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Alshahrani AM, Bakheet OS, Makkawi MH, Alasmari SZ. Hematological malignancies: Prevalence and hematological characteristics in a single center in southern Saudi Arabia. Saudi Med J 2024; 45:295-306. [PMID: 38438211 DOI: 10.15537/smj.2024.45.3.20230776] [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: 10/10/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES To determine the prevalence of leukemia in the Aseer region of Saudi Arabia and the importance of hematological, biochemical and coagulation profiles for leukemic patients in the context of disease management. METHODS This retrospective study comprised 210 patients between 2012 and 2022 who had been diagnosed with leukemia at different ages. The multiple unpaired t-test was used to compare leukemic patients with control samples, which consisted of healthy individuals, and p<0.05 was taken as significant. The data was compiled from Aseer Central Hospital in the Aseer region and collected through peripheral blood smear and bone marrow biopsy (2012-2017) or by flow cytometry (2018-2022), according to the hospital information system and registry data. RESULTS Of the total 210 leukemic patients (61.4% males and 38.6% females), 104 cases (2012-2017) were diagnosed based on peripheral blood smear and bone marrow biopsy, and 106 cases (2018-2022) based on flow cytometry. Fifteen subtypes of leukemia were identified, with chronic myeloid leukemia being the most common (34.2%), followed by acute myeloid leukemia (17.6%), chronic lymphoblastic leukemia (11.9%), and B-cell acute lymphoid leukemia (9.5%). Other rare cases were also found. CONCLUSION Of the 210 leukemia cases diagnosed in the Aseer region between 2012-2022, the most common subtype was chronic myeloid leukemia, followed by acute myeloid leukemia. In all leukemia subtypes, distinctive significant changes were observed in hematological parameters, biochemical parameters, and coagulation profiles.
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Affiliation(s)
- Adil M Alshahrani
- From the Department of Laboratory and Blood Bank (Adil, Omayma), Aseer Central Hospital; and from the Department of Clinical Laboratory Sciences (Mohammed, Sultan), Faculty of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Omayma S Bakheet
- From the Department of Laboratory and Blood Bank (Adil, Omayma), Aseer Central Hospital; and from the Department of Clinical Laboratory Sciences (Mohammed, Sultan), Faculty of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Mohammed H Makkawi
- From the Department of Laboratory and Blood Bank (Adil, Omayma), Aseer Central Hospital; and from the Department of Clinical Laboratory Sciences (Mohammed, Sultan), Faculty of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Sultan Z Alasmari
- From the Department of Laboratory and Blood Bank (Adil, Omayma), Aseer Central Hospital; and from the Department of Clinical Laboratory Sciences (Mohammed, Sultan), Faculty of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
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Kliniec K, Snopkowska A, Łyko M, Jankowska-Konsur A. Erythroderma: A Retrospective Study of 212 Patients Hospitalized in a Tertiary Center in Lower Silesia, Poland. J Clin Med 2024; 13:645. [PMID: 38337339 PMCID: PMC10856417 DOI: 10.3390/jcm13030645] [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: 12/17/2023] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
Erythroderma is a condition characterized by erythema affecting at least 90% of the skin surface area. It can be caused by various underlying conditions. Due to nonspecific clinical and laboratory findings, determining the cause may pose a challenge. In the retrospective study, we identified 212 patients hospitalized for erythroderma in the Department of Dermatology, Venereology, and Allergology at Wroclaw Medical University between January 2012 and March 2022. Clinical, laboratory, and histopathological features, as well as the management of patients, were studied. The median age of adults was 61 years (IQR = 47-68). The most common causes of erythroderma were psoriasis (n = 49, 24.01%), followed by atopic dermatitis (AD) (n = 27, 13.23%), and cutaneous T-cell lymphomas (CTCL) (n = 27, 13.23%). Despite laboratory tests and histopathological examination, the etiology of erythroderma remained undetermined in 39 cases (19.12%). In 70.59% of patients, it was the first episode of erythroderma, while 29.41% experienced a recurrent episode. Regardless of the etiology of erythroderma, patients were most frequently treated with systemic antihistamines (146 cases, 71.57%) and systemic steroids (132 cases, 64.71%). Patients with idiopathic erythroderma constitute the greatest diagnostic and therapeutic challenge, requiring particularly thorough evaluation.
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Affiliation(s)
- Katarzyna Kliniec
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (K.K.); (A.J.-K.)
| | - Aleksandra Snopkowska
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Magdalena Łyko
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (K.K.); (A.J.-K.)
| | - Alina Jankowska-Konsur
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (K.K.); (A.J.-K.)
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Miraj F, Karda IWAM, Abdullah A, Dionysios E. Lessons learned from "the great mimicker disease": A retrospective study of 18 patients with scurvy. J Child Orthop 2023; 17:618-625. [PMID: 38050589 PMCID: PMC10693847 DOI: 10.1177/18632521231213150] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
Purpose Scurvy is an uncommon medical condition that affects children and is caused by an inadequate intake of vitamin C. This study presents the characteristics of patients with scurvy to raise awareness of the diagnostic process in developing countries where laboratory testing for vitamin C levels is often not available. Methods A retrospective study was performed from period of 2018 to 2023. Data extraction includes patient age, sex, body mass index, constitutional symptoms, musculoskeletal, mucosal, cutaneous symptoms, other accompanying disorders, anemia, erythrocyte sedimentation rate, C-reactive protein, radiographic examination, vitamin C dose, and duration of treatment. Descriptive statistical analysis was performed in this study. Results Eighteen cases (17 males, 1 female) of scurvy were referred to our institution. Thirteen of 18 patients were misdiagnosed before referral. The median age at presentation was 4.5 (range, 2-11) years. The average body mass index was 13.93 ± 0.63 kg/m2. Half of patients had healthy weight. All patients presented with lower limb pain and 17 of 18 with refusal to walk. The median onset of diagnosis was 11 (range 4-48) weeks. White line of Frankel was described in all patients. Seven had anemia and 6 of 18 had increase in erythrocyte sedimentation rate and/or C-reactive protein levels. Only one patient had ascorbic acid levels evaluation before treatment since it was not readily available in our country. Treatment length varied from 2 weeks to 6 months. Conclusion The diagnosis of scurvy is frequently delayed due to its extreme rarity in modern society and its ability to mimic numerous other conditions. In children presenting with limb pain and/or reluctance to walk and pathognomonic radiological findings, physicians must prioritize scurvy as a differential diagnosis. In scurvy, vitamin C supplementation is curative.
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Affiliation(s)
- Faisal Miraj
- Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - I Wayan Arya Mahendra Karda
- Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ali Abdullah
- Division of Orthopaedic and Traumatology, Department of Surgery, Persahabatan General Hospital, Jakarta, Indonesia
| | - Eugene Dionysios
- Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Nemati Zargaran F, Rostamian M, Alimoradi S, Rezaeian S, Javadirad E, Chegene Lorestani R, Motamed H, Hasanpourshahlaei M, Rostami E, Ghadiri K. Clinical and laboratory characteristics of children with severe and nonsevere COVID-19 in Kermanshah, west of Iran: A retrospective study. Health Sci Rep 2023; 6:e1659. [PMID: 37920662 PMCID: PMC10618436 DOI: 10.1002/hsr2.1659] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
Background and Aims The study aimed to collect and compare clinical and laboratory findings of children with severe and nonsevere COVID-19 in Kermanshah City, located in the west of Iran. Methods The study was conducted on 500 children with COVID-19 hospitalized in Mohammad-Kermanshahi Hospital in Kermanshah City. Pediatric COVID-19 was confirmed by reverse transcription-polymerase chain reaction (RT-PCR) test using respiratory secretion samples. Medical records were reviewed and information related to demographic characteristics, underlying diseases, clinical manifestations, laboratory findings, and chest computed tomography (CT) scans were all extracted from electronic and paper records. Patients were divided into three groups according to the severity of the disease: mild, moderate, and severe. Clinical and laboratory findings were compared between the groups and the collected data were analyzed by statistical methods. Results Out of 500 patients, 286 were boys and 214 were girls. Of the patients, 321 cases were only COVID-19, while 179 patients were diagnosed as Multisystem Inflammatory Syndrome in Children (MIS-C) positive. The average age of COVID-19 patients was 3.85 ± 4.48 and of MIS-C patients was 3.1 ± 3.5. In order, fever, cough, and heart disorders were the most common symptoms in patients with COVID-19 and MIS-C, respectively. In terms of disease severity, 246 patients had mild disease, 19 patients had moderate disease, and 56 patients had severe disease. In severe patients, the average number of white blood cells (WBC) was higher, while the average number of lymphocytes was lower. Also, in these patients, the average age was lower, and most of them had respiratory distress. In mild patients, often cough, diarrhea, and vomiting were observed. Conclusion The results of our study showed that laboratory factors such as WBC count, lymphocyte count, CT findings, Respiratory distress, cough, diarrhea, and vomiting can be used to evaluate the severity of COVID-19 in children.
