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Bagnato G, Imbalzano E, Ioppolo C, La Rosa D, Chiappalone M, De Gaetano A, Viapiana V, Irrera N, Nassisi V, Tringali MC, Singh EB, Falcomatà N, Russo V, Neal Roberts W, Di Micco P, Versace AG. Stratification of COVID-19 Patients with Moderate-to-Severe Hypoxemic Respiratory Failure for Response to High-Flow Nasal Cannula: A Retrospective Observational Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:71. [PMID: 38256332 PMCID: PMC10819134 DOI: 10.3390/medicina60010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/12/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: In patients with COVID-19, high-flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) are widely applied as initial treatments for moderate-to-severe acute hypoxemic respiratory failure. The aim of the study was to assess which respiratory supports improve 28-day mortality and to identify a predictive index of treatment response. Materials and Methods: This is a single-center retrospective observational study including 159 consecutive adult patients with COVID-19 and moderate-to-severe hypoxemic acute respiratory failure. Results: A total of 159 patients (82 in the CPAP group and 77 in the HFNC group) were included in the study. Mortality within 28 days was significantly lower with HFNC compared to CPAP (16.8% vs. 50%), while ICU admission and tracheal intubation within 28 days were significantly higher with CPAP compared to HFNC treatment (32% vs. 13%). We identified an index for survival in HFNC by including three variables easily available at admission (LDH, age, and respiratory rate) and the PaO2/FiO2 ratio at 48 h. The index showed high discrimination for survival with an AUC of 0.88, a negative predictive value of 86%, and a positive predictive value of 95%. Conclusions: Treatment with HFNC appears to be associated with greater survival and fewer ICU admission than CPAP. LDH, respiratory rate, age, and PaO2/FiO2 at 48 h were independently associated with survival and an index based on these variables allows for the prediction of treatment success and the assessment of patient allocation to the appropriate intensity of care after 48 h. Further research is warranted to determine effects on other outcomes and to assess the performance of the index in larger cohorts.
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Affiliation(s)
- Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Carmelo Ioppolo
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Daniela La Rosa
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Marianna Chiappalone
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Alberta De Gaetano
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Valeria Viapiana
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Veronica Nassisi
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Maria Concetta Tringali
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Emanuele Balwinder Singh
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Nicola Falcomatà
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
| | - Vincenzo Russo
- Department of Medical Translational Sciences, Division of Cardiology, Monaldi Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Pierpaolo Di Micco
- Emergency Department, Rizzoli Hospital, Health Authority NA2, 80122 Napoli, Italy
| | - Antonio Giovanni Versace
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.B.); (E.I.); (C.I.); (D.L.R.); (M.C.); (A.D.G.); (N.I.); (V.N.); (M.C.T.); (E.B.S.); (N.F.); (A.G.V.)
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Restelli D, Carerj ML, Bella GD, Zito C, Poleggi C, D’Angelo T, Donato R, Ascenti G, Blandino A, Micari A, Mazziotti S, Minutoli F, Baldari S, Carerj S. Constrictive Pericarditis: An Update on Noninvasive Multimodal Diagnosis. J Cardiovasc Echogr 2023; 33:161-170. [PMID: 38486689 PMCID: PMC10936705 DOI: 10.4103/jcecho.jcecho_61_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/28/2023] [Accepted: 10/29/2023] [Indexed: 03/17/2024] Open
Abstract
Constrictive pericarditis (CP) is a rare condition that can affect the pericardium after every pericardial disease process and has been described even after SARS-CoV-2 infection or vaccine. In CP, the affected pericardium, usually the inner layer, is noncompliant, constraining the heart to a fixed maximum volume and impairing the diastolic function. This leads to several clinical features, that, however, can be pleomorphic. In its difficult diagnostic workup, noninvasive multimodal imaging plays a central role, providing important morphological and functional data, like the enhanced ventricular interdependence and the dissociation between intrathoracic and intracardiac pressures. An early and proper diagnosis is crucial to set an appropriate therapy, changing the prognosis of patients affected by CP. In this review, we cover in detail the main elements of each imaging technique, after a reminder of pathophysiology useful for understanding the diagnostic findings.
