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Santos AC, Costa VDD, Silva LLD, Miguel JC, Jardim R, Dávila AMR, Paula VSD, Melgaço JG, Lago BVD, Villar LM. SARS-CoV-2 and dialysis: humoral response, clinical and laboratory impacts before vaccination. Braz J Infect Dis 2024; 28:103735. [PMID: 38467386 DOI: 10.1016/j.bjid.2024.103735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/25/2024] [Accepted: 02/22/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Patients with kidney disease on Hemodialysis (HD) are susceptible to Coronavirus Disease (COVID-19) due to multiple risk factors. AIM This study aims to report the prevalence of antibodies against SARS-CoV-2 among patients on hemodialysis before vaccination in Brazil and to compare with clinical, demographic, and laboratory data. METHODS Blood samples from 398 Chronic Kidney Disease (CKD) patients treated in three different private institutions in Rio de Janeiro State, Brazil were submitted to the total anti-SARS-CoV-2 testing. Kidney, liver, and hematological markers were also determined. Respiratory samples were tested by real-time PCR for SARS-CoV-2 RNA and positive samples were subjected to high-throughput sequencing on the MinION device. RESULTS Overall, anti-SARS-CoV-2 prevalence was 54.5 % (217/398) and two individuals had SARS-CoV-2 RNA with variant B.1.1. High anti-SARS-CoV-2 seroprevalence was found in male gender and those with hospital admission in the last 3-months before the inclusion in the study. Lower red blood cell count was observed in the anti-SARS-CoV-2 seropositive group. High levels of anti-SARS-CoV-2 were found in those who reported symptoms, had low levels of eosinophils and low hematocrit, and who practiced physical activity. CONCLUSION High prevalence of anti-SARS-CoV-2 was found in CKD patients before the universal immunization in Brazil suggesting that dialysis patients were highly exposed to SARS-CoV-2.
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Affiliation(s)
- Alanna Calheiros Santos
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório Brasileiro de Referência em Hepatites Virais, Rio de Janeiro, RJ, Brazil
| | - Vanessa Duarte da Costa
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório Brasileiro de Referência em Hepatites Virais, Rio de Janeiro, RJ, Brazil
| | - Lucas Lima da Silva
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório Brasileiro de Referência em Hepatites Virais, Rio de Janeiro, RJ, Brazil
| | - Juliana Custódio Miguel
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório Brasileiro de Referência em Hepatites Virais, Rio de Janeiro, RJ, Brazil
| | - Rodrigo Jardim
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório de Biologia Computacional e de Sistemas, Programa de Pós-Graduação em Biodiversidade e Saúde, Rio de Janeiro, RJ, Brazil
| | - Alberto Martín Rivera Dávila
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório de Biologia Computacional e de Sistemas, Programa de Pós-Graduação em Biodiversidade e Saúde, Rio de Janeiro, RJ, Brazil
| | - Vanessa Salete de Paula
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório de Virologia Molecular e Parasitologia, Rio de Janeiro, RJ, Brazil
| | - Juliana Gil Melgaço
- Bio-Manguinhos (FIOCRUZ), Laboratório de Tecnologia Imunológica, Rio de Janeiro, RJ, Brazil
| | - Barbara Vieira do Lago
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório Brasileiro de Referência em Hepatites Virais, Rio de Janeiro, RJ, Brazil
| | - Livia Melo Villar
- Instituto Oswaldo Cruz (FIOCRUZ), Laboratório Brasileiro de Referência em Hepatites Virais, Rio de Janeiro, RJ, Brazil.
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Ligi D, Della Franca C, Notarte KI, Goldrich N, Kavteladze D, Henry BM, Mannello F. Platelet distribution width (PDW) as a significant correlate of COVID-19 infection severity and mortality. Clin Chem Lab Med 2024; 62:385-395. [PMID: 37725416 DOI: 10.1515/cclm-2023-0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
SARS-CoV-2 infection may cause a wide spectrum of symptoms, from asymptomatic, to mild respiratory symptoms and life-threatening sepsis. Among the clinical laboratory biomarkers analyzed during COVID-19 pandemic, platelet indices have raised great interest, due to the critical involvement of platelets in COVID-19-related thromboinflammation. Through an electronic literature search on MEDLINE, CINAHL, PubMed, EMBASE, Web of Science, and preprint servers we performed and updated a systematic review aimed at providing a detailed analysis of studies addressing the potential clinical utility of platelet distribution width, platelet distribution width (PDW), in laboratory medicine, exploring the possible association between increased PDW levels, disease severity, and mortality in COVID-19. Our systematic review revealed a wide heterogeneity of COVID-19 cohorts examined and a lack of homogenous expression of platelet indices. We found that 75 % of studies reported significantly elevated PDW values in COVID-19 infected cohorts compared to healthy/non-COVID-19 controls, and 40 % of studies reported that patients with severe COVID-19 showed increased PDW values than those with less-than-severe illness. Interestingly, 71.4 % of studies demonstrated significant increased PDW values in non survivors vs. survivors. Overall, these results suggest that platelets are critically involved as major players in the process of immunothrombosis in COVID-19, and platelet reactivity and morphofunctional alterations are mirrored by PDW, as indicator of platelet heterogeneity. Our results confirm that the use of PDW as prognostic biomarkers of COVID-19 sepsis still remains debated due to the limited number of studies to draw a conclusion, but new opportunities to investigate the crucial role of platelets in thrombo-inflammation are warranted.
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Affiliation(s)
- Daniela Ligi
- Laboratories of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences - DISB, University of Urbino Carlo Bo, Urbino, Italy
| | - Chiara Della Franca
- Laboratories of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences - DISB, University of Urbino Carlo Bo, Urbino, Italy
| | - Kin Israel Notarte
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - David Kavteladze
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Brandon Michael Henry
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ferdinando Mannello
- Laboratories of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences - DISB, University of Urbino Carlo Bo, Urbino, Italy
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Schmidt G, Martens A, Koch C, Markmann M, Schneck E, Matt U, Hecker M, Tello K, Wolff M, Sander M, Vadász I. Nucleated red blood cells are a late biomarker in predicting intensive care unit mortality in patients with COVID-19 acute respiratory distress syndrome: an observational cohort study. Front Immunol 2024; 15:1313977. [PMID: 38304431 PMCID: PMC10830722 DOI: 10.3389/fimmu.2024.1313977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
Background Nucleated red blood cells (nRBC) are precursor cells of the erythropoiesis that are absent from the peripheral blood under physiological conditions. Their presence is associated with adverse outcomes in critically ill patients. This study aimed to evaluate the predictive value of nRBC on mortality in intensive care unit (ICU) patients with COVID-19 acute respiratory distress syndrome (ARDS). Material and methods This retrospective, observational cohort study analyzed data on 206 ICU patients diagnosed with COVID-19 ARDS between March 2020 and March 2022. The primary endpoint was ICU mortality, and secondary endpoints included ICU and hospital stay lengths, ventilation hours, and the time courses of disease severity scores and clinical and laboratory parameters. Results Among the included patients, 68.9% tested positive for nRBC at least once during their ICU stay. A maximum nRBC of 105 µl-1 had the highest accuracy in predicting ICU mortality (area under the curve of the receiver operating characteristic [AUCROC] 0.780, p < 0.001, sensitivity 69.0%, specificity 75.5%). Mortality was significantly higher among patients with nRBC >105 µl-1 than ≤105 µl-1 (86.5% vs. 51.3%, p = 0.008). Compared to patients negative for nRBC in their peripheral blood, those positive for nRBC required longer mechanical ventilation (127 [44 - 289] h vs. 517 [255 - 950] h, p < 0.001), ICU stays (12 [8 - 19] vs. 27 [13 - 51] d, p < 0.001), and hospital stays (19 [12 - 29] d vs. 31 [16 - 58] d, p < 0.001). Peak Sepsis-related Organ Failure Assessment (SOFA), Simplified Acute Physiology Score, PaO2/FiO2, interleukin-6, and procalcitonin values were reached before the peak nRBC level. However, the predictive performance of the SOFA (AUCROC 0.842, p < 0.001) was considerably improved when a maximum SOFA score >8 and nRBC >105 µl-1 were combined. Discussion nRBC predict ICU mortality and indicate disease severity among patients with COVID-19 ARDS, and they should be considered a clinical alarm signal for a worse outcome. nRBC are a late predictor of ICU mortality compared to other established clinical scoring systems and laboratory parameters but improve the prediction accuracy when combined with the SOFA score.
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Affiliation(s)
- Götz Schmidt
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - Arnd Martens
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - Christian Koch
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - Melanie Markmann
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - Emmanuel Schneck
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - Ulrich Matt
- Department of Internal Medicine V, Universities of Giessen and Marburg Lung Center (UGMLC), Excellence Cluster Cardiopulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus-Liebig University, Giessen, Germany
| | - Matthias Hecker
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center (UGMLC), Excellence Cluster Cardiopulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus-Liebig University, Giessen, Germany
| | - Khodr Tello
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center (UGMLC), Excellence Cluster Cardiopulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus-Liebig University, Giessen, Germany
| | - Matthias Wolff
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - Michael Sander
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University Giessen, Giessen, Germany
| | - István Vadász
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center (UGMLC), Excellence Cluster Cardiopulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus-Liebig University, Giessen, Germany
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Kokkoris S, Kanavou A, Katsaros D, Karageorgiou S, Kremmydas P, Gkoufa A, Ntaidou T, Giannopoulos C, Kardamitsi MA, Dimopoulou G, Theodorou E, Georgakopoulou VE, Spandidos DA, Orfanos S, Kotanidou A, Routsi C. Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment. Biomed Rep 2024; 20:12. [PMID: 38124763 PMCID: PMC10731161 DOI: 10.3892/br.2023.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Although coronavirus disease 2019 (COVID-19)-induced changes in laboratory parameters in patients upon admission have been well-documented, information on their temporal changes is limited. The present study describes the laboratory trends and the effect of dexamethasone treatment on these parameters, in patients with COVID-19 in the intensive care unit (ICU). Routine laboratory parameters, namely white blood cell (WBC), neutrophil, lymphocyte and platelet (PLT) counts, fibrinogen, C-reactive protein (CRP), lactate dehydrogenase (LDH) and albumin concentrations, were recorded upon admission to the ICU and, thereafter, on days 3, 5, 10, 15 and 21; these values were compared between survivors and non-survivors, as well as between those who were treated with dexamethasone and those who were not. Among the 733 patients in the ICU, (mean age, 65±13 years; 68% males; ICU mortality rate 45%; 76% of patients treated with dexamethasone), the WBC and neutrophil counts were persistently high in all patients, without significant differences over the first 15 days. Initially, low lymphocyte counts exhibited increasing trends, but remained higher in survivors compared to non-survivors (P=0.01). The neutrophil-to-lymphocyte ratio (NLR) was persistently elevated in all patients, although it was significantly higher in non-survivors compared to survivors (P<0.001). The PLT count was initially increased in all patients, although it was significantly decreased in non-survivors over time. The fibrinogen and LDH values remained similarly elevated in all patients. However, the increased levels of CRP, which did not differ between patients upon admission, further increased in non-survivors compared to survivors after day 10 (P=0.001). Declining trends in albumin levels over time, overall, with a significant decrease in non-survivors compared to survivors, were observed. Dexamethasone treatment significantly affected the temporal progression of fibrinogen and CRP in survivors and that of NLR in non-survivors. On the whole, the present study demonstrates that patients in the ICU with COVID-19 present persistently abnormal laboratory findings and significant differences in laboratory trends of NLR, CRP, PLT and albumin, but not in WBC and neutrophil count, and fibrinogen and LDH levels, between survivors and non-survivors. The temporal progression of fibrinogen, CRP and NLR is affected by dexamethasone treatment.
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Affiliation(s)
- Stelios Kokkoris
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Angeliki Kanavou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Dimitrios Katsaros
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Stavros Karageorgiou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Panagiotis Kremmydas
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Aikaterini Gkoufa
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
- Department of Infectious Diseases, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodora Ntaidou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Charalampos Giannopoulos
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Marina-Areti Kardamitsi
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Georgia Dimopoulou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Evangelia Theodorou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Stylianos Orfanos
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Anastasia Kotanidou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Christina Routsi
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
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Gałgańska H, Jarmuszkiewicz W, Gałgański Ł. Carbon dioxide and MAPK signalling: towards therapy for inflammation. Cell Commun Signal 2023; 21:280. [PMID: 37817178 PMCID: PMC10566067 DOI: 10.1186/s12964-023-01306-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/05/2023] [Indexed: 10/12/2023] Open
Abstract
Inflammation, although necessary to fight infections, becomes a threat when it exceeds the capability of the immune system to control it. In addition, inflammation is a cause and/or symptom of many different disorders, including metabolic, neurodegenerative, autoimmune and cardiovascular diseases. Comorbidities and advanced age are typical predictors of more severe cases of seasonal viral infection, with COVID-19 a clear example. The primary importance of mitogen-activated protein kinases (MAPKs) in the course of COVID-19 is evident in the mechanisms by which cells are infected with SARS-CoV-2; the cytokine storm that profoundly worsens a patient's condition; the pathogenesis of diseases, such as diabetes, obesity, and hypertension, that contribute to a worsened prognosis; and post-COVID-19 complications, such as brain fog and thrombosis. An increasing number of reports have revealed that MAPKs are regulated by carbon dioxide (CO2); hence, we reviewed the literature to identify associations between CO2 and MAPKs and possible therapeutic benefits resulting from the elevation of CO2 levels. CO2 regulates key processes leading to and resulting from inflammation, and the therapeutic effects of CO2 (or bicarbonate, HCO3-) have been documented in all of the abovementioned comorbidities and complications of COVID-19 in which MAPKs play roles. The overlapping MAPK and CO2 signalling pathways in the contexts of allergy, apoptosis and cell survival, pulmonary oedema (alveolar fluid resorption), and mechanical ventilation-induced responses in lungs and related to mitochondria are also discussed. Video Abstract.