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Affiliation(s)
- Fatemeh Nemati Zargaran
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Mosayeb Rostamian
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Saeed Alimoradi
- Clinical Research Development Center, Taleghani and Imam Ali HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Etrat Javadirad
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi and Imam Reza HospitalsKermanshah University of Medical SciencesKermanshahIran
| | - Roya Chegene Lorestani
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Hajar Motamed
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | | | - Elham Rostami
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi and Imam Reza HospitalsKermanshah University of Medical SciencesKermanshahIran
| | - Keyghobad Ghadiri
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
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Güder H, Eker P. A Retrospective Evaluation of the Laboratory Findings of Dermatology Patients Whose Biotin Levels Were Checked. Cureus 2023; 15:e41482. [PMID: 37551230 PMCID: PMC10404308 DOI: 10.7759/cureus.41482] [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] [Accepted: 07/04/2023] [Indexed: 08/09/2023] Open
Abstract
Objective Biotin is widely known to be beneficial for the hair, nails, and skin, but there are only a few studies on biotin. We evaluated whether there is a relationship between biotin levels and age, gender, and frequently observed laboratory findings. We also evaluated biotin levels according to the reason for checking biotin levels. Methods One hundred five patients applied to the dermatology outpatient clinic and had their biotin levels checked. Patient files were retrospectively analyzed. Results There were a weak positive (r=0.207) relationship between biotin levels and basophil count, a weak positive (r=0.201) relationship between biotin levels and creatinine, and a weak positive (r=0.314) relationship between biotin levels and cholesterol/triglyceride ratio. There were a weak negative (r=-0.216) relationship between biotin levels and mean platelet volume (MPV) and a moderately negative (r=-0.315) relationship between biotin levels and triglyceride levels. Conclusion Biotin levels do not significantly differ with gender but increase with age. Although a weak correlation was detected between hemogram parameters and biotin levels with basophil percentage and mean platelet volume values, biotin did not significantly change hemogram parameters. The relationship between biotin levels and triglyceride levels was the most critical finding of our study. We recommend examining biotin levels in the patients with high triglyceride levels. When we encounter dermatological side effects related to the use of epidermal growth factor receptor tyrosine kinase inhibitors, we recommend evaluating biotin levels. We recommend that biotin supplementation be made only in the patients with deficiencies and that biotin levels be measured in the follow-up.
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Affiliation(s)
- Hüsna Güder
- Department of Dermatology, Maltepe University Faculty of Medicine, İstanbul, TUR
| | - Pınar Eker
- Department of Biochemistry, Maltepe University Faculty of Medicine, İstanbul, TUR
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Majrashi NA, Alhulaibi RA, Nammazi IH, Alqasi MH, Alyami AS, Ageeli WA, Abuhadi NH, Kharizy AA, Khormi AM, Ghazwani MG, Alqasmi AA, Refaee TA. A Systematic Review of the Relationship between Chest CT Severity Score and Laboratory Findings and Clinical Parameters in COVID-19 Pneumonia. Diagnostics (Basel) 2023; 13:2223. [PMID: 37443616 DOI: 10.3390/diagnostics13132223] [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: 05/26/2023] [Revised: 06/17/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The COVID-19 virus has infected millions of people and became a global pandemic in 2020. The efficacy of laboratory and clinical parameters in the diagnosis and monitoring of COVID-19 has been established. The CT scan has been identified as a crucial tool in the prognostication of COVID-19 pneumonia. Moreover, it has been proposed that the CT severity score can be utilized for the diagnosis and prognostication of COVID-19 disease severity and exhibits a correlation with laboratory findings such as inflammatory markers, blood glucose levels, and clinical parameters such as endotracheal intubation, oxygen saturation, mortality, and hospital admissions. Nevertheless, the correlation between the CT severity score and clinical or laboratory parameters has not been firmly established. The objective of this study is to provide a comprehensive review of the aforementioned association. This review used a systematic approach to collate and assess the existing literature that investigates the correlation between CT severity score and laboratory and clinical parameters. The search was conducted using Embase Ovid, MEDLINE Ovid, and PubMed databases, covering the period from inception to 20 May 2023. This review identified 20 studies involving more than 8000 participants of varying designs. The findings showed that the CT severity score is positively associated with laboratory and clinical parameters in COVID-19 patients. The findings indicate that the CT severity score exhibits a satisfactory level of prognostic accuracy in predicting mortality among patients with COVID-19.
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Affiliation(s)
- Naif A Majrashi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Rakan A Alhulaibi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ibrahim H Nammazi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohammed H Alqasi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ali S Alyami
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Wael A Ageeli
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Nouf H Abuhadi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ali A Kharizy
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Abdu M Khormi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohammed G Ghazwani
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ali A Alqasmi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Turkey A Refaee
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
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Shoushtari MHZ, Safapour N, Savaie M, Raji H, Cheraghian B. Demographic features, laboratory findings and outcomes of ICU patients with COVID-19 in Ahvaz, Iran: A single-centered prospective study. J Family Med Prim Care 2023; 12:881-887. [PMID: 37448932 PMCID: PMC10336945 DOI: 10.4103/jfmpc.jfmpc_1061_22] [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: 05/16/2022] [Revised: 07/19/2022] [Accepted: 08/27/2022] [Indexed: 07/18/2023] Open
Abstract
Background COVID-19 can lead to severe acute respiratory syndrome so that some patients need to be admitted to the Intensive Care Unit (ICU). The aim of the current study is to investigate the frequency of demographic, laboratory and imaging findings and type of treatment and their relationship with disease outcomes in patients with COVID-19. Material and Methods This prospective cross-sectional study was conducted on all patients with COVID-19 who were admitted in the ICU of Razi Hospital in Ahvaz, Iran from January 20 to February 20, 2021. Patient information including demographic features, laboratory and imaging findings and clinical outcomes was recorded. Results One hundred and thirty-three patients were recruited in the present study, out of which 74 patients (55.6%) were males and 59 patients (44.4%) were females. The overall mortality rate of patients was 35.3% (47 patients) and was higher in patients over 65 years of age. There was a significant difference in terms of thrombocytopenia (P value: 0.001), lymphopenia (P value: 0.004), progression of lung involvement in imaging, shock, disseminated intravascular coagulation (DIC), sepsis and receiving invasive respiratory support in living and deceased patients (P value < 0.001). Furthermore, the difference in life status and the length of in-ICU stay in patients with hyperkalemia and renal failure was statistically significant (P value = 0.033, P value < 0.001 respectively). Conclusion Mortality rate of patients with COVID- 19 admitted to ICU is generally high. According to the findings of this study, thrombocytopenia, lymphopenia, hyperkalemia and AKI are laboratory disorders associated with increased mortality. Moreover, the progression of pulmonary involvement in imaging, shock, DIC, sepsis, and need to invasive respiratory support is associated with low survival of patients.
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Affiliation(s)
| | - Neda Safapour
- Dapartment of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Savaie
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanieh Raji
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistic, School of Public Health, Ahvaz Jundishpur University of Medical Sciences, Ahvaz, Iran
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Pascu BM, Miron VD, Matei ER, Craiu M. Laboratory Findings in Children with Excess Body Weight in Romania. Medicina (Kaunas) 2023; 59. [PMID: 36837520 DOI: 10.3390/medicina59020319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Background and Objectives: Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. Materials and Methods: We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. Results: A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Conclusions: Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings.
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Zeng J, Zhou G, Pan F. Clinical Analysis of Intestinal Tuberculosis: A Retrospective Study. J Clin Med 2023; 12:jcm12020445. [PMID: 36675374 PMCID: PMC9863723 DOI: 10.3390/jcm12020445] [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: 11/26/2022] [Revised: 12/30/2022] [Accepted: 12/30/2022] [Indexed: 01/08/2023] Open
Abstract
PURPOSE This study aimed to summarize and analyze the clinical data of intestinal tuberculosis (ITB) in order to provide guidance for accurate diagnosis and treatment of ITB. METHODS This study consecutively included patients with ITB who were admitted to our hospital from 2008 to 2021 and retrospectively analyzed their clinical features. RESULTS Forty-six patients were included. The most common clinical symptom was weight loss (67.4%). Seventy percent of 20 patients were positive for tuberculin skin test; 57.1% of 14 patients were positive for mycobacterium tuberculosis specific cellular immune response test, while 84.6% of 26 patients were positive for tuberculosis infection T cell spot test. By chest computed tomography (CT) examination, 25% and 5.6% of 36 patients were diagnosed with active pulmonary tuberculosis and with inactive pulmonary tuberculosis, respectively. By abdominal CT examination, the most common sign was abdominal lymph node enlargement (43.2%). Forty-two patients underwent colonoscopy, and the most common endoscopic manifestation was ileocecal ulcer (59.5%), followed by colonic ulcer (35.7%) and ileocecal valve deformity (26.2%). ITB most frequently involved the terminal ileum/ileocecal region (76.1%). Granulomatous inflammation with multinucleated giant cells and caseous necrosis was found via endoscopic biopsies, the ultrasound-guided percutaneous biopsy of enlarged mesentery lymph nodes, and surgical interventions. The acid-fast bacilli were discovered in 53.1% of 32 samples. Twenty-one cases highly suspected of ITB were confirmed after responding to empiric anti-tuberculosis therapy. CONCLUSIONS It was necessary to comprehensively analyze clinical features to make an accurate diagnosis of ITB and aid in distinguishing ITB from diseases such as Crohn's disease and malignant tumors.