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Affiliation(s)
- Davide Restelli
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Maria Ludovica Carerj
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Concetta Zito
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Cristina Poleggi
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Tommaso D’Angelo
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Rocco Donato
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Antonio Micari
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Silvio Mazziotti
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Scipione Carerj
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
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Orlando L, Bagnato G, Ioppolo C, Franzè MS, Perticone M, Versace AG, Sciacqua A, Russo V, Cicero AFG, De Gaetano A, Dattilo G, Fogacci F, Tringali MC, Di Micco P, Squadrito G, Imbalzano E. Natural Course of COVID-19 and Independent Predictors of Mortality. Biomedicines 2023; 11:939. [PMID: 36979918 PMCID: PMC10046319 DOI: 10.3390/biomedicines11030939] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND During the SARS-CoV-2 pandemic, several biomarkers were shown to be helpful in determining the prognosis of COVID-19 patients. The aim of our study was to evaluate the prognostic value of N-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP) in a cohort of patients with COVID-19. METHODS One-hundred and seven patients admitted to the Covid Hospital of Messina University between June 2022 and January 2023 were enrolled in our study. The demographic, clinical, biochemical, instrumental, and therapeutic parameters were recorded. The primary outcome was in-hospital mortality. A comparison between patients who recovered and were discharged and those who died during the hospitalization was performed. The independent parameters associated with in-hospital death were assessed by multivariable analysis and a stepwise regression logistic model. RESULTS A total of 27 events with an in-hospital mortality rate of 25.2% occurred during our study. Those who died during hospitalization were older, with lower GCS and PaO2/FiO2 ratio, elevated D-dimer values, INR, creatinine values and shorter PT (prothrombin time). They had an increased frequency of diagnosis of heart failure (p < 0.0001) and higher NT-pro-BNP values. A multivariate logistic regression analysis showed that higher NT-pro-BNP values and lower PT and PaO2/FiO2 at admission were independent predictors of mortality during hospitalization. CONCLUSIONS This study shows that NT-pro-BNP levels, PT, and PaO2/FiO2 ratio are independently associated with in-hospital mortality in subjects with COVID-19 pneumonia. Further longitudinal studies are warranted to confirm the results of this study.
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Affiliation(s)
- Luana Orlando
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Carmelo Ioppolo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Maria Stella Franzè
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | | | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Russo
- Department of Medical Translational Sciences, Division of Cardiology, Monaldi Hospital, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
| | - Arrigo Francesco Giuseppe Cicero
- IRCCS Policlinico S. Orsola—Malpighi, Hypertension and Cardiovascular risk Research Center, DIMEC, University of Bologna, 40100 Bologna, Italy
| | - Alberta De Gaetano
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Federica Fogacci
- IRCCS Policlinico S. Orsola—Malpighi, Hypertension and Cardiovascular risk Research Center, DIMEC, University of Bologna, 40100 Bologna, Italy
| | - Maria Concetta Tringali
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Pierpaolo Di Micco
- Department of Medicine, PO Santa Maria delle Grazie Pozzuoli, 80100 Naples, Italy
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
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Aragona CO, Bagnato G, Tomeo S, Rosa DL, Chiappalone M, Tringali MC, Singh EB, Versace AG. Echocardiography in Coronavirus Disease 2019 Era: A Single Tool for Diagnosis and Prognosis. J Cardiovasc Echogr 2023; 33:10-16. [PMID: 37426709 PMCID: PMC10328134 DOI: 10.4103/jcecho.jcecho_11_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/07/2023] [Accepted: 03/18/2023] [Indexed: 07/11/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by multi-organ involvement, including respiratory and cardiac events. Echocardiography is widely considered the first-choice tool for the evaluation of cardiac structures and function because of its reproducibility, feasibility, easy to use at bedside, and for good cost-effectiveness. The aim of our literature review is to define the utility of echocardiography in the prediction of prognosis and mortality in COVID-19 patients with mild to critical respiratory illness, with or without known cardiovascular disease. Moreover, we focused our attention on classical echocardiographic parameters and the use of speckle tracking to predict the evolution of respiratory involvement. Finally, we tried to explore the possible relationship between pulmonary disease and cardiac manifestations.
