/jmv.28977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 08/29/2023]
Abstract
To evaluate clinical characteristics and identify risk factors associated with severe outcomes in outpatients infected with the Omicron subvariant BF.7, data were collected from outpatients diagnosed with Corona Virus Disease 2019 from December 19, 2022 to January 5, 2023. Clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with serious outcomes. Variables with a p < 0.10 in the univariate analysis were included in the multivariate model. Our study analyzed 770 patients, of whom 380 (49.4%) were male, with a median age of 59. The most common symptoms reported were cough (71.2%), fever (64.7%), and sore throat (37.7%). Fever lasted an average of 5.93 ± 3.37 days for the general population and 10.64 ± 7.12 days for impaired-immunity patients. Most cases were mild (68.7%), followed by moderate (27.1%). Severe cases accounted for 2.2%, with 0.5% critically ill. Serious outcomes occurred in 4.2% of cases, with 11 deaths during follow-up. Underlying-diseases patients had a higher rate of serious outcomes. Factors associated with serious outcomes included receiving a three-dose vaccination (odds ratio [OR] = 0.324, 95% confidence interval [CI]: 0.113-0.932, p = 0.037), male gender (OR = 2.890, 95% CI: 1.107-7.548, p = 0.030), age (OR = 1.060, 95% CI: 1.024-1.097, p = 0.001), and chest tightness or dyspnea at the time of visit (OR = 4.861, 95% CI: 2.054-11.507, p < 0.001). Our study found that cough, fever, and sore throat were the most common symptoms reported by patients. Receiving a three-dose vaccination was protective, while male gender, age, and chest tightness or dyspnea were identified as risk factors for serious outcomes.
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Affiliation(s)
- Hui Yang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhaojian Wang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Clinical Pharmacy, School of Pharmaceutical Science, Capital Medical University, Beijing, China
| | - Ying Zhang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Clinical Pharmacy, School of Pharmaceutical Science, Capital Medical University, Beijing, China
- Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Man Xu
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Clinical Pharmacy, School of Pharmaceutical Science, Capital Medical University, Beijing, China
- Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yushu Wang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuefeng Liu
- Departments of Pathology, Urology, and Radiation Oncology, The Ohio State University, Columbus, Ohio, USA
| | - Zhuoling An
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing, China
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Shaikh AA, Mubasher TA, Makkawi MH, Alasmari SZ. Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia. Saudi Med J 2023; 44:773-781. [PMID: 37582571 PMCID: PMC10425619 DOI: 10.15537/smj.2023.44.8.20230162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 07/11/2023] [Indexed: 08/17/2023] Open
Abstract
OBJECTIVES To correlate demographics, blood groupings, and laboratory characteristics of hospitalized COVID-19 patients with disease severity and outcomes. METHODS This study included 294 COVID-19 patients. Data on patient age, gender, laboratory results, clinical severity, mortality, comorbidities, and blood group were obtained from medical records retrospectively. RESULTS High levels of ferritin (p<0.01), urea (p<0.0001), and creatinine (p<0.05) were detected in intensive care unit (ICU)-admitted patients. Ferritin (p<0.05), glucose (p<0.0001), urea (p<0.0001), and creatinine (p<0.0001) were significantly higher in non-survivor compared to survivor COVID-19 patients. Predictors for ICU admission among patients were ferritin (odd ratio [OR]=0.999, p=0.0055) and urea (OR=0.991, p=0.0001). Predictors for mortality were: age (OR=0.963, p=0.0001), ferritin (OR=0.999, p=0.0149), glucose (OR=0.993, p=0.0001), urea (OR=0.976, p=0.0001), and creatinine (OR=0.556, p=0.0001). The most reliable laboratory parameters in predicting mortality were: age (area under the curve [AUC]=0.685, p<0.0001), ferritin (AUC=0.610, p<0.05), glucose (AUC=0.681, p<0.0001), urea (AUC=0.856, p<0.0001), and creatinine (AUC=0.823, p<0.0001). CONCLUSION High ferritin, glucose, urea, and creatinine levels may predict poor outcomes in COVID-19 patients. These findings could help predict admissions to the ICU and mortality among such patients.