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Affiliation(s)
- Jiaqi Zeng
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Chinese PLA Medical School, Beijing 100853, China
| | - Guanzhou Zhou
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Medical School, Nankai University, Tianjin 300071, China
| | - Fei Pan
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Correspondence:
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Bogovič P, Kastrin A, Lotrič-Furlan S, Ogrinc K, Avšič Županc T, Korva M, Knap N, Resman Rus K, Strle K, Strle F. Comparison of laboratory and immune characteristics of the initial and second phase of tick-borne encephalitis. Emerg Microbes Infect 2022; 11:1647-1656. [PMID: 35657098 PMCID: PMC9225760 DOI: 10.1080/22221751.2022.2086070] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Indexed: 12/13/2022]
Abstract
Tick-borne encephalitis (TBE) usually has a biphasic course which begins with unspecific febrile illness, followed by central nervous system involvement. Because TBE is not yet suspected during the initial phase, knowledge of early TBE pathogenesis is incomplete. Herein we evaluated laboratory and immune findings in the initial and second (meningoencephalitic) phase of TBE in 88 well-defined adult patients. Comparison of nine laboratory blood parameters in both phases of TBE revealed that laboratory abnormalities, consisting of low leukocyte and platelet counts and increased liver enzymes levels, were predominately associated with the initial phase of TBE and resolved thereafter. Assessment of 29 immune mediators in serum during the initial phase, and in serum and cerebrospinal fluid (CSF) during the second phase of TBE revealed highly distinct clustering patterns among the three groups. In the initial phase of TBE, the primary finding in serum was a rather heterogeneous immune response involving innate (CXCL11), B cell (CXCL13, BAFF), and T cell mediators (IL-27 and IL-4). During the second phase of TBE, growth factors associated with angiogenesis (GRO-α and VEGF-A) were the predominant characteristic in serum, whereas innate and Th1 mediators were the defining feature of immune responses in CSF. These findings imply that distinct immune processes play a role in the pathophysiology of different phases of TBE and in different compartments.
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Affiliation(s)
- Petra Bogovič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Andrej Kastrin
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Stanka Lotrič-Furlan
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katarina Ogrinc
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Klemen Strle
- Laboratory of Microbial Pathogenesis and Immunology, Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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11
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Muacevic A, Adler JR. Acute COVID-19 Syndrome Predicts Severe Long COVID-19: An Observational Study. Cureus 2022; 14:e29826. [PMID: 36204261 PMCID: PMC9527039 DOI: 10.7759/cureus.29826] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Tissue damage, chronic dysfunction, and symptoms that last more than 12 weeks are hallmarks of long-term chronic opportunistic viral infection (COVID-19), and the disease may have a permanent, relapsing/remitting, or gradually improving course. This study aimed to determine the risk factors of severe long COVID-19. Methods In October 2021, primary care clinics enrolled consenting 18- to 89-year-olds to complete an online questionnaire on self-diagnosis, clinician diagnosis, testing, symptom presence, and duration of COVID-19. Long COVID-19 was identified if symptoms were beyond 12 weeks. Patients with long-lasting COVID-19 symptoms were assessed using multivariable regression to identify potential predictors of severe long COVID-19. Results Of the 220 respondents, 108 (49%) patients were self- or clinician-diagnosed with COVID-19 or had a confirmed positive laboratory test result. Patients aged >45 years and with at least 15 COVID-19 symptoms were 5.55 and 6.02 times, respectively, more likely to acquire severe long COVID-19. Most patients with severe and moderate post-acute COVID-19 syndrome had no relevant comorbidities (p=0.0402; odds ratio [OR]=0.4; 95% confidence interval [CI]=0.18-0.98). Obesity was a significant predictor (p=0.0307; OR=6.2; 95% CI=1.1-33.2). Conclusion The simultaneous presence of 15 or more COVID-19 symptoms, age >45 years, and obesity were related to a higher probability of severe long COVID-19.
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12
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Telles Correia D, Novais F. “Delirium and COVID-19”: From Symptomatology to Laboratorial and Neuroimaging Findings”. Eur Psychiatry 2022. [PMCID: PMC9567394 DOI: 10.1192/j.eurpsy.2022.102] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction The infection caused by the SARS-CoV-2 virus called COVID-19 may affect not only the respiratory system but also the central nervous system (CNS). Delirium is a frequent and serious condition in COVID-19 patients and may be caused by the direct invasion of the CNS or the induction of CNS inflammatory mediators or by indirect effects due to the systemic inflammatory status, other organ failure, prolonged mechanical ventilation time, immobilization but also social isolation. We aim to critically review literature reporting this syndrome in patients infected by the SARS-CoV-2 virus with a particular emphasis on reported clinical, laboratorial and neuroimaging findings. Methods: A state-of-the-art literature review was performed using PubMed, Embase and Web of Knowledge using the following keywords: delirium, COVID-19, SARS-Cov-2, neuroimaging, laboratorial findings. Results: More than 50% of patients with COVID-19 may present with delirium and in about 20% of the cases this is the primary presentation of the disorder. Previous data suggests that these patients may show a higher frequency of certain symptoms such as agitation, myoclonus, abulia, and alogia. Some distinct neuroinflammatory syndromes have been identified in patients presenting with delirium associated with the virus, namely, autoimmune encephalitis, Acute Disseminated Encephalomyelitis (ADEM) and stroke showing its potential for CNS involvement. Many of these patients present normal brain imaging, EEG and CSF findings but others have more specific laboratorial changes such as elevated creatinine kinase, elevated D-dimer levels, abnormal coagulation parameters and positive SARS-Cov-2 PCR in CSF or meningeal enhancement, ischemic stroke and perfusion changes in MRI imaging. Disclosure No significant relationships.
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Affiliation(s)
- D. Telles Correia
- FACULDADE DE MEDICINA UNIVERSIDADE DE LISBOA, Psychiatry, Lisboa, Portugal,Corresponding author
| | - F. Novais
- Lisbon University, Faculty Of Medicine, Lisbon, Portugal
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13
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Churiso G, Diriba K, Girma H, Tafere S. Laboratory Findings in Different Disease Status of COVID-19 Admitted Patients at Dilla University Referral Hospital Treatment Center, South Ethiopia. Infect Drug Resist 2022; 15:4307-4320. [PMID: 35965852 PMCID: PMC9373995 DOI: 10.2147/idr.s370907] [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: 04/26/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023] Open
Abstract
Background Millions were infected and many were dying because of the coronavirus disease 2019, since its emergence. The patients experience asymptomatic, mild, moderate, severe and critical disease with varying signs and symptoms. Decreased lymphocytes and abnormal liver and renal function tests are common among COVID-19 patients. Severe and critical cases show higher number of white blood cells, and neutrophils. However, studies showed different laboratory findings in different disease status. Therefore, this study investigated laboratory findings of COVID-19 admitted patients at Dilla University Referral Hospital treatment center, South Ethiopia. Methods A retrospective study design was conducted on 220 patients confirmed by real time polymerase chain reaction, and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients’ record, and analyzed by GraphPad Prism version 8.0.1.244 software. Descriptive statistics were used to analyze the frequency while independent t-test was used to compare means of each parameter for each disease status. Results Of the 220 study cases, 120 (54.5%) were severe, 89 (40.5%) were moderate and 11 (5.0%) were mild. One hundred forty (71.1%) of the 197 laboratory tested cases, 87 (77.7%) of severe, and 49 (64.5%) of the moderate cases had neutrophils above normal range. However, 134 (68.0%) of them, 82 (73.2%) of severe and 49 (64.5%) of moderate cases showed decreased lymphocyte level. Most of the cases showed an increased level of aspartate transaminase, alanine transaminase, alkaline phosphatase, total bilirubin, and total calcium. There was statistically significant mean neutrophils (p=0.04), number of white blood cells (p= 0.02), and creatinine level (p=0.00) difference between severe and mild cases. Conclusion Most of the severe COVID-19 patients showed increased neutrophils, liver function tests; and decreased lymphocytes; suggesting higher inflammation and lymphopenia. Therefore, patients with severe and critical disease status require close follow-up.