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Affiliation(s)
- Hanna Gałgańska
- Faculty of Biology, Molecular Biology Techniques Laboratory, Adam Mickiewicz University in Poznan, Uniwersytetu Poznanskiego 6, 61-614, Poznan, Poland
| | - Wieslawa Jarmuszkiewicz
- Faculty of Biology, Department of Bioenergetics, Adam Mickiewicz University in Poznan, Institute of Molecular Biology and Biotechnology, Uniwersytetu Poznanskiego 6, 61-614, Poznan, Poland
| | - Łukasz Gałgański
- Faculty of Biology, Department of Bioenergetics, Adam Mickiewicz University in Poznan, Institute of Molecular Biology and Biotechnology, Uniwersytetu Poznanskiego 6, 61-614, Poznan, Poland.
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Kokkoris S, Kanavou A, Kremmydas P, Katsaros D, Karageorgiou S, Gkoufa A, Georgakopoulou VE, Spandidos DA, Giannopoulos C, Kardamitsi M, Routsi C. Temporal evolution of laboratory characteristics in patients critically ill with COVID‑19 admitted to the intensive care unit (Review). Med Int (Lond) 2023; 3:52. [PMID: 37810906 PMCID: PMC10557099 DOI: 10.3892/mi.2023.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023]
Abstract
In the context of coronavirus disease 2019 (COVID-19), laboratory medicine has played a crucial role in both diagnosis and severity assessment. Although the importance of baseline laboratory findings has been extensively reported, data regarding their evolution over the clinical course are limited. The aim of the present narrative review was to provide the dynamic changes of the routine laboratory variables reported in patients with severe COVID-19 over the course of their critical illness. A search was made of the literature for articles providing data on the time-course of routine laboratory tests in patients with severe COVID-19 during their stay in the intensive care unit (ICU). White blood cell, neutrophil and lymphocyte counts, neutrophil to lymphocyte ratio, platelet counts, as well as D-dimer, fibrinogen, C-reactive protein, lactate dehydrogenase and serum albumin levels were selected as disease characteristics and routine laboratory parameters. A total of 25 research articles reporting dynamic trends in the aforementioned laboratory parameters over the clinical course of severe COVID-19 were identified. During the follow-up period provided by each study, the majority of the laboratory values remained persistently abnormal in both survivors and non-survivors. Furthermore, in the majority of studies, the temporal trends of laboratory values distinctly differentiated patients between survivors and non-survivors. In conclusion, there are distinct temporal trends in selected routine laboratory parameters between survivors and non-survivors with severe COVID-19 admitted to the ICU, indicating their importance in the prognosis of clinical outcome.
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Affiliation(s)
- Stelios Kokkoris
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Angeliki Kanavou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Panagiotis Kremmydas
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Dimitrios Katsaros
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Stavros Karageorgiou
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Aikaterini Gkoufa
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
- Department of Infectious Diseases, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Charalampos Giannopoulos
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Marina Kardamitsi
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Christina Routsi
- First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
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Abstract
COVID-19 infections decrease total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I, A-II, and B levels while triglyceride levels may be increased or inappropriately normal for the poor nutritional status. The degree of reduction in total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I are predictive of mortality. With recovery lipid/lipoprotein levels return towards pre-infection levels and studies have even suggested an increased risk of dyslipidemia post-COVID-19 infection. The potential mechanisms for these changes in lipid and lipoprotein levels are discussed. Decreased HDL-C and apolipoprotein A-I levels measured many years prior to COVID-19 infections are associated with an increased risk of severe COVID-19 infections while LDL-C, apolipoprotein B, Lp (a), and triglyceride levels were not consistently associated with an increased risk. Finally, data suggest that omega-3-fatty acids and PCSK9 inhibitors may reduce the severity of COVID-19 infections. Thus, COVID-19 infections alter lipid/lipoprotein levels and HDL-C levels may affect the risk of developing COVID-19 infections.
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Xu J, Cao Z, Miao C, Zhang M, Xu X. Predicting omicron pneumonia severity and outcome: a single-center study in Hangzhou, China. Front Med (Lausanne) 2023; 10:1192376. [PMID: 37305146 PMCID: PMC10250627 DOI: 10.3389/fmed.2023.1192376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Background In December 2022, there was a large Omicron epidemic in Hangzhou, China. Many people were diagnosed with Omicron pneumonia with variable symptom severity and outcome. Computed tomography (CT) imaging has been proven to be an important tool for COVID-19 pneumonia screening and quantification. We hypothesized that CT-based machine learning algorithms can predict disease severity and outcome in Omicron pneumonia, and we compared its performance with the pneumonia severity index (PSI)-related clinical and biological features. Methods Our study included 238 patients with the Omicron variant who have been admitted to our hospital in China from 15 December 2022 to 16 January 2023 (the first wave after the dynamic zero-COVID strategy stopped). All patients had a positive real-time polymerase chain reaction (PCR) or lateral flow antigen test for SARS-CoV-2 after vaccination and no previous SARS-CoV-2 infections. We recorded patient baseline information pertaining to demographics, comorbid conditions, vital signs, and available laboratory data. All CT images were processed with a commercial artificial intelligence (AI) algorithm to obtain the volume and percentage of consolidation and infiltration related to Omicron pneumonia. The support vector machine (SVM) model was used to predict the disease severity and outcome. Results The receiver operating characteristic (ROC) area under the curve (AUC) of the machine learning classifier using PSI-related features was 0.85 (accuracy = 87.40%, p < 0.001) for predicting severity while that using CT-based features was only 0.70 (accuracy = 76.47%, p = 0.014). If combined, the AUC was not increased, showing 0.84 (accuracy = 84.03%, p < 0.001). Trained on outcome prediction, the classifier reached the AUC of 0.85 using PSI-related features (accuracy = 85.29%, p < 0.001), which was higher than using CT-based features (AUC = 0.67, accuracy = 75.21%, p < 0.001). If combined, the integrated model showed a slightly higher AUC of 0.86 (accuracy = 86.13%, p < 0.001). Oxygen saturation, IL-6, and CT infiltration showed great importance in both predicting severity and outcome. Conclusion Our study provided a comprehensive analysis and comparison between baseline chest CT and clinical assessment in disease severity and outcome prediction in Omicron pneumonia. The predictive model accurately predicts the severity and outcome of Omicron infection. Oxygen saturation, IL-6, and infiltration in chest CT were found to be important biomarkers. This approach has the potential to provide frontline physicians with an objective tool to manage Omicron patients more effectively in time-sensitive, stressful, and potentially resource-constrained environments.
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Affiliation(s)
- Jingjing Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhengye Cao
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunqin Miao
- Party and Hospital Administration Office, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Njekwa K, Muyoyeta M, Mulenga B, Chisenga CC, Simuyandi M, Chilengi R. Superimposed Pulmonary Tuberculosis (PTB) in a 26-Year-Old Female with No Underlying Co-Morbidities Recovering from COVID-19-Case Report. Trop Med Infect Dis 2023; 8:tropicalmed8050268. [PMID: 37235316 DOI: 10.3390/tropicalmed8050268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/16/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Tuberculosis before the COVID-19 pandemic is said to have killed more people globally than any other communicable disease and is ranked the 13th cause of death, according to the WHO. Tuberculosis also still remains highly endemic, especially in LIMCs with a high burden of people living with HIV/AIDS, in which it is the leading cause of mortality. Given the risk factors associated with COVID-19, the cross similarities between tuberculosis and COVID-19 symptoms, and the paucity of data on how both diseases impact each other, there is a need to generate more information on COVID-19-TB co-infection. In this case report, we present a young female patient of reproductive age with no underlying comorbidities recovering from COVID-19, who later presented with pulmonary tuberculosis. It describes the series of investigations performed and treatments given during the follow-up. There is a need for more surveillance for possible COVID-19-TB co-infection cases and further research to understand the impact of COVID-19 on tuberculosis and vice versa, especially in LMICs.
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Affiliation(s)
- Katanekwa Njekwa
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
| | - Monde Muyoyeta
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
- Tuberculosis Programs-Director, Centre for Infectious Disease Research, P.O. Box 34681, Lusaka 10101, Zambia
| | - Bavin Mulenga
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
| | | | - Michelo Simuyandi
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
- Enteric Diseases and Vaccine Research Unit (EDVRU)-Director, P.O. Box 34681, Lusaka 10101, Zambia
| | - Roma Chilengi
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
- Zambia National Public Health Institute (ZNPHI)-Director, H9M2+WGX, Lusaka 10101, Zambia
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10
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Raman G, Ashraf B, Demir YK, Kershaw CD, Cheruku S, Atis M, Atis A, Atar M, Chen W, Ibrahim I, Bat T, Mete M. Machine learning prediction for COVID-19 disease severity at hospital admission. BMC Med Inform Decis Mak 2023; 23:46. [PMID: 36882829 PMCID: PMC9990559 DOI: 10.1186/s12911-023-02132-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
IMPORTANCE Early prognostication of patients hospitalized with COVID-19 who may require mechanical ventilation and have worse outcomes within 30 days of admission is useful for delivering appropriate clinical care and optimizing resource allocation. OBJECTIVE To develop machine learning models to predict COVID-19 severity at the time of the hospital admission based on a single institution data. DESIGN, SETTING, AND PARTICIPANTS We established a retrospective cohort of patients with COVID-19 from University of Texas Southwestern Medical Center from May 2020 to March 2022. Easily accessible objective markers including basic laboratory variables and initial respiratory status were assessed using Random Forest's feature importance score to create a predictive risk score. Twenty-five significant variables were identified to be used in classification models. The best predictive models were selected with repeated tenfold cross-validation methods. MAIN OUTCOMES AND MEASURES Among patients with COVID-19 admitted to the hospital, severity was defined by 30-day mortality (30DM) rates and need for mechanical ventilation. RESULTS This was a large, single institution COVID-19 cohort including total of 1795 patients. The average age was 59.7 years old with diverse heterogeneity. 236 (13%) required mechanical ventilation and 156 patients (8.6%) died within 30 days of hospitalization. Predictive accuracy of each predictive model was validated with the 10-CV method. Random Forest classifier for 30DM model had 192 sub-trees, and obtained 0.72 sensitivity and 0.78 specificity, and 0.82 AUC. The model used to predict MV has 64 sub-trees and returned obtained 0.75 sensitivity and 0.75 specificity, and 0.81 AUC. Our scoring tool can be accessed at https://faculty.tamuc.edu/mmete/covid-risk.html . CONCLUSIONS AND RELEVANCE In this study, we developed a risk score based on objective variables of COVID-19 patients within six hours of admission to the hospital, therefore helping predict a patient's risk of developing critical illness secondary to COVID-19.
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Affiliation(s)
- Ganesh Raman
- grid.267313.20000 0000 9482 7121Departments of Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Bilal Ashraf
- grid.267313.20000 0000 9482 7121Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Yusuf Kemal Demir
- grid.266859.60000 0000 8598 2218School of Data Science, University of North Carolina at Charlotte, Charlotte, NC USA
| | - Corey D. Kershaw
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Sreekanth Cheruku
- grid.267313.20000 0000 9482 7121Department of Anesthesiology and Pain Management, Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Murat Atis
- grid.267313.20000 0000 9482 7121Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Ahsen Atis
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mustafa Atar
- grid.239578.20000 0001 0675 4725Cleveland Clinic, Cleveland, OH 44195 USA
| | - Weina Chen
- grid.267313.20000 0000 9482 7121Department of Pathology, Hematopathology Section, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Ibrahim Ibrahim
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Taha Bat
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mutlu Mete
- grid.264758.a0000 0004 1937 0087Department of Computer Science and Information Systems, Texas A&M University – Commerce, Commerce, TX 75429-3011 USA
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11
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Düz ME, Arslan M, Menek EE, Avci BY. Impact of the seventh day nucleated red blood cell count on mortality in COVID-19 intensive care unit patients: A retrospective case-control study. J Med Biochem 2023; 42:138-144. [PMID: 36819135 PMCID: PMC9920868 DOI: 10.5937/jomb0-39839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/24/2022] [Indexed: 11/09/2022] Open
Abstract
Background COVID-19 covers a broad clinical spectrum, threatening global health. Although several studies have investigated various prognostic biochemical and hematological parameters, they generally lack specificity and are insufficient for decision-making. Beyond the neonatal period, NRBCs (nucleated red blood cells) in peripheral blood is rare and often associated with malignant neoplasms, bone marrow diseases, and other severe disorders such as sepsis and hypoxia. Therefore, we investigated if NRBCs can predict mortality in hypoxic ICU (Intensive Care Unit) patients of COVID-19. Methods Seventy-one unvaccinated RT-PCR confirmed COVID-19 ICU patients was divided into those who survived (n=35, mean age=58) and died (n=36, mean age=75). Venous blood samples were collected in K3 EDTA tubes and analyzed on a Sysmex XN-1000 hematology analyzer with semiconductor laser flow cytometry and nucleic acid fluorescence staining method for NRBC analysis. NRBC numbers and percentages of the patients were compared on the first and seventh days of admission to the ICU. Results are reported as a proportion of NRBCs per 100 WBCs NRBCs/100 WBC (NRBC% and as absolute NRBC count (NRBC #, × 109/L). Results NRBC 7th-day count and % values were statistically higher in non-survival ones. The sensitivity for 7th day NRBC value <0.01 (negative) was 86.11%, the specificity was 48.57%, for <0.02; 75.00%, and 77.14%, for <0.03; 61.11%, and 94.60%. Conclusions In conclusion, our results indicate that NRBC elevation (>0.01) significantly predicts mortality in ICU hospitalized patients due to COVID-19. Worse, a high mortality rate is expected, especially with NRBC values of >0.03.