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Affiliation(s)
- Caterina Oriana Aragona
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Gianluca Bagnato
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Simona Tomeo
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Daniela La Rosa
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Marianna Chiappalone
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Maria Concetta Tringali
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Emanuele Balwinder Singh
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
| | - Antonio Giovanni Versace
- Department of Emergency, Unit of Emergency Mecicine, AOU Policlinico “G.Martino”, University of Messina, Messina, Italy
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Dönmez E, Özcan S, Tuğrul S, Ziyrek M, İnce O, Nar Sagir G, Baran Yavuz M, Gungor B, Okuyan E, Sahin I. Prognostic value of GRACE risk score in patients hospitalized for coronavirus disease 2019. Coron Artery Dis 2022; 33:465-472. [PMID: 35811509 DOI: 10.1097/mca.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE COVID-19 pandemic continues to threaten human health as novel mutant variants emerge and disease severity ranges from asymptomatic to fatal. Thus, studies are needed to identify the patients with ICU need as well as those who have subsequent mortality. Global Registry of Acute Coronary Events (GRACE) risk score is a validated score in acute coronary syndrome. We aimed to evaluate if GRACE score can indicate adverse outcomes and major ischemic events in hospitalized COVID-19 patients. METHODS All hospitalized patients due to COVID-19 at our institution between March 2020 and September 2020 were included in this retrospective study. Patients were grouped according to GRACE risk scores: low risk 0-108 points, intermediate risk 109-140 and high risk ≥141. RESULTS A total of 787 patients were enrolled; 434 patients formed group 1. One-hundred forty-one patients in group 2 and 212 patients formed group 3. We found that inhospital mortality, length of hospital stay, ICU and advanced ventilatory support need were associated with increasing GRACE risk score. In addition, major ischemic events were more frequently observed in higher risk groups and strong positive correlations between GRACE risk score and pro-BNP, procalcitonin and moderate positive correlation with D-dimer, CRP, NLR was found. Regression analysis showed that only GRACE risk score was an independent risk factor associated with inhospital mortality, major ischemic events, advanced ventilatory support and ICU need. CONCLUSION The GRACE risk score is easy to apply on hospital admission and useful for classifying those in medium-high-intensity care units and to raise the assignments of sources.
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Affiliation(s)
- Esra Dönmez
- Department of Cardiology, Bağcilar Training and Research Hospital
| | - Sevgi Özcan
- Department of Cardiology, Bağcilar Training and Research Hospital
| | - Sevil Tuğrul
- Department of Cardiology, Başakşehir Çam and Sakura City Hospital
| | - Murat Ziyrek
- Department of Cardiology, Bağcilar Training and Research Hospital
| | - Orhan İnce
- Department of Cardiology, Bağcilar Training and Research Hospital
| | - Gurur Nar Sagir
- Department of Cardiology, Bağcilar Training and Research Hospital
| | | | - Baris Gungor
- Department of Cardiology, University of Health Sciences Dr. Siyami Ersek Hospital, İstanbul, Turkey
| | - Ertugrul Okuyan
- Department of Cardiology, Bağcilar Training and Research Hospital
| | - Irfan Sahin
- Department of Cardiology, Bağcilar Training and Research Hospital
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Bagnato G, Imbalzano E, Aragona CO, Ioppolo C, Di Micco P, La Rosa D, Costa F, Micari A, Tomeo S, Zirilli N, Sciacqua A, D’Angelo T, Cacciola I, Bitto A, Irrera N, Russo V, Roberts WN, Gangemi S, Versace AG. New-Onset Atrial Fibrillation and Early Mortality Rate in COVID-19 Patients: Association with IL-6 Serum Levels and Respiratory Distress. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:530. [PMID: 35454369 PMCID: PMC9032834 DOI: 10.3390/medicina58040530] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 01/09/2023]
Abstract