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Affiliation(s)
- Gemechu Churiso
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Kuma Diriba
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Henok Girma
- Ohio State University, Global One Health Initiative, Dilla, Ethiopia
| | - Soressa Tafere
- COVID-19 Treatment Center, Dilla University, Dilla, Ethiopia
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14
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Helfgott D, Capozzoli G, Madray J, Baig A, Uppaluri L, Gaur S, Simon M, Amorosa J, Ramagopal M. E-cigarette or vaping product use associated lung injury (EVALI) in the time of COVID-19: A clinical dilemma. Pediatr Pulmonol 2022; 57:623-630. [PMID: 34964550 DOI: 10.1002/ppul.25804] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/15/2021] [Accepted: 12/01/2021] [Indexed: 11/09/2022]
Abstract
AIM To report on the clinical, laboratory, and radiological findings of adolescents who presented during the SARS-CoV-2 surge with symptoms of Coronavirus disease 2019 (COVID-19), did not test positive for the infection, and were diagnosed with E-cigarette and vaping product use associated lung injury (EVALI). METHODS A retrospective review of 12 cases of EVALI admitted to the Bristol Meyers Squibb Children's Hospital between February 2020 and June 2020 was conducted. RESULTS The ages of the patients ranged from 14 to 19 years. There were six males and six females. Three patients had a past history of anxiety, depression, or other psychiatric/mental health disorder, 9 had prolonged coagulation profile (prothrombin time, partial thromboplastin time, and/or International Normalized Ratio), and 11 had elevated inflammatory markers. Eight needed respiratory support. All 12 were negative for SARS-CoV-2 PCR. Four were tested for IgG antibodies and were negative. As these cases were admitted to rule out COVID infection, initial treatment included hydroxychloroquine. Steroids were started only after SARS-CoV-2 PCR was shown to be negative. Urine tetrahydrocannabinol was positive in all cases. Chest X-ray and computed tomography findings showed ground glass opacities. CONCLUSIONS Clinical and radiological features are similar in both EVALI and SARS-CoV-2 infection. Inflammatory markers are elevated in both conditions. A detailed social and substance use history in patients presenting with "typical" COVID pneumonia like illness is important. EVALI should be ruled in early to start the appropriate treatment. Given the ongoing pandemic, pediatricians and other health-care providers need to be aware of other conditions that can masquerade as SARS-CoV-2.
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Affiliation(s)
- Daniel Helfgott
- Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Gabrielle Capozzoli
- Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Jovanna Madray
- Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Aisha Baig
- Department of Pediatrics, Division of Pulmonology and Cystic Fibrosis Center, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Lakshmi Uppaluri
- Department of Pediatrics, Division of Pulmonology and Cystic Fibrosis Center, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Sunanda Gaur
- Department of Infectious Diseases, Allergy and Immunology, Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Mitchell Simon
- Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Judith Amorosa
- Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Maya Ramagopal
- Department of Pediatrics, Division of Pulmonology and Cystic Fibrosis Center, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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15
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Jain S, Raval DA, Mitra A, Chaudhary D, Khare U. Epidemiological and Clinical Profile of COVID-19 Patients Admitted in a Tertiary Care Hospital in Western India. Indian J Community Med 2022; 47:138-141. [PMID: 35368499 PMCID: PMC8971864 DOI: 10.4103/ijcm.ijcm_940_21] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/16/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Ahmedabad city reported the highest number of cases and deaths. In order to guide various interventions and monitor future trends, evidence is required. Hence, we conducted the present study to explore the epidemiological determinants, clinical profile, risk factors, and predictors of mortality of COVID-19. Methods: This was a retrospective record-based descriptive study of 2268 confirmed COVID-19 patients admitted in a designated COVID hospital of Ahmedabad city from March to July 2020. Results: The median age of patients was 54 years, and 60.9% of them were males. Majority (83.27%) had comorbidities; the most common comorbidity was hypertension (62.59%) followed by diabetes (44.76%). The most common symptoms reported were fever (69.76%), breathlessness (55.47%), and cough (53.18%). Majority (61.12%) of the patients showed lymphocytopenia, and in one-third (34.85%), D-dimer levels were elevated (>1 μg/ml). Odds of inhospital deaths were higher in patients having breathlessness and gastrointestinal symptoms and comorbidities. More of the deceased had leukocytosis and lymphocytopenia, high D-dimer levels, C-reactive protein, and altered liver function tests as compared to the survivors. Conclusion: While making decisions such as prevention of exposure of high-risk population to the infection, control of the existing comorbid condition, and prioritization of this population for vaccination, criteria of case definition for surveillance keeping in mind the typical and atypical manifestations of the disease, require robust evidence which the current study could provide insight to.
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Affiliation(s)
- Shikha Jain
- Department of Community Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
| | - Devang A Raval
- Department of Community Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
| | - Aarohi Mitra
- Department of Community Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
| | - Diksha Chaudhary
- Department of Community Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
| | - Utkarsh Khare
- Department of Community Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
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16
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Briana DD, Papaevangelou V, Syridou G, Paparizou K, Siafakas N, Konstantinidou AE, Malamitsi-Puchner A. Clinical symptoms associated with laboratory findings and placental histopathology in full-term, non-infected neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive mothers. J Matern Fetal Neonatal Med 2021; 35:8706-8709. [PMID: 34762576 DOI: 10.1080/14767058.2021.1998894] [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] [Indexed: 10/19/2022]
Abstract
This study comprehensively examines clinical symptoms, laboratory findings, and placental pathology in 40 cases of singleton full-term SARS-CoV-2 negative neonates. Their mothers, previously healthy, with uncomplicated pregnancies, were infected peripartum and presented COVID-19 symptoms of various severity. Neonates had predominately diarrhea, the yet unreported absent sucking reflex, elevated COVID-19 inflammatory and ischemia/asphyxia markers as serum ferritin, interleukin-6 and cardiac troponin-T, while placentas demonstrated mild vascular and/or inflammatory lesions. We hypothesize that the above placental lesions may be associated with transient perinatal hypoxia resulting in absent sucking reflex, as well as with inflammatory cytokines transfer causing diarrhea.
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Affiliation(s)
- Despina D Briana
- Third Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Garyfallia Syridou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Kleopatra Paparizou
- First Department of Pathology, Unit of Perinatal Pathology, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Siafakas
- Department of Clinical Microbiology, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia E Konstantinidou
- First Department of Pathology, Unit of Perinatal Pathology, National and Kapodistrian University of Athens, Athens, Greece
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17
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Abdulkareem KH, Mohammed MA, Salim A, Arif M, Geman O, Gupta D, Khanna A. Realizing an Effective COVID-19 Diagnosis System Based on Machine Learning and IoT in Smart Hospital Environment. IEEE Internet Things J 2021; 8:15919-15928. [PMID: 35782183 PMCID: PMC8769008 DOI: 10.1109/jiot.2021.3050775] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/05/2020] [Accepted: 01/06/2021] [Indexed: 05/18/2023]
Abstract
The aim of this study is to propose a model based on machine learning (ML) and Internet of Things (IoT) to diagnose patients with COVID-19 in smart hospitals. In this sense, it was emphasized that by the representation for the role of ML models and IoT relevant technologies in smart hospital environment. The accuracy rate of diagnosis (classification) based on laboratory findings can be improved via light ML models. Three ML models, namely, naive Bayes (NB), Random Forest (RF), and support vector machine (SVM), were trained and tested on the basis of laboratory datasets. Three main methodological scenarios of COVID-19 diagnoses, such as diagnoses based on original and normalized datasets and those based on feature selection, were presented. Compared with benchmark studies, our proposed SVM model obtained the most substantial diagnosis performance (up to 95%). The proposed model based on ML and IoT can be served as a clinical decision support system. Furthermore, the outcomes could reduce the workload for doctors, tackle the issue of patient overcrowding, and reduce mortality rate during the COVID-19 pandemic.