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Affiliation(s)
- Muhammed Emin Düz
- Amasya University, Sabuncuoğlu Şerefeddin Training, and Research Hospital, Medical Biochemistry, Amasya, Turkey
| | - Mustafa Arslan
- Amasya University, Sabuncuoğlu Şerefeddin Training, and Research Hospital, Infectious Diseases, Amasya, Turkey
| | - Elif E. Menek
- Amasya University, Sabuncuoğlu Şerefeddin Training, and Research Hospital, Medical Biochemistry, Amasya, Turkey
| | - Burak Yasin Avci
- Amasya University, Sabuncuoğlu Şerefeddin Training, and Research Hospital, Infectious Diseases, Amasya, Turkey
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12
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Zhang L, Yang J, Lai C, Wan L, Xiong S, Kong W, Liu Z, Yu P, Chen M, Mai W, Khan SA, Deng M, Chen L, Lei Y, Zhou Q, Yu N, Li P, Chen Z, Ji T. Immunity against Delta and Omicron variants elicited by homologous inactivated vaccine booster in kidney transplant recipients. Front Immunol 2023; 13:1042784. [PMID: 36700230 PMCID: PMC9868555 DOI: 10.3389/fimmu.2022.1042784] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Background A third mRNA vaccine booster is recommended to improve immunity against SARS-CoV-2 in kidney transplant recipients (KTRs). However, the immunity against SARS-CoV-2 Ancestral strain and Delta and Omicron variants elicited by the third dose of inactivated booster vaccine in KTRs remains unknown. Methods The blood parameters related to blood cells count, hepatic function, kidney function, heart injury and immunity were explored clinically from laboratory examinations. SARS-CoV-2 specific antibody IgG titer was detected using an enzyme-linked immunosorbent assay. Cellular immunity was analyzed using interferon-γ enzyme-linked immunospot assay. Results The results showed that there were no severe adverse effects and apparent changes of clinical laboratory biomarkers in KTRs and healthy volunteers (HVs) after homologous inactivated vaccine booster. A third dose of inactivated vaccine booster significantly increased anti-Ancestral-spike-trimer-IgG and anti-Ancestral-receptor binding domain (RBD)-IgG titers in KTRs and HVs compared with the second vaccination. However, the anti-Delta-RBD-IgG and anti-Omicron-RBD-IgG titers were significantly lower than anti-Ancestral-RBD-IgG titer in KTRs and HVs after the third dose. Notably, only 25.6% (10/39) and 10.3% (4/39) of KTRs had seropositivity for anti-Delta-RBD-IgG and anti-Omicron-RBD-IgG after booster, which were significantly lower than HVs (anti-Delta-RBD-IgG: 100%, anti-Omicron-RBD-IgG: 77.8%). Ancestral strain nucleocapsid protein and spike specific T cell frequency after booster was not significantly increased in KTRs compared with the second dose, significantly lower than that in HVs. Moreover, 33.3% (12/36), 14.3% (3/21) and 14.3% (3/21) of KTRs were positive for the Ancestral strain and Delta and Omicron spike-specific T cells, which were significantly lower than HVs (Ancestral: 80.8%, Delta: 53.8%, and Omicron: 57.7%). Conclusions A third dose of inactivated booster vaccine may significantly increase humoral immunity against the Ancestral strain in KTRs, while humoral and cellular immunity against the Delta and Omicron variants were still poor in KTRs.
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Affiliation(s)
- Lei Zhang
- Kidney Transplant Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiaqing Yang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Changchun Lai
- Provincial Key Laboratory of Immune Regulation and Immunotherapy, Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China,Clinical Laboratory Medicine Department, Maoming People’s Hospital, Maoming, Guangdong, China
| | - Li Wan
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shilong Xiong
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weiya Kong
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zijian Liu
- State Key Laboratories of Respiratory Diseases, Guangdong-Hong Kong-Macao Joint Laboratory of Infectious Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Pei Yu
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingxiao Chen
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weikang Mai
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shahzad Akbar Khan
- Laboratory of Pathology, Department of Pathobiology, University of Poonch Rawalakot, Azad Kashmir, Pakistan
| | - Min Deng
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lu Chen
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Lei
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Zhou
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nan Yu
- Provincial Key Laboratory of Immune Regulation and Immunotherapy, Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China,*Correspondence: Tianxing Ji, ; Zheng Chen, ; Pingchao Li, ; Nan Yu,
| | - Pingchao Li
- State Key Laboratories of Respiratory Diseases, Guangdong-Hong Kong-Macao Joint Laboratory of Infectious Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China,*Correspondence: Tianxing Ji, ; Zheng Chen, ; Pingchao Li, ; Nan Yu,
| | - Zheng Chen
- Kidney Transplant Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,*Correspondence: Tianxing Ji, ; Zheng Chen, ; Pingchao Li, ; Nan Yu,
| | - Tianxing Ji
- Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,*Correspondence: Tianxing Ji, ; Zheng Chen, ; Pingchao Li, ; Nan Yu,
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13
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Kim DK, Weller B, Lin CW, Sheykhkarimli D, Knapp JJ, Dugied G, Zanzoni A, Pons C, Tofaute MJ, Maseko SB, Spirohn K, Laval F, Lambourne L, Kishore N, Rayhan A, Sauer M, Young V, Halder H, la Rosa NMD, Pogoutse O, Strobel A, Schwehn P, Li R, Rothballer ST, Altmann M, Cassonnet P, Coté AG, Vergara LE, Hazelwood I, Liu BB, Nguyen M, Pandiarajan R, Dohai B, Coloma PAR, Poirson J, Giuliana P, Willems L, Taipale M, Jacob Y, Hao T, Hill DE, Brun C, Twizere JC, Krappmann D, Heinig M, Falter C, Aloy P, Demeret C, Vidal M, Calderwood MA, Roth FP, Falter-Braun P. A proteome-scale map of the SARS-CoV-2-human contactome. Nat Biotechnol 2023; 41:140-149. [PMID: 36217029 PMCID: PMC9849141 DOI: 10.1038/s41587-022-01475-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/15/2022] [Indexed: 01/22/2023]
Abstract
Understanding the mechanisms of coronavirus disease 2019 (COVID-19) disease severity to efficiently design therapies for emerging virus variants remains an urgent challenge of the ongoing pandemic. Infection and immune reactions are mediated by direct contacts between viral molecules and the host proteome, and the vast majority of these virus-host contacts (the 'contactome') have not been identified. Here, we present a systematic contactome map of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with the human host encompassing more than 200 binary virus-host and intraviral protein-protein interactions. We find that host proteins genetically associated with comorbidities of severe illness and long COVID are enriched in SARS-CoV-2 targeted network communities. Evaluating contactome-derived hypotheses, we demonstrate that viral NSP14 activates nuclear factor κB (NF-κB)-dependent transcription, even in the presence of cytokine signaling. Moreover, for several tested host proteins, genetic knock-down substantially reduces viral replication. Additionally, we show for USP25 that this effect is phenocopied by the small-molecule inhibitor AZ1. Our results connect viral proteins to human genetic architecture for COVID-19 severity and offer potential therapeutic targets.
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Affiliation(s)
- Dae-Kyum Kim
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Cancer Genetics and Genomics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Benjamin Weller
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Chung-Wen Lin
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Dayag Sheykhkarimli
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jennifer J Knapp
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guillaume Dugied
- Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, Institut Pasteur, Paris, France
- UMR3569, Centre National de la Recherche Scientifique, Paris, France
- Université de Paris, Paris, France
| | | | - Carles Pons
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona Institute for Science and Technology, Barcelona, Spain
| | - Marie J Tofaute
- Research Unit Cellular Signal Integration, Institute of Molecular Toxicology and Pharmacology, Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Sibusiso B Maseko
- Laboratory of Viral Interactomes, GIGA Institute, University of Liège, Liège, Belgium
| | - Kerstin Spirohn
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Florent Laval
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Laboratory of Viral Interactomes, GIGA Institute, University of Liège, Liège, Belgium
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
- TERRA Teaching and Research Centre, University of Liège, Gembloux, Belgium
- Laboratory of Molecular and Cellular Epigenetics, GIGA Institute, University of Liège, Liège, Belgium
| | - Luke Lambourne
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nishka Kishore
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ashyad Rayhan
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mayra Sauer
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Veronika Young
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Hridi Halder
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Nora Marín-de la Rosa
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Oxana Pogoutse
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alexandra Strobel
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Patrick Schwehn
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Roujia Li
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Simin T Rothballer
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Melina Altmann
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Patricia Cassonnet
- Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, Institut Pasteur, Paris, France
- UMR3569, Centre National de la Recherche Scientifique, Paris, France
- Université de Paris, Paris, France
| | - Atina G Coté
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lena Elorduy Vergara
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Isaiah Hazelwood
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Betty B Liu
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria Nguyen
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ramakrishnan Pandiarajan
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Bushra Dohai
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Patricia A Rodriguez Coloma
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Juline Poirson
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Molecular Architecture of Life Program, Canadian Institute for Advanced Research (CIFAR), Toronto, ON, Canada
| | - Paolo Giuliana
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Luc Willems
- TERRA Teaching and Research Centre, University of Liège, Gembloux, Belgium
- Laboratory of Molecular and Cellular Epigenetics, GIGA Institute, University of Liège, Liège, Belgium
| | - Mikko Taipale
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Laboratory of Viral Interactomes, GIGA Institute, University of Liège, Liège, Belgium
| | - Yves Jacob
- Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, Institut Pasteur, Paris, France
- UMR3569, Centre National de la Recherche Scientifique, Paris, France
- Université de Paris, Paris, France
| | - Tong Hao
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David E Hill
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christine Brun
- Aix-Marseille Université, Inserm, TAGC, Marseille, France
- CNRS, Marseille, France
| | - Jean-Claude Twizere
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA
- Laboratory of Viral Interactomes, GIGA Institute, University of Liège, Liège, Belgium
- TERRA Teaching and Research Centre, University of Liège, Gembloux, Belgium
| | - Daniel Krappmann
- Research Unit Cellular Signal Integration, Institute of Molecular Toxicology and Pharmacology, Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Matthias Heinig
- Institute of Computational Biology (ICB), Computational Health Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- Department of Informatics, Technische Universität München, Munich, Germany
| | - Claudia Falter
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Patrick Aloy
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona Institute for Science and Technology, Barcelona, Spain
- Institució Catalana de Recerca I Estudis Avaçats (ICREA), Barcelona, Spain
| | - Caroline Demeret
- Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, Institut Pasteur, Paris, France.
- UMR3569, Centre National de la Recherche Scientifique, Paris, France.
- Université de Paris, Paris, France.
| | - Marc Vidal
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA.
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
| | - Michael A Calderwood
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA.
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Frederick P Roth
- Donnelly Centre for Cellular and Biomolecular Research (CCBR), University of Toronto, Toronto, Ontario, Canada.
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
- Lunenfeld-Tanenbaum Research Institute (LTRI), Sinai Health System, Toronto, Ontario, Canada.
- Center for Cancer Systems Biology (CCSB), Dana-Farber Cancer Institute, Boston, MA, USA.
- Department of Computer Science, University of Toronto, Toronto, Ontario, Canada.
| | - Pascal Falter-Braun
- Institute of Network Biology (INET), Molecular Targets and Therapeutics Center (MTTC), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany.
- Microbe-Host Interactions, Faculty of Biology, Ludwig-Maximilians-Universität (LMU) München, Planegg-Martinsried, Germany.