Background and objectives: COVID-19 is associated with an aberrant inflammatory response that may trigger new-onset cardiac arrhythmias. The aim of this study was to assess the mortality risk in hospitalized COVID-19 patients according to IL-6 serum levels and new-onset atrial fibrillation (AF) according to PaO2/FiO2 stratification. Materials and Methods: 175 COVID-19 patients (25 new-onset AF, 22 other types of AF and 128 no-AF) were included in this single-center, retrospective study; clinical and demographic data, vital signs, electrocardiograms and laboratory results were collected and analyzed. The primary outcome of the study was to evaluate the mortality rate in new-onset AF patients according to IL-6 serum levels and PaO2/FiO2 stratification. Results: The incidence of new-onset AF in the study population was 14.2%. Compared to the no-AF group, new-onset AF patients were older with a positive history of chronic kidney disease and heart failure, had higher IL-6, creatinine and urea serum levels whereas their platelet count was reduced. After PaO2/FiO2 stratification, 5-days mortality rate was higher in new-onset AF patients compared to patients with other types of AF and no-AF patients, and mortality risk increases 5.3 fold compared to no-AF (p = 0.0014) and 4.8 fold compared to other forms of AF (p = 0.03). Conclusions: New-onset AF is common in COVID-19 patients and is associated with increased IL-6 serum levels and early mortality. Further studies are needed to support the use of IL-6 as an early molecular target for COVID-19 patients to reduce their high rate of mortality.
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Affiliation(s)
- Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Caterina Oriana Aragona
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Carmelo Ioppolo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Pierpaolo Di Micco
- Department of Medicine, Buonconsiglio Fatebenefratelli Hospital, 80122 Naples, Italy;
| | - Daniela La Rosa
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Francesco Costa
- BIOMORF Department, University of Messina, 98125 Messina, Italy; (F.C.); (A.M.); (T.D.)
| | - Antonio Micari
- BIOMORF Department, University of Messina, 98125 Messina, Italy; (F.C.); (A.M.); (T.D.)
| | - Simona Tomeo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Natalia Zirilli
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy;
| | - Tommaso D’Angelo
- BIOMORF Department, University of Messina, 98125 Messina, Italy; (F.C.); (A.M.); (T.D.)
| | - Irene Cacciola
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Vincenzo Russo
- Department of Medical Translational Sciences, Division of Cardiology, Monaldi Hospital, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | | | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Antonio Giovanni Versace
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
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Laza R, Dragomir C, Musta VF, Lazureanu VE, Nicolescu ND, Marinescu AR, Paczeyka R, Porosnicu TM, Bica-Porfir V, Laitin SMD, Dragomir I, Ilie C, Baditoiu LM. Analysis of Deaths and Favorable Developments of Patients with SARS-CoV-2 Hospitalized in the Largest Hospital for Infectious Diseases and Pneumo-Phthisiology in the West of the Country. Int J Gen Med 2022; 15:3417-3431. [PMID: 35378919 PMCID: PMC8976499 DOI: 10.2147/ijgm.s359483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/16/2022] [Indexed: 12/11/2022] Open
Abstract
Purpose Romania is one of the European countries that has been hit the hardest by the severe acute respiratory syndrome caused by the new coronavirus SARS-CoV-2, with over 1.91 million reported cases and over 59,257 deaths. The aim of this study was to identify the main predictors of death in hospitalized patients. Patients and Methods In the period from 1 March 2020 to 30 June 2021, an observational, retrospective, randomized, case-control study was conducted, which included a sample of 139 patients who died in hospital and another sample of 275 patients who had been discharged in an improved or healed condition. Confirmation of COVID-19 cases was performed by RT-PCR from nasopharyngeal and oropharyngeal exudates. Statistical data were analyzed by logistic regression, Cox regression and a comparison of survival curves by the log-rank (Mantel-Cox) test. Results The most powerful logistic regression model identified the following independent predictors of death: history of coagulopathy HR = 30.73 [1.94–487.09], p = 