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Affiliation(s)
| | - Mazin Abed Mohammed
- College of Computer Science and Information TechnologyUniversity of Anbar Anbar 00964 Iraq
| | - Ahmad Salim
- Department of Computer SystemsTechnical Institute of Anbar, Middle Technical University Baghdad 10074 Iraq
| | - Muhammad Arif
- School of Computer ScienceGuangzhou University Guangzhou 510006 China
| | - Oana Geman
- Department of Health and Human DevelopmentUniversitatea Stefan cel Mare din Suceava 720229 Suceava Romania
| | - Deepak Gupta
- Department of Computer Science and EngineeringMaharaja Agrasen Institute of Technology New Delhi 110086 India
| | - Ashish Khanna
- Department of Computer Science and EngineeringMaharaja Agrasen Institute of Technology New Delhi 110086 India
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18
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Chok KC, Ng MG, Ng KY, Koh RY, Tiong YL, Chye SM. Edible Bird's Nest: Recent Updates and Industry Insights Based On Laboratory Findings. Front Pharmacol 2021; 12:746656. [PMID: 34658881 PMCID: PMC8517086 DOI: 10.3389/fphar.2021.746656] [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: 07/24/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022] Open
Abstract
Edible bird’s nest (EBN) is a traditional Chinese delicacy made of the saliva of swiftlets found in Southeast Asia. With increasing demands for EBN, quality control of EBN products is important for safe consumption. The processing steps are particularly important for efficient extraction of bioactive compounds. Geographical location, collection place, and harvesting season contribute to differences in nutritional contents in EBN. Concerns regarding presence of adulterant, chemical, and microbial contaminants in EBN as well as authentication and chemical composition measuring methods are discussed in this review. Recent discoveries of beneficial health functions of EBN in antimicrobial and antiviral actions, immunomodulation, cancer prevention and treatment, tissue regeneration, cardiometabolic maintenance, antioxidant action and neuroprotection are also reviewed. Our review provides an update on the recent research on EBN.
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Affiliation(s)
- Kian Chung Chok
- School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| | - Ming Guan Ng
- School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| | - Khuen Yen Ng
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | - Rhun Yian Koh
- Division of Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| | - Yee Lian Tiong
- School of Postgraduate, International Medical University, Kuala Lumpur, Malaysia
| | - Soi Moi Chye
- Division of Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
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19
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Yu L, Shi X, Liu X, Jin W, Jia X, Xi S, Wang A, Li T, Zhang X, Tian G, Sun D. Artificial Intelligence Systems for Diagnosis and Clinical Classification of COVID-19. Front Microbiol 2021; 12:729455. [PMID: 34650534 PMCID: PMC8507494 DOI: 10.3389/fmicb.2021.729455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/23/2021] [Accepted: 08/17/2021] [Indexed: 01/14/2023] Open
Abstract
Objectives: COVID-19 is highly infectious and has been widely spread worldwide, with more than 159 million confirmed cases and more than 3 million deaths as of May 11, 2021. It has become a serious public health event threatening people's lives and safety. Due to the rapid transmission and long incubation period, shortage of medical resources would easily occur in the short term of discovering disease cases. Therefore, we aimed to construct an artificial intelligent framework to rapidly distinguish patients with COVID-19 from common pneumonia and non-pneumonia populations based on computed tomography (CT) images. Furthermore, we explored artificial intelligence (AI) algorithms to integrate CT features and laboratory findings on admission to predict the clinical classification of COVID-19. This will ease the burden of doctors in this emergency period and aid them to perform timely and appropriate treatment on patients. Methods: We collected all CT images and clinical data of novel coronavirus pneumonia cases in Inner Mongolia, including domestic cases and those imported from abroad; then, three models based on transfer learning to distinguish COVID-19 from other pneumonia and non-pneumonia population were developed. In addition, CT features and laboratory findings on admission were combined to predict clinical types of COVID-19 using AI algorithms. Lastly, Spearman's correlation test was applied to study correlations of CT characteristics and laboratory findings. Results: Among three models to distinguish COVID-19 based on CT, vgg19 showed excellent diagnostic performance, with area under the curve (AUC) of the receiver operating characteristic (ROC) curve at 95%. Together with laboratory findings, we were able to predict clinical types of COVID-19 with AUC of the ROC curve at 90%. Furthermore, biochemical markers, such as C-reactive protein (CRP), LYM, and lactic dehydrogenase (LDH) were identified and correlated with CT features. Conclusion: We developed an AI model to identify patients who were positive for COVID-19 according to the results of the first CT examination after admission and predict the progression combined with laboratory findings. In addition, we obtained important clinical characteristics that correlated with the CT image features. Together, our AI system could rapidly diagnose COVID-19 and predict clinical types to assist clinicians perform appropriate clinical management.
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Affiliation(s)
- Lan Yu
- Clinical Medical Research Center/Inner Mongolia Key Laboratory of Gene Regulation of the Metabolic Diseases, Inner Mongolia People's Hospital, Hohhot, China.,Department of Endocrinology, Inner Mongolia People's Hospital, Hohhot, China
| | - Xiaoli Shi
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Xiaoling Liu
- Department of Otolaryngology, Inner Mongolia People's Hospital, Hohhot, China
| | - Wen Jin
- Clinical Medical Research Center/Inner Mongolia Key Laboratory of Gene Regulation of the Metabolic Diseases, Inner Mongolia People's Hospital, Hohhot, China
| | - Xiaoqing Jia
- Baotou City Hospital for Infectious Diseases, Baotou, China
| | - Shuxue Xi
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Ailan Wang
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Tianbao Li
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Xiao Zhang
- Clinical Medical Research Center/Inner Mongolia Key Laboratory of Gene Regulation of the Metabolic Diseases, Inner Mongolia People's Hospital, Hohhot, China
| | - Geng Tian
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Dejun Sun
- Department of Pulmonary and Critical Care Medicine/Key Laboratory of National Health Commission for the Diagnosis & Treatment of COPD, Inner Mongolia People's Hospital, Hohhot, China
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20
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Ma L, Ma J, Chen X, Dong L. A 10-year retrospective comparative analysis of the clinical features of brucellosis in children and adults. J Infect Dev Ctries 2021; 15:1147-1154. [PMID: 34516423 DOI: 10.3855/jidc.13962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/20/2020] [Accepted: 02/15/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Brucellosis is a zoonosis with a wide spectrum of clinical manifestations. However, it is still unclear whether the clinical manifestations in children are significantly different from those in adults. METHODOLOGY Patients with brucellosis and treated at the General Hospital of Ningxia Medical University between 2009 and 2019 were divided into two groups; children (88) and adults (354). Thereafter, the records of the two groups were analyzed retrospectively. RESULTS The findings showed that: 1. School-age children, young and middle-aged individuals were more likely to suffer from brucellosis and most were male; 2. Fever and arthralgia were the most common manifestations in the two groups. In addition, fatigue and low back pain were rare in children although fever and lymphadenopathy were more common in this group. However, hepatomegaly and splenomegaly were common in both groups; 3. The most common complication was osteoarthritis and peripheral arthritis occurred more frequently in children. On the other hand, spondylitis was the most common in adults (this particularly involved the lumbar and sacral vertebrae); 4. An increase in the erythrocyte sedimentation rate, levels of the C-reactive protein and liver enzymes was common in both two groups; 5. There was no significant difference in the positive rate of the standard agglutination test between children (96.59%) and adults (95.20%). However, the positive rate of blood culture was higher in children (65.85%) than in adults (51.00%). CONCLUSIONS Brucellosis causes damage to multiple systems and differences in clinical characteristics were found between children and adults.
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Affiliation(s)
- Liyuan Ma
- Department of Pediatrics, Southern University of science and Technology Hospital, Shenzhen, Guangdong, China
| | - Jinhai Ma
- Department of Pediatrics, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
| | - Xiaoyuan Chen
- Department of Pediatrics, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Linghua Dong
- Department of Pediatrics, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
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21
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Han L, Shen P, Yan J, Huang Y, Ba X, Lin W, Wang H, Huang Y, Qin K, Wang Y, Chen Z, Tu S. Exploring the Clinical Characteristics of COVID-19 Clusters Identified Using Factor Analysis of Mixed Data-Based Cluster Analysis. Front Med (Lausanne) 2021; 8:644724. [PMID: 34336871 PMCID: PMC8323882 DOI: 10.3389/fmed.2021.644724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/21/2020] [Accepted: 06/23/2021] [Indexed: 12/22/2022] Open
Abstract
The COVID-19 outbreak has brought great challenges to healthcare resources around the world. Patients with COVID-19 exhibit a broad spectrum of clinical characteristics. In this study, the Factor Analysis of Mixed Data (FAMD)-based cluster analysis was applied to demographic information, laboratory indicators at the time of admission, and symptoms presented before admission. Three COVID-19 clusters with distinct clinical features were identified by FAMD-based cluster analysis. The FAMD-based cluster analysis results indicated that the symptoms of COVID-19 were roughly consistent with the laboratory findings of COVID-19 patients. Furthermore, symptoms for mild patients were atypical. Different hospital stay durations and survival differences among the three clusters were also found, and the more severe the clinical characteristics were, the worse the prognosis. Our aims were to describe COVID-19 clusters with different clinical characteristics, and a classifier model according to the results of FAMD-based cluster analysis was constructed to help provide better individualized treatments for numerous COVID-19 patients in the future.