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Çevik Y, Karaarslan FN, Çorbacıoğlu ŞK, Türkeş GF, Emektar E. The Effectiveness of Immature Granulocyte Count for Predicting COVID-19 Severity and Poor Outcomes. Eurasian J Emerg Med 2022. [DOI: 10.4274/eajem.galenos.2021.79836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Fragoso-Saavedra S, Núñez I, Audelo-Cruz BM, Arias-Martínez S, Manzur-Sandoval D, Quintero-Villegas A, Benjamín García-González H, Carbajal-Morelos SL, PoncedeLeón-Rosales S, Gotés-Palazuelos J, Maza-Larrea JA, Rosales-de la Rosa JJ, Diaz-Rivera D, Luna-García E, Piten-Isidro E, Del Río-Estrada PM, Fragoso-Saavedra M, Caro-Vega Y, Batina I, Islas-Weinstein L, Iruegas-Nunez DA, Calva JJ, Belaunzarán-Zamudio PF, Sierra-Madero J, Crispín JC, Valdés-Ferrer SI. Pyridostigmine reduces mortality of patients with severe SARS-CoV-2 infection: A phase 2/3 randomized controlled trial. Mol Med 2022; 28:131. [PMID: 36348276 PMCID: PMC9644007 DOI: 10.1186/s10020-022-00553-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/05/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022] Open
Abstract
Background: Respiratory failure in severe coronavirus disease 2019 (COVID-19) is associated with a severe inflammatory response. Acetylcholine (ACh) reduces systemic inflammation in experimental bacterial and viral infections. Pyridostigmine increases the half-life of endogenous ACh, potentially reducing systemic inflammation. We aimed to determine if pyridostigmine decreases a composite outcome of invasive mechanical ventilation (IMV) and death in adult patients with severe COVID-19. Methods: We performed a double-blinded, placebo-controlled, phase 2/3 randomized controlled trial of oral pyridostigmine (60 mg/day) or placebo as add-on therapy in adult patients admitted due to confirmed severe COVID-19 not requiring IMV at enrollment. The primary outcome was a composite of IMV or death by day 28. Secondary outcomes included reduction of inflammatory markers and circulating cytokines, and 90-day mortality. Adverse events (AEs) related to study treatment were documented and described. Results: We recruited 188 participants (94 per group); 112 (59.6%) were men; the median (IQR) age was 52 (44–64) years. The study was terminated early due to a significant reduction in the primary outcome in the treatment arm and increased difficulty with recruitment. The primary outcome occurred in 22 (23.4%) participants in the placebo group vs. 11 (11.7%) in the pyridostigmine group (hazard ratio, 0.47, 95% confidence interval 0.24–0.9; P = 0.03). This effect was driven by a reduction in mortality (19 vs. 8 deaths, respectively). Conclusion: Our data indicate that adding pyridostigmine to standard care reduces mortality among patients hospitalized for severe COVID-19.
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Romanelli A, Toigo P, Scarpati G, Caccavale A, Lauro G, Baldassarre D, Oliva F, Lacava G, Pascale G, Piazza O. Predictor factors for non-invasive mechanical ventilation failure in severe COVID-19 patients in the intensive care unit: a single-center retrospective study. J Anesth Analg Crit Care 2022. [PMCID: PMC8853166 DOI: 10.1186/s44158-022-00038-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background During the COVID-19 pandemia, non-invasive mechanical ventilation (NIV) has been largely applied. Few data are available about predictors of NIV failure in critical COVID-19 patients admitted to ICU. The aim of this study is to analyze clinical and laboratory features able to predict non-invasive ventilation success in avoiding endotracheal intubation. Methods A retrospective observational study was performed in our COVID-19 ICU during a 6-month period. Demographic, clinical, laboratory, imaging, and outcome data were extracted from electronic and paper medical records and anonymously collected. Results Eighty-two severe COVID-19 patients were supported by NIV at ICU admission. The median PaO2/FiO2 ratio was 125 [98.5–177.7]. NIV failed in 44 cases (53%). Patients who experienced NIV failure had a higher Charlson Comorbidity Index (median value 4) compared to those who were dismissed without endotracheal intubation (median 2, p < 0.0001). At Cox regression analysis, the Charlson Comorbidity Index represented a predictive factor related to NIV failure. PaO2/FiO2, CPK, INR, and AT III at ICU admission showed a significant relationship with the outcome, when single variables were adjusted for the Charlson Comorbidity Index. Conclusion The Charlson Comorbidity Index may be helpful to stratify patients’ risk of NIV failure in a severe COVID-19 population; even if this study, retrospective design does not allow definitive conclusions. Supplementary Information The online version contains supplementary material available at 10.1186/s44158-022-00038-7.
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Song QX, Jin Z, Fang W, Zhang C, Peng C, Chen M, Zhuang X, Zhai W, Wang J, Cao M, Wei S, Cai X, Pan L, Xu Q, Zheng J. The machine learning model based on trajectory analysis of ribonucleic acid test results predicts the necessity of quarantine in recurrently positive patients with SARS-CoV-2 infection. Front Public Health 2022; 10:1011277. [PMID: 36466454 PMCID: PMC9714505 DOI: 10.3389/fpubh.2022.1011277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background SARS-CoV-2 patients re-experiencing positive nucleic acid test results after recovery is a concerning phenomenon. Current pandemic prevention strategy demands the quarantine of all recurrently positive patients. This study provided evidence on whether quarantine is required in those patients, and predictive algorithms to detect subjects with infectious possibility. Methods This observational study recruited recurrently positive patients who were admitted to our shelter hospital between May 12 and June 10, 2022. The demographic and epidemiologic data was collected, and nucleic acid tests were performed daily. virus isolation was done in randomly selected cases. The group-based trajectory model was developed based on the cycle threshold (Ct) value variations. Machine learning models were validated for prediction accuracy. Results Among the 494 subjects, 72.04% were asymptomatic, and 23.08% had a Ct value under 30 at recurrence. Two trajectories were identified with either rapid (92.24%) or delayed (7.76%) recovery of Ct values. The latter had significantly higher incidence of comorbidities; lower Ct value at recurrence; more persistent cough; and more frequently reported close contacts infection compared with those recovered rapidly. However, negative virus isolation was reported in all selected samples. Our predictive model can efficiently discriminate those with delayed Ct value recovery and infectious potentials. Conclusion Quarantine seems to be unnecessary for the majority of re-positive patients who may have low transmission risks. Our predictive algorithm can screen out the suspiciously infectious individuals for quarantine. These findings may assist the enaction of SARS-CoV-2 pandemic prevention strategies regarding recurrently positive patients in the future.
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Affiliation(s)
- Qi-Xiang Song
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhichao Jin
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Weilin Fang
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenxu Zhang
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Chi Peng
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Min Chen
- Department of Nursing, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Zhuang
- Department of Obstetrics and Gynecology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Zhai
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Wang
- Department of Interventional Oncology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Cao
- Department of Emergency, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shun Wei
- Department of Information Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Cai
- BSL-3 Laboratory of Fudan University, Shanghai, China
| | - Lei Pan
- Department of Rheumatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingrong Xu
- Department of Orthopedics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junhua Zheng
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Junhua Zheng
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Sarzyńska K, Świątkowski F, Janc J, Zabierowski J, Jankowska-polańska B, Chabowski M. Analysis of Mortality in Unvaccinated Patients with COVID-19 and Cardiovascular Risk. J Clin Med 2022; 11:5004. [PMID: 36078933 PMCID: PMC9456782 DOI: 10.3390/jcm11175004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is a contagious disease that has spread globally, killing millions of people around the world. In order to reduce the likelihood of in-hospital death due to COVID-19, it is reasonable to select a group of patients with a low probability of survival and to implement measures in advance to minimize the risk of death. One way to do this is to establish cut-off values for the most commonly performed blood laboratory tests, above or below which the likelihood of death increases significantly. The aim of the study was to determine the basic laboratory parameters among unvaccinated patients hospitalized for COVID-19 with concomitant cardiovascular disease, which are the predictors of in-hospital death. Out of 1234 patients, 446 people who met the specific inclusion criteria were enrolled in the study. The multivariate regression analysis has shown that the independent predictors of death are: troponin levels of at least 0.033 μg/L (OR = 2.04 [1.10; 3.79]), creatinine of at least 1.88 mg/dL (OR = 2.88 [1.57; 5.30]), D-dimers of at least 0.97 g/L (OR = 2.04 [1.02; 4.07]), and C-reactive protein minimum of 0.89 mg/L (OR = 2.28 [1.24; 4.18]).
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Nain M, Gupta A, Malhotra S, Sharma A. High-density lipoproteins may play a crucial role in COVID-19. Virol J 2022; 19:135. [PMID: 35999545 PMCID: PMC9395887 DOI: 10.1186/s12985-022-01865-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background Lipids play a central role in the virus life cycle and are a crucial target to develop antiviral therapeutics. Importantly, among the other lipoproteins, the ‘good cholesterol’ high-density lipoprotein (HDL) has been widely studied for its role in not only cardiovascular but several infectious diseases as well. Studies have suggested a role of serum lipids and lipoproteins including HDL, total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL) in several viral infections including COVID-19. This disease is currently a major public health problem and there is a need to explore the role of these host lipids/lipoproteins in virus pathogenesis. Methodology A total of 75 retrospective COVID-19 positive serum samples and 10 COVID-19 negative controls were studied for their lipid profiles including TC, HDL, LDL, and very-low-density lipoproteins (VLDL), and TG. Results Systematic literature search on dyslipidemia status in India shows that low HDL is the most common dyslipidemia. In this cohort, 65% (49) of COVID-19 patients had severely low HDL levels whereas 35% (26) had moderately low HDL and none had normal HDL levels. On the other hand, ~ 96% of samples had normal TC (72) and LDL (72) levels. VLDL and TG levels were also variable. In the controls, 100% of samples had moderately low HDL but none severely low HDL levels. Conclusion HDL likely plays a crucial role in COVID-19 infection and outcomes. The causal relationships between HDL levels and COVID-19 need to be studied extensively for an understanding of disease pathogenesis and management. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01865-4.
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Affiliation(s)
- Minu Nain
- National Institute of Malaria Research, New Delhi, 110 077, India
| | - Apoorv Gupta
- National Institute of Malaria Research, New Delhi, 110 077, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Amit Sharma
- National Institute of Malaria Research, New Delhi, 110 077, India. .,Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, 110 067, India.
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Costanza G, Paba P, Ciotti M, Ombres D, Di Carlo S, Marcuccilli F, Bertoli A, Di Traglia L, Mozzani M, Piredda L, Petrone V, Fanelli M, Paganelli C, Cortese B, Balestrieri E, Bernardini S, Andreoni M, Matteucci C, Minutolo A, Grelli S. Infection Rate of Respiratory Viruses in the Pandemic SARS-CoV-2 Period Considering Symptomatic Patients: Two Years of Ongoing Observations. Biomolecules 2022; 12:987. [PMID: 35883543 DOI: 10.3390/biom12070987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the last two years, the SARS-CoV-2 pandemic has determined radical changes in human behaviors and lifestyles, with a drastic reduction in socialization due to physical distancing and self-isolation. These changes have also been reflected in the epidemiological patterns of common respiratory viruses. For this reason, early discrimination of respiratory viruses is important as new variants emerge. METHODS Nasopharyngeal swabs of 2554 patients, with clinically suspected Acute Respiratory Infections (ARIs) from October 2019 to November 2021, were collected to detect 1 or more of the 23 common respiratory pathogens, especially viruses, via BioFilmArray RP2.1plus, including SARS-CoV-2. Demographical characteristics and epidemiological analyses were performed as well as a laboratory features profile of positive patients. RESULTS An observational study on 2300 patients (254 patients were excluded because of missing data) including 1560 men and 760 women, median age of 64.5 years, was carried out. Considering the respiratory virus research request, most of the patients were admitted to the Emergency Medicine Department (41.2%, of patients), whereas 29.5% were admitted to the Infectious Diseases Department. The most frequently detected pathogens included SARS-CoV-2 (31.06%, 707/2300, from March 2020 to November 2021), InfA-B (1.86%, 43/2300), HCoV (2.17% 50/2300), and HSRV (1.65%, 38/2300). Interestingly, coinfection rates decreased dramatically in the SARS-CoV-2 pandemic period. The significative decrease in positive rate of SARS-CoV-2 was associated with the massive vaccination. CONCLUSION This study represents a dynamic picture of the epidemiological curve of common respiratory viruses during the two years of pandemic, with a disregarded trend for additional viruses. Our results showed that SARS-CoV-2 had a preferential tropism for the respiratory tract without co-existing with other viruses. The possible causes were attributable either to the use of masks, social isolation, or to specific respiratory receptors mostly available for this virus, external and internal lifestyle factors, vaccination campaigns, and emergence of new SARS-CoV-2 variants.