0.015; high percentage of neutrophils HR = 1.09 [1.01–1.19], p = 0.027; and decreased blood-oxygenation HR = 53881.97 [1762.24–1647489.44], p < 0.001. Cox regression identified the following factors that influenced the evolution of cases: history of coagulopathy HR = 2.44 [1.38–4.35], p = 0.000; O2 saturation HR = 0.98 [0.96–0.99], p = 0.043; serum creatinine HR = 1.23 [1.08–1.39], p = 0.001; dyspnea on admission HR = 2.99 [1.42–6.30], p = 0.004; hospitalization directly in the ICU HR = 3.803 [1.97–7.33], p < 0.001; heart damage HR = 16.76 [1.49–188.56], p = 0.022; and decreased blood-oxygenation HR = 35.12 [5.92–208.19], p < 0.001. Conclusion Knowledge of the predictors of death in hospitalized patients allows for the future optimization of triage and therapeutic case management for COVID-19.
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Affiliation(s)
- Ruxandra Laza
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
| | - Cristina Dragomir
- Doctoral School, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania
| | - Virgil Filaret Musta
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
| | - Voichita Elena Lazureanu
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
| | - Narcisa Daniela Nicolescu
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
| | - Adelina Raluca Marinescu
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
- Doctoral School, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania
| | - Roxana Paczeyka
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
| | - Tamara Mirela Porosnicu
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
- Doctoral School, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania
| | - Valerica Bica-Porfir
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
| | - Sorina Maria Denisa Laitin
- Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania
- Department XIII, Discipline of Epidemiology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania
| | - Ion Dragomir
- Individual Family Medical Office, Ostroveni, Dolj, Romania
| | - Constantin Ilie
- Department XII, Discipline of Neonatology and Childcare, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Luminita Mirela Baditoiu
- Department XIII, Discipline of Epidemiology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania
- Multidisciplinary Research Centre on Antimicrobial Resistance, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Correspondence: Luminita Mirela Baditoiu, Cristina Dragomir Department XIII, Discipline of Epidemiology, Victor Babes University of Medicine and Pharmacy; Doctoral School, University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, Timisoara, 300041, Romania, Tel +40727746440; +40753036306, Email ;
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Implication of COVID-19 on Erythrocytes Functionality: Red Blood Cell Biochemical Implications and Morpho-Functional Aspects. Int J Mol Sci 2022; 23:ijms23042171. [PMID: 35216286 PMCID: PMC8878454 DOI: 10.3390/ijms23042171] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 01/08/2023] Open
Abstract
Several diseases (such as diabetes, cancer, and neurodegenerative disorders) affect the morpho-functional aspects of red blood cells, sometimes altering their normal metabolism. In this review, the hematological changes are evaluated, with particular focus on the morphology and metabolic aspects of erythrocytes. Changes in the functionality of such cells may, in fact, help provide important information about disease severity and progression. The viral infection causes significant damage to the blood cells that are altered in size, rigidity, and distribution width. Lower levels of hemoglobin and anemia have been reported in several studies, and an alteration in the concentration of antioxidant enzymes has been shown to promote a dangerous state of oxidative stress in red blood cells. Patients with severe COVID-19 showed an increase in hematological changes, indicating a progressive worsening as COVID-19 severity progressed. Therefore, monitored hematological alterations in patients with COVID-19 may play an important role in the management of the disease and prevent the risk of a severe course of the disease. Finally, monitored changes in erythrocytes and blood, in general, may be one of the causes of the condition known as Long COVID.
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