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Affiliation(s)
- Liang Han
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Pan Shen
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Jiahui Yan
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yao Huang
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xin Ba
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Weiji Lin
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Hui Wang
- Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Ying Huang
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Kai Qin
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yu Wang
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zhe Chen
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Shenghao Tu
- Department of Integrated Chinese Traditional and Western Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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22
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Akdogan D, Guzel M, Tosun D, Akpinar O. Diagnostic and early prognostic value of serum CRP and LDH levels in patients with possible COVID-19 at the first admission. J Infect Dev Ctries 2021; 15:766-772. [PMID: 34242184 DOI: 10.3855/jidc.14072] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/05/2020] [Accepted: 04/01/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION COVID-19 is the infection caused by the new coronavirus. Specific treatment for COVID-19 has not been established, yet. It is important to determine the disease severity of the patients at the first admission. Therefore, the exploration of biomarkers is deemed necessary. We aimed to assess the diagnostic and early prognostic value of CRP and LDH levels in possible COVID-19 patients presenting with a severe clinical picture. METHODOLOGY We evaluated the correlations of relevant routine laboratory test results with disease severity in COVID-19 patients admitted to our infectious diseases clinic. Patients were divided into severe and non-severe disease groups based on clinical findings, oxygen saturation levels in the arterial blood, biochemical test results, and radiological findings. Differences in the findings between the two disease severity groups were examined to determine potential biomarkers. RESULTS Median age and the CRP and LDH levels in the severe disease group were statistically significantly higher compared to the nonsevere group (p < 0.0001). No other parameters statistically significant differences have been observed between the two groups (P > 0.05). CONCLUSIONS CRP and LDH levels were positively correlated with lung lesions in early-stage COVID-19, potentially reflecting disease severity. Because LDH and CRP levels can potentially reflect the pulmonary function, they can be potential predictors of COVID-19- related respiratory failure. For avoiding poor prognosis; LDH and CRP should be considered as potential predictors for identifying the need for thoracic CT scans, close monitoring of pulmonary function, and aggressive supportive therapy early in the course of COVID-19.
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Affiliation(s)
- Dogan Akdogan
- Pursaklar State Hospital Department of Medical Microbiology, Ankara, Turkey
| | - Mustafa Guzel
- Maltepe Medical Center Department of Medical Microbiology, Istanbul, Turkey
| | - Dervis Tosun
- Pursaklar State Hospital Department of Infectious Diseases, Ankara, Turkey
| | - Orhan Akpinar
- Department of Medical Microbiology, Health Sciences Institute, University of Süleyman Demirel, Isparta, Turkey.
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23
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Zhou M, Xu J, Liao T, Yin Z, Yang F, Wang K, Wang Z, Yang D, Wang S, Peng Y, Peng S, Wu F, Chen L, Jin Y. Comparison of Residual Pulmonary Abnormalities 3 Months After Discharge in Patients Who Recovered From COVID-19 of Different Severity. Front Med (Lausanne) 2021; 8:682087. [PMID: 34249973 PMCID: PMC8270002 DOI: 10.3389/fmed.2021.682087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives: To investigate whether coronavirus disease 2019 (COVID-19) survivors who had different disease severities have different levels of pulmonary sequelae at 3 months post-discharge. Methods: COVID-19 patients discharged from four hospitals 3 months previously, recovered asymptomatic patients from an isolation hotel, and uninfected healthy controls (HCs) from the community were prospectively recruited. Participants were recruited at Wuhan Union Hospital and underwent examinations, including quality-of-life evaluation (St. George Respiratory Questionnaire [SGRQ]), laboratory examination, chest computed tomography (CT) imaging, and pulmonary function tests. Results: A total of 216 participants were recruited, including 95 patients who had recovered from severe/critical COVID-19 (SPs), 51 who had recovered from mild/moderate disease (MPs), 28 who had recovered from asymptomatic disease (APs), and 42 HCs. In total, 154 out of 174 (88.5%) recovered COVID-19 patients tested positive for serum SARS-COV-2 IgG, but only 19 (10.9%) were still positive for IgM. The SGRQ scores were highest in the SPs, while APs had slightly higher SGRQ scores than those of HCs; 85.1% of SPs and 68.0% of MPs still had residual CT abnormalities, mainly ground-glass opacity (GGO) followed by strip-like fibrosis at 3 months after discharge, but the pneumonic lesions were largely absorbed in the recovered SPs or MPs relative to findings in the acute phase. Pulmonary function showed that the frequency of lung diffusion capacity for carbon monoxide abnormalities were comparable in SPs and MPs (47.1 vs. 41.7%), while abnormal total lung capacity (TLC) and residual volume (RV) were more frequent in SPs than in MPs (TLC, 18.8 vs. 8.3%; RV, 11.8 vs. 0%). Conclusions: Pulmonary abnormalities remained after recovery from COVID-19 and were more frequent and conspicuous in SPs at 3 months after discharge.
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Affiliation(s)
- Mei Zhou
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juanjuan Xu
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Liao
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhengrong Yin
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Wang
- Key Laboratory for Environmental and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Wang
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Yang
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sufei Wang
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Peng
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuyi Peng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feihong Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Leqing Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Jin
- NHC Key Laboratory of Pulmonary Diseases, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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24
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Meng Z, Wang M, Zhao Z, Zhou Y, Wu Y, Guo S, Li M, Zhou Y, Yang S, Li W, Ying B. Development and Validation of a Predictive Model for Severe COVID-19: A Case-Control Study in China. Front Med (Lausanne) 2021; 8:663145. [PMID: 34113636 PMCID: PMC8185163 DOI: 10.3389/fmed.2021.663145] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/12/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Predicting the risk of progression to severe coronavirus disease 2019 (COVID-19) could facilitate personalized diagnosis and treatment options, thus optimizing the use of medical resources. Methods: In this prospective study, 206 patients with COVID-19 were enrolled from regional medical institutions between December 20, 2019, and April 10, 2020. We collated a range of data to derive and validate a predictive model for COVID-19 progression, including demographics, clinical characteristics, laboratory findings, and cytokine levels. Variation analysis, along with the least absolute shrinkage and selection operator (LASSO) and Boruta algorithms, was used for modeling. The performance of the derived models was evaluated by specificity, sensitivity, area under the receiver operating characteristic (ROC) curve (AUC), Akaike information criterion (AIC), calibration plots, decision curve analysis (DCA), and Hosmer–Lemeshow test. Results: We used the LASSO algorithm and logistic regression to develop a model that can accurately predict the risk of progression to severe COVID-19. The model incorporated alanine aminotransferase (ALT), interleukin (IL)-6, expectoration, fatigue, lymphocyte ratio (LYMR), aspartate transaminase (AST), and creatinine (CREA). The model yielded a satisfactory predictive performance with an AUC of 0.9104 and 0.8792 in the derivation and validation cohorts, respectively. The final model was then used to create a nomogram that was packaged into an open-source and predictive calculator for clinical use. The model is freely available online at https://severeconid-19predction.shinyapps.io/SHINY/. Conclusion: In this study, we developed an open-source and free predictive calculator for COVID-19 progression based on ALT, IL-6, expectoration, fatigue, LYMR, AST, and CREA. The validated model can effectively predict progression to severe COVID-19, thus providing an efficient option for early and personalized management and the allocation of appropriate medical resources.
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Affiliation(s)
- Zirui Meng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Minjin Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenzhen Zhao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yongzhao Zhou
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shuo Guo
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Mengjiao Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yanbing Zhou
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shuyu Yang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Binwu Ying
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
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25
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Meng Z, Wang M, Guo S, Zhou Y, Lyu M, Hu X, Bai H, Wu Q, Tao C, Ying B. Novel Long Non-coding RNA and LASSO Prediction Model to Better Identify Pulmonary Tuberculosis: A Case-Control Study in China. Front Mol Biosci 2021; 8:632185. [PMID: 34113649 PMCID: PMC8185277 DOI: 10.3389/fmolb.2021.632185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/25/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction The insufficient understanding and misdiagnosis of clinically diagnosed pulmonary tuberculosis (PTB) without an aetiological evidence is a major problem in the diagnosis of tuberculosis (TB). This study aims to confirm the value of Long non-coding RNA (lncRNA) n344917 in the diagnosis of PTB and construct a rapid, accurate, and universal prediction model. Methods A total of 536 patients were prospectively and consecutively recruited, including clinically diagnosed PTB, PTB with an aetiological evidence and non-TB disease controls, who were admitted to West China hospital from Dec 2014 to Dec 2017. The expression levels of lncRNA n344917 of all patients were analyzed using reverse transcriptase quantitative real-time PCR. Then, the laboratory findings, electronic health record (EHR) information and expression levels of n344917 were used to construct a prediction model through the Least Absolute Shrinkage and Selection Operator algorithm and multivariate logistic regression. Results The factors of n344917, age, CT calcification, cough, TBIGRA, low-grade fever and weight loss were included in the prediction model. It had good discrimination (area under the curve = 0.88, cutoff = 0.657, sensitivity = 88.98%, specificity = 86.43%, positive predictive value = 85.61%, and negative predictive value = 89.63%), consistency and clinical availability. It also showed a good replicability in the validation cohort. Finally, it was encapsulated as an open-source and free web-based application for clinical use and is available online at https://ziruinptb.shinyapps.io/shiny/. Conclusion Combining the novel potential molecular biomarker n344917, laboratory and EHR variables, this web-based prediction model could serve as a user-friendly, accurate platform to improve the clinical diagnosis of PTB.