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Sada KE, Yamamoto R, Yano A, Miyauchi A, Kawamura M, Ito H. Bicarbonate concentration as a predictor of prognosis in moderately severe COVID-19 patients: A multicenter retrospective study. PLoS One 2022; 17:e0270141. [PMID: 35749694 PMCID: PMC9232226 DOI: 10.1371/journal.pone.0270141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 06/03/2022] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) patients reportedly have high bicarbonate concentration. However, its relationship to the disease progression are obscure. Methods In this two-center retrospective study, we included COVID-19 patients with moderate severity between March 2020 and May 2021. We classified patients into three groups according to bicarbonate concentrations: high (>27 mEq/L), normal (21 to 27 mEq/L), and low (<21 mEq/L). The primary outcome was the time to clinical worsening defined by the requirement of intubation or death during 90 days. We evaluated high or low bicarbonate concentration during the clinical course related to the primary outcome using multivariable Cox proportional hazard models. Results Of the 60 participants (median age 72 years), 60% were men. Participants were classified into high (13 patients), normal (30 patients), and low (17 patients) groups. Clinical worsening occurred in 54% of patients in the high group, 23% in the normal group, and 65% in the low group. Both high and low groups were associated with a higher clinical worsening rate: HR, 3.02 (95% CI, 1.05 to 8.63) in the high group; 3.49 (95% CI: 1.33 to 9.12) in the low group. Conclusion Monitoring of bicarbonate concentrations may be useful to predict the prognosis.
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Affiliation(s)
- Ken-ei Sada
- Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku, Japan
- Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital, Sukumo, Japan
- Department of General Medicine, Kochi Health Sciences Center, Kochi, Japan
- * E-mail:
| | - Ryohei Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiko Yano
- Department of General Medicine, Kochi Health Sciences Center, Kochi, Japan
| | - Atsushi Miyauchi
- Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital, Sukumo, Japan
| | - Masafumi Kawamura
- Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital, Sukumo, Japan
| | - Hideki Ito
- Department of General Medicine, Kochi Health Sciences Center, Kochi, Japan
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Giner-Galvañ V, Pomares-Gómez FJ, Quesada JA, Rubio-Rivas M, Tejada-Montes J, Baltasar-Corral J, Taboada-Martínez ML, Sánchez-Mesa B, Arnalich-Fernández F, Del Corral-Beamonte E, López-Sampalo A, Pesqueira-Fontán PM, Fernández-Garcés M, Gómez-Huelgas R, Ramos-Rincón JM. C-Reactive Protein and Serum Albumin Ratio: A Feasible Prognostic Marker in Hospitalized Patients with COVID-19. Biomedicines 2022; 10:biomedicines10061393. [PMID: 35740416 PMCID: PMC9219981 DOI: 10.3390/biomedicines10061393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
(1) Background: C-reactive protein (CRP) and albumin are inflammatory markers. We analyzed the prognostic capacity of serum albumin (SA) and CRP for an outcome comprising mortality, length of stay, ICU admission, and non-invasive mechanical ventilation in hospitalized COVID-19 patients. (2) Methods: We conducted a retrospective cohort study based on the Spanish national SEMI-COVID-19 Registry. Two multivariate logistic models were adjusted for SA, CRP, and their combination. Training and testing samples were used to validate the models. (3) Results: The outcome was present in 41.1% of the 3471 participants, who had lower SA (mean [SD], 3.5 [0.6] g/dL vs. 3.8 [0.5] g/dL; p < 0.001) and higher CRP (108.9 [96.5] mg/L vs. 70.6 [70.3] mg/L; p < 0.001). In the adjusted multivariate model, both were associated with poorer evolution: SA, OR 0.674 (95% CI, 0.551−0.826; p < 0.001); CRP, OR 1.002 (95% CI, 1.001−1.004; p = 0.003). The CRP/SA model had a similar predictive capacity (honest AUC, 0.8135 [0.7865−0.8405]), with a continuously increasing risk and cutoff value of 25 showing the highest predictive capacity (OR, 1.470; 95% CI, 1.188−1.819; p < 0.001). (4) Conclusions: SA and CRP are good independent predictors of patients hospitalized with COVID-19. For the CRP/SA ratio value, 25 is the cutoff for poor clinical course.
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Affiliation(s)
- Vicente Giner-Galvañ
- Department of Internal Medicine, Hospital Clínico Universitario San Juan de Alicante, 03550 Alicante, Spain
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), 46020 Valencia, Spain;
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
- Correspondence: or ; Tel.: +34-680-588-421
| | - Francisco José Pomares-Gómez
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), 46020 Valencia, Spain;
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
- Department of Endocrinology, Hospital Clínico Universitario San Juan de Alicante, 03550 Alicante, Spain
| | - José Antonio Quesada
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
| | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, 08097 L’Hospitalet de Llobregat, Spain;
| | - Javier Tejada-Montes
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | | | | | - Blanca Sánchez-Mesa
- Department of Internal Medicine, Hospital Costa del Sol, 20603 Marbella, Spain;
| | | | | | - Almudena López-Sampalo
- Department of Internal Medicine, Regional University Hospital of Málaga, 29010 Málaga, Spain; (A.L.-S.); (R.G.-H.)
- Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29590 Málaga, Spain
| | - Paula María Pesqueira-Fontán
- Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain;
| | - Mar Fernández-Garcés
- Department of Internal Medicine, Doctor Peset University Hospital, 46017 Valencia, Spain;
| | - Ricardo Gómez-Huelgas
- Department of Internal Medicine, Regional University Hospital of Málaga, 29010 Málaga, Spain; (A.L.-S.); (R.G.-H.)
- Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29590 Málaga, Spain
| | - José Manuel Ramos-Rincón
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
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Garcia-gutiérrez S, Esteban-aizpiri C, Lafuente I, Barrio I, Quiros R, Quintana JM, Uranga A, García-gutiérrez S, Lafuente I, Quintana JM, Orive M, Gonzalez N, Anton A, Villanueva A, Muñoz C, Legarreta MJ, Quirós R, Yandiola PPE, Egurrola M, Aramburu A, Artaraz A, Chasco L, Bronte O, García P, Jodar A, Fernandez V, Esteban C, Mas N, Pulido E, Bengoetxea I, Martínez AE, Bilbao A, Gorostiza I, Arriaga I, Zapiarain JJP, Parraza N, Iriberri M, Zalacain R, Ruiz LA, Serrano L, Couto A, Ateka O, Cano A, Ibarra MO, Millan E, Bacigalupe M, Letona J, Arcelay A, Berraondo I, Castells X, Posso M, Perestelo L, Acosta GP, Gonzñalez CM, Redondo M, Padilla M, Muñoz A, de Madariaga RS; COVID-REDISSEC Working Group. Machine learning-based model for prediction of clinical deterioration in hospitalized patients by COVID 19. Sci Rep 2022; 12. [PMID: 35501359 PMCID: PMC9059444 DOI: 10.1038/s41598-022-09771-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/29/2022] [Indexed: 12/20/2022] Open
Abstract
AbstractDespite the publication of great number of tools to aid decisions in COVID-19 patients, there is a lack of good instruments to predict clinical deterioration. COVID19-Osakidetza is a prospective cohort study recruiting COVID-19 patients. We collected information from baseline to discharge on: sociodemographic characteristics, comorbidities and associated medications, vital signs, treatment received and lab test results. Outcome was need for intensive ventilatory support (with at least standard high-flow oxygen face mask with a reservoir bag for at least 6 h and need for more intensive therapy afterwards or Optiflow high-flow nasal cannula or noninvasive or invasive mechanical ventilation) and/or admission to a critical care unit and/or death during hospitalization. We developed a Catboost model summarizing the findings using Shapley Additive Explanations. Performance of the model was assessed using area under the receiver operating characteristic and prediction recall curves (AUROC and AUPRC respectively) and calibrated using the Hosmer–Lemeshow test. Overall, 1568 patients were included in the derivation cohort and 956 in the (external) validation cohort. The percentages of patients who reached the composite endpoint were 23.3% vs 20% respectively. The strongest predictors of clinical deterioration were arterial blood oxygen pressure, followed by age, levels of several markers of inflammation (procalcitonin, LDH, CRP) and alterations in blood count and coagulation. Some medications, namely, ATC AO2 (antiacids) and N05 (neuroleptics) were also among the group of main predictors, together with C03 (diuretics). In the validation set, the CatBoost AUROC was 0.79, AUPRC 0.21 and Hosmer–Lemeshow test statistic 0.36. We present a machine learning-based prediction model with excellent performance properties to implement in EHRs. Our main goal was to predict progression to a score of 5 or higher on the WHO Clinical Progression Scale before patients required mechanical ventilation. Future steps are to externally validate the model in other settings and in a cohort from a different period and to apply the algorithm in clinical practice.Registration: ClinicalTrials.gov Identifier: NCT04463706.
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24
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Quispe-Pari JF, Gonzales-Zamora JA, Munive-Dionisio J, Castro-Contreras C, Villar-Astete A, Kong-Paravicino C, Vilcapoma-Balbin P, Hurtado-Alegre J. Mean Platelet Volume as a Predictor of COVID-19 Severity: A Prospective Cohort Study in the Highlands of Peru. Diseases 2022; 10:diseases10020022. [PMID: 35466192 PMCID: PMC9044747 DOI: 10.3390/diseases10020022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/04/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Although 80% of symptomatic individuals with COVID-19 develop mild forms, it is the severe (15%) and critical (5%) forms that have the greatest impact in the hospital setting. Recognizing markers that can predict severe forms is essential, especially in high-altitude populations. Methods: We conducted a prospective cohort study at 3200 masl (meters above sea level) in a city in Peru to determine if MPV (mean platelet volume) level is a predictor of COVID-19 severity. Patients with mild/moderate disease were enrolled and followed for 21 days or until the development of severe disease (primary outcome). A bivariate analysis was used to identify variables associated with severe disease. A ROC analysis determined the best MPV (mean platelet count) cut-off to predict COVID-19 severity, and then, a multiple regression analysis was performed. Results: 64 patients were enrolled. The median age was 48.5 years (IQT 39–64.5) and the proportion of women was 51.6%, the most frequent symptoms were chest pain (73%), fever (71%), and dyspnea (67%). The median time to develop a severe form from the onset of symptoms was 11 days (IQT 10.5–13). The most common radiographic phase on CT scan (computed tomography) was progressive (60.38%). We observed that an MPV of more than 10.15 fL in the first week of disease predicted severity regardless of age and sex at high altitudes. Conclusions: MPV in the first week of the disease may predict severity in patients diagnosed with COVID-19 at high altitudes; however, we need prospective studies with a larger population and at a different altitude, levels to confirm these findings.
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Affiliation(s)
- Jhosef Franck Quispe-Pari
- Infectology Unit, Department of Medicine, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru; (J.F.Q.-P.); (J.M.-D.); (P.V.-B.); (J.H.-A.)
- Faculty of Human Medicine, Universidad Nacional del Centro del Peru, Huancayo 12004, Peru
| | - Jose Armando Gonzales-Zamora
- Infectious Disease Division, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Peruvian American Medical Society, Albuquerque, NM 87111, USA
- Correspondence: ; Tel.: +1-706-284-3510
| | - Judith Munive-Dionisio
- Infectology Unit, Department of Medicine, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru; (J.F.Q.-P.); (J.M.-D.); (P.V.-B.); (J.H.-A.)
| | - Cristhian Castro-Contreras
- Clinical Pathology Unit, Department of Diagnostic, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru; (C.C.-C.); (C.K.-P.)
| | - Abelardo Villar-Astete
- Radiology Unit, Department of Diagnostic, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru;
| | - Cesar Kong-Paravicino
- Clinical Pathology Unit, Department of Diagnostic, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru; (C.C.-C.); (C.K.-P.)
| | - Pierina Vilcapoma-Balbin
- Infectology Unit, Department of Medicine, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru; (J.F.Q.-P.); (J.M.-D.); (P.V.-B.); (J.H.-A.)
- Facultad de Medicina Humana, Universidad Continental, Huancayo 12004, Peru
| | - Jorge Hurtado-Alegre
- Infectology Unit, Department of Medicine, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12004, Peru; (J.F.Q.-P.); (J.M.-D.); (P.V.-B.); (J.H.-A.)
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25
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Mohammed Y, Goodlett DR, Cheng MP, Vinh DC, Lee TC, Mcgeer A, Sweet D, Tran K, Lee T, Murthy S, Boyd JH, Singer J, Walley KR, Patrick DM, Quan C, Ismail S, Amar L, Pal A, Bassawon R, Fesdekjian L, Gou K, Lamontagne F, Marshall J, Haljan G, Fowler R, Winston BW, Russell JA. Longitudinal Plasma Proteomics Analysis Reveals Novel Candidate Biomarkers in Acute COVID-19. J Proteome Res 2022; 21:975-992. [PMID: 35143212 PMCID: PMC8864781 DOI: 10.1021/acs.jproteome.1c00863] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 12/15/2022]
Abstract
The host response to COVID-19 pathophysiology over the first few days of infection remains largely unclear, especially the mechanisms in the blood compartment. We report on a longitudinal proteomic analysis of acute-phase COVID-19 patients, for which we used blood plasma, multiple reaction monitoring with internal standards, and data-independent acquisition. We measured samples on admission for 49 patients, of which 21 had additional samples on days 2, 4, 7, and 14 after admission. We also measured 30 externally obtained samples from healthy individuals for comparison at baseline. The 31 proteins differentiated in abundance between acute COVID-19 patients and healthy controls belonged to acute inflammatory response, complement activation, regulation of inflammatory response, and regulation of protein activation cascade. The longitudinal analysis showed distinct profiles revealing increased levels of multiple lipid-associated functions, a rapid decrease followed by recovery for complement activation, humoral immune response, and acute inflammatory response-related proteins, and level fluctuation in the regulation of smooth muscle cell proliferation, secretory mechanisms, and platelet degranulation. Three proteins were differentiated between survivors and nonsurvivors. Finally, increased levels of fructose-bisphosphate aldolase B were determined in patients with exposure to angiotensin receptor blockers versus decreased levels in those exposed to angiotensin-converting enzyme inhibitors. Data are available via ProteomeXchange PXD029437.