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Affiliation(s)
- Ahmad A. Shaikh
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
| | - Turki A. Mubasher
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
| | - Mohammed H. Makkawi
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
| | - Sultan Z. Alasmari
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
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Elhag W, Elamin BK, Idris E, Elsheikh A, Ghaleb K, Fallatah I, Hassan D, Elkhalifa M, Moglad E, Eleragi A. Clinico-Epidemiological Laboratory Findings of COVID- 19 Positive Patients in a Hospital in Saudi Arabia. Infect Drug Resist 2023; 16:4845-4856. [PMID: 37520449 PMCID: PMC10386838 DOI: 10.2147/idr.s418629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023] Open
Abstract
Background Understanding COVID-19's onset and clinical effects requires knowing host immune responses. Objective To investigate the presence of IgM, IgG, and cytokine levels (IL-2 and IL-6) in individuals with COVID-19 who have had their diagnosis confirmed by PCR. Methods This cross-sectional research included 70 adult ICU patients from King Abdullah Hospital in Bisha, Saudi Arabia. Subjects gave two blood samples. After hospital release, only 21 patients provided the second sample. Each patient provided a sample upon admission. Quantitative ELISAs evaluated IL-2, IL-6, and SARS-CoV-2-specific IgM and IgG antibodies. Results All patients were critically ill and unvaccinated against COVID-19. 46 (65.7%) of the patients were male, and their age range was 33-98 years (with a mean age of 66.5); 24.3%) were 51-61 years old. IgG was positive in all patients, although IgM predominated in 57/70 (81.4%) (6-1200 IU/mL). Total data analysis yielded these results. IL-6 was calculated at 10-1900 ng/mL, whereas IL-2 was 4-280. Discharged hospital patients had a statistically significant increase in IgM and IgG (P = 0.01, 0.004) but a statistically insignificant decline in IL-6 and IL-2 (P = 0.761, 0.071). Low IgM levels increased hospital stays. The study found lengthier hospital stays with higher IgG levels. Conclusion The identification of IgM and IgG antibodies, greater IL-6 levels, and lower IL-2 levels can help diagnose and monitor COVID-19 infection.
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Affiliation(s)
- Wafa Elhag
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Saudi Arabia
- Microbiology Department, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | - Bahaeldin K Elamin
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Saudi Arabia
- Department of Microbiology, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Ebtehal Idris
- Medical Laboratories Department, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
| | - Azza Elsheikh
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - Khaled Ghaleb
- Medical Laboratories Department, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
| | - Ibtihal Fallatah
- Laboratory and ICU (Medical Department) King Abdullah Hospital-Bisha, Bisha, Saudi Arabia
| | - Doaa Hassan
- Laboratory and ICU (Medical Department) King Abdullah Hospital-Bisha, Bisha, Saudi Arabia
| | - Mahmoud Elkhalifa
- Laboratory and ICU (Medical Department) King Abdullah Hospital-Bisha, Bisha, Saudi Arabia
| | - Ehssan Moglad
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ali Eleragi
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Exploration of Sex and Age-Based Associations in Clinical Characteristics, Predictors of Severity, and Duration of Stay among COVID-19 Patients at the University Hospital of Saudi Arabia. Healthcare (Basel) 2023; 11:healthcare11050751. [PMID: 36900756 PMCID: PMC10000835 DOI: 10.3390/healthcare11050751] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023] Open
Abstract
COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system's preparedness, which depends on predictors of severity and factors related to the duration of hospital stays. Therefore, we carried out a single-center, retrospective cohort study in a tertiary academic hospital to investigate these clinical features and predictors of severe disease and study the different factors that affect hospital stay. We utilized medical records from March 2020 to July 2021, which included 443 confirmed (positive RT-PCR) cases. The data were explained using descriptive statistics and analyzed via multivariate models. Among the patients, 65.4% were female and 34.5% were male, with a mean age of 45.7 years (SD ± 17.2). We presented seven age groups with ranges of 10 years and noticed that patients aged 30-39 years old comprised 23.02% of the records, while patients aged 70 and above comprised 10%. Nearly 47% were diagnosed as having mild, 25% as moderate, 18% as asymptomatic, and 11% as having a severe case of COVID-19 disease. Diabetes was the most common co-morbidity factor in 27.6% of patients, followed by hypertension (26.4%). Our population's predictors of severity included pneumonia, identified on a chest X-ray, and co-morbid conditions such as cardiovascular disease, stroke, ICU stay, and mechanical ventilation. The median length of hospital stay was six days. It was significantly longer in patients with a severe disease and who were administered systemic intravenous steroids. An empirical assessment of various clinical parameters could assist in effectively measuring the disease progression and follow-up with patients.
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