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Affiliation(s)
- Zirui Meng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Minjin Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shuo Guo
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yanbing Zhou
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Mengyuan Lyu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xuejiao Hu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Bai
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Wu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chuanmin Tao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Binwu Ying
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
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26
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Ismail F, Farag A, Haq S, Kamal MA. Clinical Characteristics of the First 100 Patients of COVID-19 in Tobruk, Libya: A Brief Report From Low-Resource Settings. Disaster Med Public Health Prep 2021; 16:1-4. [PMID: 33867007 PMCID: PMC8193191 DOI: 10.1017/dmp.2021.123] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aims to report the clinical features of a cohort of patients with suspected coronavirus disease (COVID-19) from Tobruk, Libya, and reflect upon the diagnosis challenge in low-resource settings. METHODS A descriptive report of the first 100 patients with suspected COVID-19 who have visited the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 screening clinic at the National Centre for Disease Control in Tobruk, Libya. RESULTS The most common presenting symptoms were fever (90%), cough (89%), dyspnea (85%), sore throat (79%), fatigue (78%), headache (64%), loss of smell (52%), loss of taste (53%), loss of appetite (43%), nausea and vomiting (26%), diarrhea (22%), and rhinorrhea (16%); 51% of the patients had lymphocytopenia, whereas 13% had thrombocytopenia. Bilateral infiltrates were the most common radiologic finding on chest X-ray (76%), and COVID-19 IgM and/or IgG antibodies were detected in 80% of the patients, whereas only 37% of the patients were tested positive by the reverse transcriptase polymerase chain reaction (RT-PCR). CONCLUSIONS The disease continued its spread across the region. Fever, cough, and dyspnea were the main symptoms; 21% of the patients did not have any chest X-ray abnormalities. Initial negative results for either antibody testing or RT-PCR-testing for COVID-19 do not rule out the infection.
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Affiliation(s)
- Faisal Ismail
- Clinical Laboratory Department, Faculty of Medical Technology, University of Tobruk, Tobruk, Libya
- National Centre for Disease Control, Tobruk, Libya
| | - Atiya Farag
- National Centre for Disease Control, Tobruk, Libya
| | - Soghra Haq
- Clinical Laboratory Department, Faculty of Medical Technology, University of Tobruk, Tobruk, Libya
| | - Mohammad A. Kamal
- West China School of Nursing/Institutes for Systems Genetics, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
- Enzymoics, Novel Global Community Educational Foundation, Australia
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27
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Karbuz A, Akkoc G, Bedir Demirdag T, Yilmaz Ciftdogan D, Ozer A, Cakir D, Hancerli Torun S, Kepenekli E, Erat T, Dalgic N, Ilbay S, Karaaslan A, Erdeniz EH, Aygun FD, Bozdemir SE, Hatipoglu N, Emiroglu M, Sahbudak Bal Z, Ciftci E, Bayhan GI, Gayretli Aydin ZG, Ocal Demir S, Kilic O, Hacimustafaoglu M, Sener Okur D, Sen S, Yahsi A, Akturk H, Cetin B, Sutcu M, Kara M, Uygun H, Tural Kara T, Korukluoglu G, Akgun O, Üstündağ G, Demir Mis M, Sali E, Kaba O, Yakut N, Kılıc O, Kanik MK, Cetin C, Dursun A, Cicek M, Kockuzu E, Sevketoglu E, Alkan G, Guner Ozenen G, İnce E, Baydar Z, Ozkaya AK, Ovali HF, Tekeli S, Celebi S, Cubukcu B, Bal A, Khalilova F, Kose M, Hatipoglu HU, Dalkiran T, Turgut M, Basak Altas A, Selcuk Duru HN, Aksay A, Saglam S, Sari Yanartas M, Ergenc Z, Akin Y, Duzenli Kar Y, Sahin S, Tuteroz SK, Bilen NM, Ozdemir H, Senoglu MC, Pariltan Kucukalioglu B, Besli GE, Kara Y, Turan C, Selbest Demirtas B, Celikyurt A, Cosgun Y, Elevli M, Sahin A, Bahtiyar Oguz S, Somer A, Karadag B, Demirhan R, Turk Dagi H, Kurugol Z, Taskin EC, Sahiner A, Yesil E, Ekemen Keles Y, Sarikaya R, Erdem Eralp E, Ozkinay F, Konca HK, Yilmaz S, Gokdemir Y, Arga G, Ozen S, Coksuer F, Vatansever G, Tezer H, Kara A. Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey. Front Pediatr 2021; 9:631547. [PMID: 34055680 PMCID: PMC8161543 DOI: 10.3389/fped.2021.631547] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/17/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children. Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4°C (38.0-38.7°C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.
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Affiliation(s)
- Adem Karbuz
- Division of Pediatric Infectious Diseases, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gulsen Akkoc
- Division of Pediatric Infectious Diseases, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tugba Bedir Demirdag
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Dilek Yilmaz Ciftdogan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Arife Ozer
- Division of Pediatric Infectious Diseases, Van Training and Research Hospital, University of Health Sciences, Van, Turkey
| | - Deniz Cakir
- Division of Pediatric Infectious Diseases, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Selda Hancerli Torun
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Eda Kepenekli
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Tugba Erat
- Division of Pediatric Infectious Diseases, Sanliurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Nazan Dalgic
- Division of Pediatric Infectious Diseases, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sare Ilbay
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ayse Karaaslan
- Division of Pediatric Infectious Diseases, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Emine H Erdeniz
- Division of Pediatric Infectious Diseases, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - F Deniz Aygun
- Division of Pediatric Infectious Diseases, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - S Elmas Bozdemir
- Division of Pediatric Infectious Diseases, Dortcelik Children's Training and Research Hospital, Bursa, Turkey
| | - Nevin Hatipoglu
- Division of Pediatric Infectious Diseases, Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Melike Emiroglu
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Zumrut Sahbudak Bal
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ergin Ciftci
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Gulsum Iclal Bayhan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Zeynep Gokce Gayretli Aydin
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey
| | - Sevliya Ocal Demir
- Division of Pediatric Infectious Diseases, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Omer Kilic
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Mustafa Hacimustafaoglu
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Dicle Sener Okur
- Division of Pediatric Infectious Diseases, Denizli Hospital, Denizli, Turkey
| | - Semra Sen
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Aysun Yahsi
- Division of Pediatric Infectious Diseases, Samsun Training and Research Hospital, University of Health Sciences, Samsun, Turkey
| | - Hacer Akturk
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Benhur Cetin
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Murat Sutcu
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Manolya Kara
- Division of Pediatric Infectious Diseases, Necip Fazil Training and Research Hospital, University of Health Sciences, Kahramanmaraş, Turkey
| | - Hatice Uygun
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey
| | - Tugce Tural Kara
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Gulay Korukluoglu
- Public Health Institutions of Turkey, Director of Virology Department, Ankara, Turkey
| | - Ozlem Akgun
- Division of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gülnihan Üstündağ
- Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Mevsim Demir Mis
- Van Training and Research Hospital, University of Health Sciences, Van, Turkey
| | - Enes Sali
- Division of Pediatric Infectious Diseases, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ozge Kaba
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nurhayat Yakut
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Orhan Kılıc
- Division of Pediatrics, Sanliurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - M Kemal Kanik
- Division of Pediatric Infectious Diseases, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ceren Cetin
- Division of Pediatric Infectious Diseases, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Adem Dursun
- Division of Pediatrics, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Muharrem Cicek
- Division of Pediatrics, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Esra Kockuzu
- Division of Pediatrics, Dortcelik Children's Training and Research Hospital, Bursa, Turkey
| | - Esra Sevketoglu
- Division of Pediatric Intensive Care, Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gulsum Alkan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Gizem Guner Ozenen
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Erdal İnce
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Zekiye Baydar
- Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ahmet Kagan Ozkaya
- Department of Pediatric Emergency, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Husnu Fahri Ovali
- Department of Pediatrics, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Seher Tekeli
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Solmaz Celebi
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
| | | | - Alkan Bal
- Department of Pediatric Emergency, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Fidan Khalilova
- Department of Pediatrics, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Mehmet Kose
- Department of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Halil Ugur Hatipoglu
- Department of Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Tahir Dalkiran
- Division of Pediatric Intensive Care, Necip Fazıl Training and Research Hospital, University of Health Sciences, Kahramanmaraş, Turkey
| | - Mehmet Turgut
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey
| | - Ayse Basak Altas
- Public Health Institutions of Turkey, Director of Virology Department, Ankara, Turkey
| | - Hatice Nilgün Selcuk Duru
- Division of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahu Aksay
- Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Sevcan Saglam
- Van Training and Research Hospital, University of Health Sciences, Van, Turkey
| | - Mehpare Sari Yanartas