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Affiliation(s)
- Yassene Mohammed
- Genome BC Proteomics Centre, University
of Victoria, Victoria V8Z 5N3, British Columbia,
Canada
- Center for Proteomics and Metabolomics,
Leiden University Medical Center, Leiden 2333 ZA,
Netherlands
| | - David R. Goodlett
- Genome BC Proteomics Centre, University
of Victoria, Victoria V8Z 5N3, British Columbia,
Canada
- Department of Biochemistry and Microbiology,
University of Victoria, Victoria V8W 2Y2, British Columbia,
Canada
- International Centre for Cancer Vaccine Science,
University of Gdansk, Gdansk 80-822, European Union,
Poland
| | - Matthew P. Cheng
- Division of Infectious Diseases (Department of
Medicine), Division of Medical Microbiology (Department of Pathology and Laboratory
Medicine), McGill University Health Centre, Montreal H4A 3J1,
Quebec, Canada
| | - Donald C. Vinh
- Division of Infectious Diseases (Department of
Medicine), Division of Medical Microbiology (Department of Pathology and Laboratory
Medicine), McGill University Health Centre, Montreal H4A 3J1,
Quebec, Canada
| | - Todd C. Lee
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Allison Mcgeer
- Mt. Sinai Hospital and University of
Toronto, University Avenue, Toronto M5G 1X5, Ontario,
Canada
| | - David Sweet
- Division of Critical Care Medicine, Department of
Emergency Medicine, Vancouver General Hospital and University of British
Columbia, Vancouver V5Z 1M9, British Columbia,
Canada
| | - Karen Tran
- Division of General Internal Medicine,
Vancouver General Hospital and University of British
Columbia, Vancouver V5Z 1M9, British Columbia,
Canada
| | - Terry Lee
- Centre for Health Evaluation and Outcome Science
(CHEOS), St. Paul’s Hospital, University of British
Columbia, 1081 Burrard Street, Vancouver V6Z 1Y6, British Columbia,
Canada
| | - Srinivas Murthy
- BC Children’s Hospital,
University of British Columbia, Vancouver V6H 3N1, British Columbia,
Canada
| | - John H. Boyd
- Centre for Heart Lung Innovation, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
- Division of Critical Care Medicine, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
| | - Joel Singer
- Centre for Health Evaluation and Outcome Science
(CHEOS), St. Paul’s Hospital, University of British
Columbia, 1081 Burrard Street, Vancouver V6Z 1Y6, British Columbia,
Canada
| | - Keith R. Walley
- Centre for Heart Lung Innovation, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
- Division of Critical Care Medicine, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
| | - David M. Patrick
- British Columbia Centre for Disease
Control (BCCDC) and University of British Columbia, Vancouver V5Z 4R4,
British Columbia, Canada
| | - Curtis Quan
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Sara Ismail
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Laetitia Amar
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Aditya Pal
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Rayhaan Bassawon
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Lara Fesdekjian
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | - Karine Gou
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
| | | | - John Marshall
- Department of Surgery, St.
Michael’s Hospital, Toronto M5B 1W8, Ontario,
Canada
| | - Greg Haljan
- Division of Critical Care, Surrey
Memorial Hospital and University of British Columbia, Surrey V3V 1Z2,
British Columbia, Canada
| | - Robert Fowler
- Sunnybrook Health Sciences
Centre, Toronto M4N 3M5, Ontario, Canada
| | - Brent W. Winston
- Departments of Critical Care Medicine, Medicine and
Biochemistry and Molecular Biology, University of Calgary,
Calgary T2N 4N1, Alberta, Canada
| | - James A. Russell
- Centre for Heart Lung Innovation, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
- Division of Critical Care Medicine, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
| | - ARBs CORONA I
- Genome BC Proteomics Centre, University
of Victoria, Victoria V8Z 5N3, British Columbia,
Canada
- Center for Proteomics and Metabolomics,
Leiden University Medical Center, Leiden 2333 ZA,
Netherlands
- Department of Biochemistry and Microbiology,
University of Victoria, Victoria V8W 2Y2, British Columbia,
Canada
- International Centre for Cancer Vaccine Science,
University of Gdansk, Gdansk 80-822, European Union,
Poland
- Department of Medicine, McGill
University, Montreal H4A 3J1, Quebec, Canada
- Mt. Sinai Hospital and University of
Toronto, University Avenue, Toronto M5G 1X5, Ontario,
Canada
- Division of Critical Care Medicine, Department of
Emergency Medicine, Vancouver General Hospital and University of British
Columbia, Vancouver V5Z 1M9, British Columbia,
Canada
- Division of General Internal Medicine,
Vancouver General Hospital and University of British
Columbia, Vancouver V5Z 1M9, British Columbia,
Canada
- Centre for Health Evaluation and Outcome Science
(CHEOS), St. Paul’s Hospital, University of British
Columbia, 1081 Burrard Street, Vancouver V6Z 1Y6, British Columbia,
Canada
- BC Children’s Hospital,
University of British Columbia, Vancouver V6H 3N1, British Columbia,
Canada
- Centre for Heart Lung Innovation, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
- Division of Critical Care Medicine, St.
Paul’s Hospital, University of British Columbia, 1081 Burrard
Street, Vancouver V6Z 1Y6, British Columbia, Canada
- British Columbia Centre for Disease
Control (BCCDC) and University of British Columbia, Vancouver V5Z 4R4,
British Columbia, Canada
- University of Sherbrooke,
Sherbrooke J1K 2R1, Quebec, Canada
- Department of Surgery, St.
Michael’s Hospital, Toronto M5B 1W8, Ontario,
Canada
- Division of Critical Care, Surrey
Memorial Hospital and University of British Columbia, Surrey V3V 1Z2,
British Columbia, Canada
- Sunnybrook Health Sciences
Centre, Toronto M4N 3M5, Ontario, Canada
- Departments of Critical Care Medicine, Medicine and
Biochemistry and Molecular Biology, University of Calgary,
Calgary T2N 4N1, Alberta, Canada
- Division of Infectious Diseases (Department of
Medicine), Division of Medical Microbiology (Department of Pathology and Laboratory
Medicine), McGill University Health Centre, Montreal H4A 3J1,
Quebec, Canada
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26
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Li H, Li X, Wu Q, Wang X, Qin Z, Wang Y, He Y, Wu Q, Li L, Chen H. Plasma proteomic and metabolomic characterization of COVID-19 survivors 6 months after discharge. Cell Death Dis 2022; 13:235. [PMID: 35288537 PMCID: PMC8919172 DOI: 10.1038/s41419-022-04674-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 02/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has gained prominence as a global pandemic. Studies have suggested that systemic alterations persist in a considerable proportion of COVID-19 patients after hospital discharge. We used proteomic and metabolomic approaches to analyze plasma samples obtained from 30 healthy subjects and 54 COVID-19 survivors 6 months after discharge from the hospital, including 30 non-severe and 24 severe patients. Through this analysis, we identified 1019 proteins and 1091 metabolites. The differentially expressed proteins and metabolites were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. Among the patients evaluated, 41% of COVID-19 survivors reported at least one clinical symptom and 26.5% showed lung imaging abnormalities at 6 months after discharge. Plasma proteomics and metabolomics analysis showed that COVID-19 survivors differed from healthy control subjects in terms of the extracellular matrix, immune response, and hemostasis pathways. COVID-19 survivors also exhibited abnormal lipid metabolism, disordered immune response, and changes in pulmonary fibrosis-related proteins. COVID-19 survivors show persistent proteomic and metabolomic abnormalities 6 months after discharge from the hospital. Hence, the recovery period for COVID-19 survivors may be longer.
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Affiliation(s)
- Hongwei Li
- Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin, China
| | - Xue Li
- Department of Basic Medicine, Haihe Hospital, Tianjin University, Tianjin, China
- Department of Basic Medicine, Haihe Clinical School, Tianjin Medical University, Tianjin, China
| | - Qian Wu
- Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin, China
| | - Xing Wang
- Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin, China
| | - Zhonghua Qin
- Department of Laboratory Medicine, Haihe Hospital, Tianjin University, Tianjin, China
| | - Yaguo Wang
- Key Laboratory of RNA Biology, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Yanbin He
- Key Laboratory of RNA Biology, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Qi Wu
- Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine, Tianjin Institute of Respiratory Diseases, Tianjin, China.
| | - Li Li
- Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin, China.
- Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin, China.
| | - Huaiyong Chen
- Department of Basic Medicine, Haihe Hospital, Tianjin University, Tianjin, China.
- Department of Basic Medicine, Haihe Clinical School, Tianjin Medical University, Tianjin, China.
- Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine, Tianjin Institute of Respiratory Diseases, Tianjin, China.
- Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin, China.
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27
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Korkut M, Bedel C, Selvi F, Zortuk Ö. Can Peripheral Perfusion Index (PPI) Predict Disease Severity in COVID-19 Patients in the Emergency Department? Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1748776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Background Coronavirus disease 2019 (COVID-19) causes significant mortality and morbidity in severe patients.
Objective In this study, we aimed to examine the relationship between COVID-19 disease severity and peripheral perfusion index (PPI).
Patients and Methods This prospective observational study included COVID-19 patients admitted to the tertiary hospital emergency department. Basal clinical and demographic data of the patients and PPI values at the time of admission were recorded. The patients were categorized to severe and nonsevere groups according to clinical severity. The relationship between COVID-19 severity and PPI was examined in comparison with the control group.
Results A total of 324 patients who met the inclusion criteria were analyzed. COVID-19 (+) was detected in 180 of these patients. Ninety-two of the COVID-19 (+) patients were in the severe group, and 88 of them were in the non severe group. Note that 164 COVID-19 (–) patients were in the control group. PPI average was found to be 1.44 ± 1.12 in the severe group, and 3.69 ± 2.51 in the nonsevere group. PPI average was found to be significantly lower in the severe group than the nonsevere group (p< 0.01) As for the nonsevere group and control group, PPI averages were found to be 3.69 ± 2.51 and3.54 ± 2.32, respectively, and a significant difference was determined between the two groups (p< 0.05). PPI COVID-19 severity predicting activity was calculated as area under the curve: 0.833, sensitivity:70.4%, andspecificity:71%(p = 0.025) at 2.2 cutoff value.
Conclusion The results of our study showed that PPI is an easy-to-apply and useful parameter in the emergency department in determining the severity of COVID-19 patients.
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Affiliation(s)
- Mustafa Korkut
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ökkeş Zortuk
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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28
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Cavezzi A, Menicagli R, Troiani E, Corrao S. COVID-19, Cation Dysmetabolism, Sialic Acid, CD147, ACE2, Viroporins, Hepcidin and Ferroptosis: A Possible Unifying Hypothesis. F1000Res 2022; 11:102. [PMID: 35340277 PMCID: PMC8921693 DOI: 10.12688/f1000research.108667.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 12/15/2022] Open
Abstract
Background: iron and calcium dysmetabolism, with hyperferritinemia, hypoferremia, hypocalcemia and anemia have been documented in the majority of COVID-19 patients at later/worse stages. Furthermore, complementary to ACE2, both sialic acid (SA) molecules and CD147 proved relevant host receptors for SARS-CoV-2 entry, which explains the viral attack to multiple types of cells, including erythrocytes, endothelium and neural tissue. Several authors advocated that cell ferroptosis may be the core and final cell degenerative mechanism. Methods: a literature research was performed in several scientific search engines, such as PubMed Central, Cochrane Library, Chemical Abstract Service. More than 500 articles were retrieved until mid-December 2021, to highlight the available evidence about the investigated issues. Results: based on COVID-19 literature data, we have highlighted a few pathophysiological mechanisms, associated with virus-based cation dysmetabolism, multi-organ attack, mitochondria degeneration and ferroptosis. Our suggested elucidated pathological sequence is: a) spike protein subunit S1 docking with sialylated membrane glycoproteins/receptors (ACE2, CD147), and S2 subunit fusion with the lipid layer; b) cell membrane morpho-functional changes due to the consequent electro-chemical variations and viroporin action, which induce an altered ion channel function and intracellular cation accumulation; c) additional intracellular iron concentration due to a deregulated hepcidin-ferroportin axis, with higher hepcidin levels. Viral invasion may also affect erythrocytes/erythroid precursors, endothelial cells and macrophages, through SA and CD147 receptors, with relative hemoglobin and iron/calcium dysmetabolism. AB0 blood group, hemochromatosis, or environmental elements may represent possible factors which affect individual susceptibility to COVID-19. Conclusions: our literature analysis confirms the combined role of SA molecules, ACE2, CD147, viroporins and hepcidin in determining the cation dysmetabolism and final ferroptosis in the cells infected by SARS-CoV-2. The altered ion channels and electrochemical gradients of the cell membrane have a pivotal role in the virus entry and cell dysmetabolism, with subsequent multi-organ immune-inflammatory degeneration and erythrocyte/hemoglobin alterations.
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Affiliation(s)
- Attilio Cavezzi
- Eurocenter Venalinfa, San Benedetto del Tronto, AP, 63074, Italy
| | | | - Emidio Troiani
- Cardiology Unit, Social Security Institute, State Hospital, Cailungo, 47893, San Marino
| | - Salvatore Corrao
- Department of Clinical Medicine, Internal Medicine Division,, ARNAS Civico Di Cristina Benfratelli Hospital Trust, Palermo, Italy
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29
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Gorog DA, Storey RF, Gurbel PA, Tantry US, Berger JS, Chan MY, Duerschmied D, Smyth SS, Parker WAE, Ajjan RA, Vilahur G, Badimon L, Berg JMT, Cate HT, Peyvandi F, Wang TT, Becker RC. Current and novel biomarkers of thrombotic risk in COVID-19: a Consensus Statement from the International COVID-19 Thrombosis Biomarkers Colloquium. Nat Rev Cardiol 2022. [PMID: 35027697 DOI: 10.1038/s41569-021-00665-7] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) predisposes patients to thrombotic and thromboembolic events, owing to excessive inflammation, endothelial cell activation and injury, platelet activation and hypercoagulability. Patients with COVID-19 have a prothrombotic or thrombophilic state, with elevations in the levels of several biomarkers of thrombosis, which are associated with disease severity and prognosis. Although some biomarkers of COVID-19-associated coagulopathy, including high levels of fibrinogen and D-dimer, were recognized early during the pandemic, many new biomarkers of thrombotic risk in COVID-19 have emerged. In this Consensus Statement, we delineate the thrombotic signature of COVID-19 and present the latest biomarkers and platforms to assess the risk of thrombosis in these patients, including markers of platelet activation, platelet aggregation, endothelial cell activation or injury, coagulation and fibrinolysis as well as biomarkers of the newly recognized post-vaccine thrombosis with thrombocytopenia syndrome. We then make consensus recommendations for the clinical use of these biomarkers to inform prognosis, assess disease acuity, and predict thrombotic risk and in-hospital mortality. A thorough understanding of these biomarkers might aid risk stratification and prognostication, guide interventions and provide a platform for future research.
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30
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Salehiniya H, Avan R, Mazidimoradi A. Effect of magnesium on severity and mortality of COVID–19 patients: A systematic review. J Acute Dis 2022. [DOI: 10.4103/2221-6189.355308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Daniels S, Wei H, van Tongeren M, Denning DW. Are platelet volume indices of clinical use in COVID-19? A systematic review. Front Cardiovasc Med 2022; 9:1031092. [PMID: 36329999 PMCID: PMC9623063 DOI: 10.3389/fcvm.2022.1031092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background The incidence of thrombotic complications is high in COVID-19 patients with severe disease. As key regulators of thrombus formation, platelets likely play a crucial role as mediators of severe acute respiratory syndrome coronavirus 2 associated pathogenesis. Studies have reported that parameters reflecting platelet size, known as platelet volume indices (PVI), are raised in patients with thrombosis and can predict poor outcomes. This systematic review evaluates the potential for PVI to be used as a predictor of COVID-19 morbidity and mortality. Methods English and Chinese databases were searched electronically to identify studies reporting data on mean platelet volume, platelet distribution width or platelet-large cell ratio in COVID-19 patients. Included articles underwent a quality rating and descriptive narrative analysis. Results Thirty-two studies were included in the systematic review. The results show a general trend for PVI to be raised in severe COVID-19 patients and non-survivors, with 14 studies reporting significant differences of baseline PVI between severe and mild disease. Nonetheless, longitudinal studies showed varying PVI trends over the course of the disease and evidence for PVI to be associated with disease progression was limited. The quality rating of 12 studies was poor, 16 were rated fair and four were good. Most studies were retrospective in design, used small study populations and did not consider confounding factors that influence platelet volume. Studies also contained technical flaws in PVI measurement, limiting the reliability of the results. Conclusion The evidence on the clinical usefulness of PVI is greatly limited by the lack of prospective evaluation, together with technical problems in measuring PVI. Carefully designed prospective studies are warranted. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=304305, identifier CRD42022304305.
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Affiliation(s)
- Sarah Daniels
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Hua Wei
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Martie van Tongeren
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - David W Denning
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.,Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
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Covali R, Socolov D, Socolov R, Pavaleanu I, Carauleanu A, Akad M, Boiculese VL, Adam AM. Complete Blood Count Peculiarities in Pregnant SARS-CoV-2-Infected Patients at Term: A Cohort Study. Diagnostics (Basel) 2021; 12:diagnostics12010080. [PMID: 35054247 PMCID: PMC8774532 DOI: 10.3390/diagnostics12010080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 01/10/2023] Open
Abstract
Background: During viral outbreaks, pregnancy poses an increased risk of infection for women. Methods: In a prospective study, all patients admitted for delivery at term to Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, between 1 April 2020 and 31 December 2020 were included. There were 457 patients, divided into two groups: group 1, SARS-CoV-2-positive patients (n = 46) and group 2, SARS-CoV-2-negative patients (n = 411). Among other tests, complete blood count was determined upon admittance, and the following values were studied: white blood cell count, lymphocytes, neutrophils, red blood cell count, hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, mean corpuscular volume, red blood cell distribution width, hematocrit, platelet count, mean platelet volume, platelet distribution width, plateletcrit, and platelet large cell ratio. Results: in pregnant SARS-CoV-2-infected patients at term, there was a significant decrease in white blood cell, neutrophil, and lymphocyte count, and an increase in mean corpuscular hemoglobin concentration, compared to healthy pregnant women at term, although all still within normal limits. None of the other components of the complete blood count or fetal outcomes studied was significantly influenced by SARS-CoV-2 infection in pregnant patients at term.
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Affiliation(s)
- Roxana Covali
- Department of Radiology, Biomedical Engineering Faculty, Grigore T. Popa University of Medicine and Pharmacy Iasi, Elena Doamna Obstetrics and Gynecology University Hospital, 700115 Iasi, Romania
- Correspondence: ; Tel.: +40-232-210-390 (ext. 275)
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Cuza Voda Obstetrics and Gynecology University Hospital, 700115 Iasi, Romania; (D.S.); (A.C.)
| | - Razvan Socolov
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Elena Doamna Obstetrics and Gynecology University Hospital, 700115 Iasi, Romania; (R.S.); (I.P.)
| | - Ioana Pavaleanu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Elena Doamna Obstetrics and Gynecology University Hospital, 700115 Iasi, Romania; (R.S.); (I.P.)
| | - Alexandru Carauleanu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Cuza Voda Obstetrics and Gynecology University Hospital, 700115 Iasi, Romania; (D.S.); (A.C.)
| | - Mona Akad
- Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.); (A.M.A.)
| | - Vasile Lucian Boiculese
- Department of Statistics, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Ana Maria Adam
- Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.); (A.M.A.)
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Schrick D, Tőkés-Füzesi M, Réger B, Molnár T. Plasma Fibrinogen Independently Predicts Hypofibrinolysis in Severe COVID-19. Metabolites 2021; 11:826. [PMID: 34940584 DOI: 10.3390/metabo11120826] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/18/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023] Open
Abstract
High rates of thrombosis are present in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Deeper insight into the prothrombotic state is essential to provide the best thromboprophylaxis care. Here, we aimed to explore associations among platelet indices, conventional hemostasis parameters, and viscoelastometry data. This pilot study included patients with severe COVID-19 (n = 21) and age-matched controls (n = 21). Each patient received 100 mg aspirin therapy at the time of blood sampling. Total platelet count, high immature platelet fraction (H-IPF), fibrinogen, D-dimer, Activated Partial Thromboplastin Time, von Willebrand factor antigen and von Willebrand factor ristocetin cofactor activity, plasminogen, and alpha2-antiplasmin were measured. To monitor the aspirin therapy, a platelet function test from hirudin anticoagulated whole blood was performed using the ASPI test by Multiplate analyser. High on-aspirin platelet reactivity (n = 8) was defined with an AUC > 40 cut-off value by ASPI tests. In addition, in vitro viscoelastometric tests were carried out using a ClotPro analyser in COVID-associated thromboembolic events (n = 8) (p = 0.071) nor the survival rate (p = 0.854) showed associations with high on-aspirin platelet reactivity status. The platelet count (p = 0.03), all subjects. COVID-19 patients presented with higher levels of inflammatory markers, compared with the controls, along with evidence of hypercoagulability by ClotPro. H-IPF (%) was significantly higher among non-survivors (n = 18) compared to survivors (p = 0.011), and a negative correlation (p = 0.002) was found between H-IPF and plasminogen level in the total population. The platelet count was significantly higher among patients with high on-aspirin platelet reactivity (p = 0.03). Neither the ECA-A10 (p = 0.008), and ECA-MCF (p = 0.016) were significantly higher, while the tPA-CFT (p < 0.001) was significantly lower among patients with high on-aspirin platelet reactivity. However, only fibrinogen proved to be an independent predictor of hypofibrinolysis in severe COVID-19 patients. In conclusion, a faster developing, more solid clot formation was observed in aspirin ‘non-responder’ COVID-19 patients. Therefore, an individually tailored thromboprophylaxis is needed to prevent thrombotic complications, particularly in the hypofibrinolytic cluster.
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Abstract
Acylcholines are comprised of an acyl chain esterified to a choline moiety; acetylcholine is the best-characterized member of this class, functioning as a neurotransmitter in the central and peripheral nervous systems as well as an inhibitor of cytokine production by macrophages and other innate immune cells. Acylcholines are metabolized by a class of cholinesterases, including acetylcholinesterase (a specific regulator of acetylcholine levels) and butyrylcholinesterase (BChE, an enigmatic enzyme whose function has not been resolved by genetic knockout models). BChE provides reserve capacity to hydrolyze acetylcholine, but its importance is arguable given acetylcholinesterase is the most catalytically efficient enzyme characterized to date. While known to be substrates of BChE in vitro, endogenous production of long-chain acylcholines is a recent discovery enabled by untargeted metabolomics. Compared to acetylcholine, long-chain acylcholines show greater stability in circulation with homeostatic levels-dictated by synthesis and clearance-suggested to impact cholinergic receptor sensitivity of acetylcholine with varying levels of antagonism. Acylcholines then provide a link between BChE and non-neuronal acetylcholine signaling, filling a gap in understanding around how imbalances between acylcholines and BChE could modulate inflammatory disease, such as the "cytokine storm" identified in severe COVID-19. Areas for further research, development, and clinical testing are outlined.
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Affiliation(s)
- Jason M Kinchen
- Owlstone Medical Inc., 600 Park Office Drive, Suite 140, Research Triangle Park, North Carolina 27709, United States
| | - Robert P Mohney
- Owlstone Medical Inc., 600 Park Office Drive, Suite 140, Research Triangle Park, North Carolina 27709, United States
| | - Kirk L Pappan
- Owlstone Medical Inc., 600 Park Office Drive, Suite 140, Research Triangle Park, North Carolina 27709, United States
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Agouridis AP, Pagkali A, Zintzaras E, Rizos EC, Ntzani EE. High-density lipoprotein cholesterol: A marker of COVID-19 infection severity? Atheroscler Plus 2021; 44:1-9. [PMID: 34622242 PMCID: PMC8383482 DOI: 10.1016/j.athplu.2021.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/01/2021] [Accepted: 08/23/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS To systematically address all the relevant evidence of the association between high-density lipoprotein cholesterol (HDL-C) and COVID-19 infection. METHODS We searched PubMed, PubMed Central and medRxiv databases (up to May 2021) for studies related to HDL-C and COVID-19 infection. A qualitative synthesis of published prospective and retrospective studies for the role of low HDL-C levels on COVID-19 infection severity was performed. RESULTS Thirty-three studies (6 prospective, 27 retrospective) including 11,918 COVID-19 patients were eligible for the systematic review. Twelve studies compared HDL-C levels on admission in COVID-19 patients with healthy controls. In these 12 studies, COVID-19 patients had significantly lower HDL-C levels on admission compared with that of healthy controls. Twenty-eight studies observed the HDL-C levels among COVID-19 diagnosed patients, to establish the role of low HDL-C values in the prognosis of the infection. Twenty-four studies showed a correlation between low HDL-C levels with disease severity, while only 4 studies showed no association. CONCLUSIONS Low HDL-C levels should be added in the list of the others well-known risk factors for COVID-19 severity.
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Affiliation(s)
- Aris P. Agouridis
- School of Medicine, European University Cyprus, Nicosia, Cyprus,Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece,Corresponding author. Internal Medicine/Pathophysiology, School of Medicine, European University Cyprus, Diogenis Str 6, Nicosia, 2404, Cyprus
| | - Antonia Pagkali
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Elias Zintzaras
- Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece
| | - Evangelos C. Rizos
- School of Medicine, European University Cyprus, Nicosia, Cyprus,Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Evangelia E. Ntzani
- Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece,Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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SOYLU VG, GÜLTEN S, YILMAZ A, TAŞKIN Ö, DEMİR U, ÇATAN İNAN F. Is macrocytic erythrocyte a new prognostic parameter in critical COVID-19 disease? Journal of Health Sciences and Medicine 2021. [DOI: 10.32322/jhsm.971934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Algin A, Özdemir S. Evaluation of The Predictability of Platelet Mass Index for Short-Term Mortality in Patients with COVID 19: A Retrospective Cohort Study. Journal of Contemporary Medicine 2021. [DOI: 10.16899/jcm.973825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Welder D, Jeon‐Slaughter H, Ashraf B, Choi S, Chen W, Ibrahim I, Bat T. Immature platelets as a biomarker for disease severity and mortality in COVID-19 patients. Br J Haematol 2021; 194:530-536. [PMID: 34132393 PMCID: PMC8444912 DOI: 10.1111/bjh.17656] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 12/19/2022]
Abstract
COVID-19, caused by SARS-CoV-2, is a contagious life-threatening viral disease that has killed more than three million people worldwide to date. Attempts have been made to identify biomarker(s) to stratify disease severity and improve treatment and resource allocation. Patients with SARS-COV-2 infection manifest with a higher inflammatory response and platelet hyperreactivity; this raises the question of the role of thrombopoiesis in COVID-19 infection. Immature platelet fraction (IPF, %) and immature platelet counts (IPC, ×109 /l) can be used to assess thrombopoiesis. This study investigates whether the level of thrombopoiesis correlates with COVID-19 severity. A large cohort of 678 well-characterized COVID-19 patients was analyzed, including 658 (97%) hospitalized and 139 (21%) admitted to the intensive care unit (ICU). Elevated percentage IPF at presentation was predictive of length of hospitalization (P < 0·01) and ICU admission (P < 0·05). Additionally, percentage IPF at the peak was significantly higher among ICU patients than non-ICU patients (6·9 ± 5·1 vs 5·3 ± 8·4, P < 0·01) and among deceased patients than recovered patients (7·9 ± 6·3 vs 5·4 ± 7·8, P < 0·01). Furthermore, IPC at the peak was significantly higher among ICU patients than non-ICU patients (18·5 ± 16·2 vs. 13·2 ± 8·3, P < 0·05) and among patients on a ventilator than those not (22·1 ± 20·1 vs.13·4 ± 8·4, P < 0·05). Our study demonstrated that elevated initial and peak values of percentage IPF and IPC might serve as prognostic biomarkers for COVID-19 progression to severe conditions.
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Affiliation(s)
- Daniel Welder
- Department of Pathology, Hematopathology SectionUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Haekyung Jeon‐Slaughter
- Department of Internal MedicineVA North Texas Health Care SystemUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Bilal Ashraf
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Sung‐Hee Choi
- Department of Internal MedicineVA North Texas Health Care System and Division of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Weina Chen
- Department of Pathology, Hematopathology SectionUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Ibrahim Ibrahim
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Taha Bat
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
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Stevens JS, Moses AA, Nickolas TL, Husain SA, Mohan S. Increased Mortality Associated with Hypermagnesemia in Severe COVID-19 Illness. Kidney360 2021; 2:1087-1094. [PMID: 35368359 PMCID: PMC8786084 DOI: 10.34067/kid.0002592021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/17/2021] [Indexed: 02/04/2023]
Abstract
Background Although electrolyte abnormalities are common among patients with COVID-19, very little has been reported on magnesium homeostasis in these patients. Here we report the incidence of hypermagnesemia, and its association with outcomes among patients admitted with COVID-19. Methods We retrospectively identified all patients with a positive test result for SARS-CoV-2 who were admitted to a large quaternary care center in New York City in spring 2020. Details of the patients' demographics and hospital course were obtained retrospectively from medical records. Patients were defined as having hypermagnesemia if their median magnesium over the course of their hospitalization was >2.4 mg/dl. Results A total of 1685 patients hospitalized with COVID-19 had their magnesium levels checked during their hospitalization, and were included in the final study cohort, among whom 355 (21%) had hypermagnesemia. Patients who were hypermagnesemic had a higher incidence of shock requiring pressors (35% vs 27%, P<0.01), respiratory failure requiring mechanical ventilation (28% vs 21%, P=0.01), AKI (65% vs 50%, P<0.001), and AKI severe enough to require renal replacement therapy (18% vs 5%, P<0.001). In an adjusted multivariable model, hypermagnesemia was observed more commonly with increasing age, male sex, AKI requiring RRT, hyperkalemia, and higher CPK. Survival probability at 30 days was 34% for the patients with hypermagnesemia, compared with 65% for patients without hypermagnesemia. An adjusted multivariable time to event analysis identified an increased risk of mortality with older age, need for vasopressors, higher C-reactive protein levels, and hypermagnesemia (HR, 2.03; 95% CI, 1.63 to 2.54, P<0.001). Conclusions In conclusion, we identified an association between hypermagnesemia among patients hospitalized with COVID-19 and increased mortality. Although the exact mechanism of this relationship remains unclear, hypermagnesemia potentially represents increased cell turnover and higher severity of illness, which is frequently associated with more severe forms of AKI.
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Affiliation(s)
- Jacob S. Stevens
- Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Andrew A. Moses
- Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Thomas L. Nickolas
- Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Syed Ali Husain
- Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Sumit Mohan
- Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Wang G, Deng J, Li J, Wu C, Dong H, Wu S, Zhong Y. The Role of High-Density Lipoprotein in COVID-19. Front Pharmacol 2021; 12:720283. [PMID: 34335279 PMCID: PMC8322438 DOI: 10.3389/fphar.2021.720283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023] Open
Abstract
The current Coronavirus disease 2019 (COVID-19) pandemic has become a global challenge. Managing a large number of acutely ill patients in a short time, whilst reducing the fatality rate and dealing with complications, brings unique difficulties. The most striking pathophysiological features of patients with severe COVID-19 are dysregulated immune responses and abnormal coagulation function, which can result in multiple-organ failure and death. Normally metabolized high-density lipoprotein (HDL) performs several functions, including reverse cholesterol transport, direct binding to lipopolysaccharide (LPS) to neutralize LPS activity, regulation of inflammatory response, anti-thrombotic effects, antioxidant, and anti-apoptotic properties. Clinical data shows that significantly decreased HDL levels in patients with COVID-19 are correlated with both disease severity and mortality. However, the role of HDL in COVID-19 and its specific mechanism remain unclear. In this analysis, we review current evidence mainly in the following areas: firstly, the pathophysiological characteristics of COVID-19, secondly, the pleiotropic properties of HDL, thirdly, the changes and clinical significance of HDL in COVID-19, and fourthly the prospect of HDL-targeting therapy in COVID-19 to clarify the role of HDL in the pathogenesis of COVID-19 and discuss the potential of HDL therapy in COVID-19.
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Affiliation(s)
- Guyi Wang
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jiayi Deng
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jinxiu Li
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chenfang Wu
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haiyun Dong
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shangjie Wu
- Department of Respiratory, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjun Zhong
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
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Zhong P, Wang Z, Du Z. Serum triglyceride levels and related factors as prognostic indicators in COVID-19 patients: A retrospective study. Immun Inflamm Dis 2021; 9:1055-1060. [PMID: 34236141 PMCID: PMC8342209 DOI: 10.1002/iid3.469] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/19/2022]
Abstract
The role of triglycerides (TG) in coronavirus disease (COVID‐19) is controversial. The objective of this study was to explore the relationship between TG levels and prognosis in COVID‐19 patients and investigate the factors that affect TG. COVID‐19 patients were divided into normal or high TG level groups. Their demographic data, medical history, signs and symptoms, laboratory results, and final clinical results were analyzed retrospectively. A total of 174 patients were included. TG level was 1.6 (interquartile range [IQR]: 1.1‒2.1) mmol/L for all patients; 2.2 (IQR: 1.8‒2.7) mmol/L and 1.1 (IQR: 1.0–1.3) mmol/L in the high TG and control groups, respectively. Overall, 29 patients (16.7%) died during hospitalization, including 19 (23.1%) in the high TG group and 10 (11.5%) in the control group (absolute survival difference, 2.5% (95% confidence interval [CI], 1.2%‐5.1%), log‐rank χ2 = 5.7, and p = .017). Serum ferritin, C‐reactive protein (CRP), lactate dehydrogenase (LDH), and interleukin‐10 (IL‐10) levels were significantly higher in the high TG group compared to the control group. Pearson correlation analysis showed that TG was positively correlated with fasting blood glucose, leukocyte, serum ferritin, LDH, CRP, and IL‐10 levels. Multiple regression showed that serum ferritin and IL‐10 levels affected the TG level (R2 = .095). The TG level in COVID‐19 patients is correlated to serum ferritin and IL‐10 levels, which reflects the activation of macrophages. It is suggested that COVID‐19 patients be monitored for elevated TG as both a prognostic indicator and potential therapeutic target for COVID‐19.
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Affiliation(s)
- Peng Zhong
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenzhou Wang
- Trauma Center, National Center for Trauma Medicine, Key Laboratory of Trauma and Neural Regeneration, Peking University People's Hospital, Beijing, China
| | - Zhe Du
- Trauma Center, National Center for Trauma Medicine, Key Laboratory of Trauma and Neural Regeneration, Peking University People's Hospital, Beijing, China
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43
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Brandon M Henry
- Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Emmanuel J Favaloro
- Department of Haematology, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
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Balestrieri E, Minutolo A, Petrone V, Fanelli M, Iannetta M, Malagnino V, Zordan M, Vitale P, Charvet B, Horvat B, Bernardini S, Garaci E, di Francesco P, Sinibaldi Vallebona P, Sarmati L, Grelli S, Andreoni M, Perron H, Matteucci C. Evidence of the pathogenic HERV-W envelope expression in T lymphocytes in association with the respiratory outcome of COVID-19 patients. EBioMedicine 2021; 66:103341. [PMID: 33867312 PMCID: PMC8082064 DOI: 10.1016/j.ebiom.2021.103341] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022] Open
Abstract
Background Despite an impressive effort in clinical research, no standard therapeutic approach for coronavirus disease 2019 (COVID-19) patients has been established, highlighting the need to identify early biomarkers for predicting disease progression and new therapeutic interventions for patient management. The present study aimed to evaluate the involvement of the human endogenous retrovirus -W envelope (HERV-W ENV) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection considering recent findings that HERVs are activated in response to infectious agents and lead to various immunopathological effects. We analysed HERV-W ENV expression in blood cells of COVID-19 patients in correlation with clinical characteristics and have discussed its potential role in the outcome of the disease. Methods We analysed HERV-W ENV expression in blood samples of COVID-19 patients and healthy donors by flow cytometry and quantitative reverse transcriptase PCR analysis, and evaluated its correlation with clinical signs, inflammatory markers, cytokine expression, and disease progression. Findings HERV-W ENV was highly expressed in the leukocytes of COVID-19 patients but not in those of healthy donors. Its expression correlated with the markers of T-cell differentiation and exhaustion and blood cytokine levels. The percentage of HERV-W ENV-positive lymphocytes correlated with inflammatory markers and pneumonia severity in COVID-19 patients. Notably, HERV-W ENV expression reflects the respiratory outcome of patients during hospitalization. Interpretation Given the known immuno- and neuro-pathogenicity of HERV-W ENV protein, it could promote certain pathogenic features of COVID-19 and therefore serve as a biomarker to predict clinical progression of disease and open to further studies for therapeutic intervention. Funding Information available at the end of the manuscript.
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Affiliation(s)
- Emanuela Balestrieri
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Antonella Minutolo
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Vita Petrone
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Marialaura Fanelli
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Marco Iannetta
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Infectious Diseases Clinic, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Vincenzo Malagnino
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Infectious Diseases Clinic, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Marta Zordan
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Infectious Diseases Clinic, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Pietro Vitale
- Infectious Diseases Clinic, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Benjamin Charvet
- International Center for Infectiology Research (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, University of Lyon, Lyon, France; Geneuro - Innovation, Lyon 69008, France
| | - Branka Horvat
- International Center for Infectiology Research (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, University of Lyon, Lyon, France
| | - Sergio Bernardini
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | | | - Paolo di Francesco
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Paola Sinibaldi Vallebona
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Institute of Translational Pharmacology, National Research Council, Rome 00133, Italy
| | - Loredana Sarmati
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Infectious Diseases Clinic, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Sandro Grelli
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Virology Unit, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy; Infectious Diseases Clinic, Policlinic of Tor Vergata, Rome 00133, Italy
| | - Hervé Perron
- Geneuro - Innovation, Lyon 69008, France; University of Lyon, Lyon 69007, France
| | - Claudia Matteucci
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy.
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Affiliation(s)
- Kenneth R Feingold
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
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Bedel C, Selvi F, Korkut M. Can the immature granulocyte count have a role in the diagnosis of coronavirus 2019 disease? Ibnosina J Med Biomed Sci 2021. [DOI: 10.4103/ijmbs.ijmbs_43_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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