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Ergenc
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Yasemin Akin
- Division of Pediatrics, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yeter Duzenli Kar
- Division of Pediatrics, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Sabit Sahin
- Division of Pediatrics, Dortcelik Children's Training and Research Hospital, Bursa, Turkey
| | - Sadiye Kubra Tuteroz
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Nimet Melis Bilen
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Halil Ozdemir
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mine Cidem Senoglu
- Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Burcu Pariltan Kucukalioglu
- Department of Pediatrics, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Gulser Esen Besli
- Department of Pediatrics, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yalcin Kara
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Cansu Turan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
| | | | - Aydın Celikyurt
- Department of Pediatrics, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Yasemin Cosgun
- Public Health Institutions of Turkey, Director of Virology Department, Ankara, Turkey
| | - Murat Elevli
- Division of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Aslihan Sahin
- Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | | | - Ayper Somer
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Recep Demirhan
- Division of Thoracic Surgery, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hatice Turk Dagi
- Department of Microbiology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Zafer Kurugol
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Esra Cakmak Taskin
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aysegul Sahiner
- Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Edanur Yesil
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Yildiz Ekemen Keles
- Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Remzi Sarikaya
- Van Training and Research Hospital, University of Health Sciences, Van, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Ferda Ozkinay
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hatice Kubra Konca
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Songul Yilmaz
- Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Gul Arga
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Seval Ozen
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Fevziye Coksuer
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Goksel Vatansever
- Department of Pediatric Emergency, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hasan Tezer
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ates Kara
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Zhu H, Qu G, Yu H, Huang G, Chen L, Zhang M, Wan S, Pei B. Features of α-HBDH in COVID-19 patients: A cohort study. J Clin Lab Anal 2020; 35:e23690. [PMID: 33372716 PMCID: PMC7843285 DOI: 10.1002/jcla.23690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/23/2020] [Revised: 11/28/2020] [Accepted: 12/02/2020] [Indexed: 01/19/2023] Open
Abstract
Background Coronavirus disease‐2019 (COVID‐19) has spread all over the world and brought extremely huge losses. At present, there is a lack of study to systematically analyze the features of hydroxybutyrate dehydrogenase (α‐HBDH) in COVID‐19 patients. Methods Electronic medical records including demographics, clinical manifestation, α‐HBDH results and outcomes of all included patients were extracted. Results α‐HBDH in COVID‐19 group was higher than that in excluded group (p < 0.001), and there was no significant difference in α‐HBDH before and after the exclusion of 5 patients with comorbidity in heart or kidney (p = 0.671). In COVID‐19 group, the α‐HBDH value in ≥61 years old group, severe group, and critical group, death group all increased at first and then decreased, while no obvious changes were observed in other groups. And there were significant differences of the α‐HBDH value among different age groups (p < 0.001), clinical type groups (p < 0.001), and outcome groups (p < 0.001). The optimal scale regression model showed that α‐HBDH value (p < 0.001) and age (p < 0.001) were related to clinical type. Conclusions α‐HBDH was increased in COVID‐19 patients, obviously in ≥61 years old, death and critical group, indicating that patients in these three groups suffer from more serious heart and kidney and other tissues and organs damage, higher α‐HBDH value, and risk of death. The difference between death and survival group in early stage might provide a approach to judge the prognosis. The accuracy of the model to distinguish severe/critical type and other types was 85.84%, suggesting that α‐HBDH could judge the clinical type accurately.
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Affiliation(s)
- Haoming Zhu
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Gaojing Qu
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Hui Yu
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Guoxin Huang
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Lei Chen
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Meiling Zhang
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Shanshan Wan
- Postgraduate Training Basement of Jinzhou Medical University, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Bin Pei
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
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Karimi Shahri M, Niazkar HR, Rad F. COVID-19 and hematology findings based on the current evidences: A puzzle with many missing pieces. Int J Lab Hematol 2020; 43:160-168. [PMID: 33264492 PMCID: PMC7753300 DOI: 10.1111/ijlh.13412] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [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: 08/22/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 12/15/2022]
Abstract
In December 2019, a new type of coronavirus was detected for the first time in Wuhan, Hubei Province, China. According to the reported data, the emerging coronavirus has spread worldwide, infecting more than fifty-seven million individuals, leading to more than one million deaths. The current study aimed to review and discuss the hematological findings of COVID-19. Laboratory changes and hematologic abnormalities have been reported repeatedly in COVID-19 patients. WBC count and peripheral blood lymphocytes are normal or slightly reduced while these indicators may change with the progression of the disease. In addition, several studies demonstrated that decreased hemoglobin levels in COVID-19 patients were associated with the severity of the disease. Moreover, thrombocytopenia, which is reported in 5%-40% of patients, is known to be associated with poor prognosis of the disease. COVID-19 can present with various hematologic manifestations. In this regard, accurate evaluation of laboratory indicators at the beginning and during COVID-19 can help physicians to adjust appropriate treatment and provide special and prompt care for those in need.
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Affiliation(s)
- Mehdi Karimi Shahri
- Department of Pathology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid R Niazkar
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fariba Rad
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.,Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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30
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Zhang ZL, Hou YL, Li DT, Li FZ. Laboratory findings of COVID-19: a systematic review and meta-analysis. Scand J Clin Lab Invest 2020; 80:441-447. [PMID: 32449374 PMCID: PMC7256350 DOI: 10.1080/00365513.2020.1768587] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [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: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/10/2020] [Indexed: 01/08/2023]
Abstract
The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. We performed a systematic review with a meta-analysis to assess laboratory findings in patients with COVID-19. Observational studies from three databases were selected. We calculated pooled proportions and 95% confidence interval (95% CI) using the random-effects model meta-analysis. A total of 1106 articles were identified from PubMed, Web of Science, CNKI (China), and other sources. After screening, 28 and 7 studies were selected for a systematic review and a meta-analysis, respectively. Of the 4,663 patients included, the most prevalent laboratory finding was increased C-reactive protein (CRP; 73.6%, 95% CI 65.0-81.3%), followed by decreased albumin (62.9%, 95% CI 28.3-91.2%), increased erythrocyte sedimentation rate (61.2%, 95% CI 41.3-81.0%), decreased eosinophils (58.4%, 95% CI 46.5-69.8%), increased interleukin-6 (53.1%, 95% CI 36.0-70.0%), lymphopenia (47.9%, 95% CI 41.6-54.9%), and increased lactate dehydrogenase (LDH; 46.2%, 95% CI 37.9-54.7%). A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit.
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Affiliation(s)
- Zu-Li Zhang
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu-Lei Hou
- Clinical Laboratories, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - De-Tao Li
- Clinical Laboratories, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng-Zeng Li
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Hassan SA, Choudhry AS, Jamal S, Sheikh FN, Farooque U. Adult Onset Still's Disease: A Retrospective, Single-Center Study. Cureus 2020; 12:e10008. [PMID: 32983705 PMCID: PMC7515547 DOI: 10.7759/cureus.10008] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Adult-onset Still's disease (AOSD) is characterized by a classical triad of spiking fever, arthritis, and evanescent rash. It is one of the main causes of hospital admissions for fever of unknown origin and has an extended mean time to diagnosis. Therefore, it remains underdiagnosed relative to its aforementioned time frame. In this study, we attempt to highlight clinical and lab findings associated with AOSD. We then compare our diagnostic results with similar previous studies. Our results should help physicians not to miss this rare entity and make the diagnosis in a reduced time frame. Materials and methods This a retrospective, single-center study conducted at Dow University Hospital in Karachi, Pakistan. Thirty patients were enrolled in this study for six months (July 2019-December 2019). All patients were identified and recruited in the medical outpatient department using Yamaguchi's criteria. Written consent was obtained from all patients to access all their clinical charts. Demographics and prior results of laboratory investigations were retrieved from the chart files. Results In our study, the mean age of patients was 26.6 years. More specifically, males accounted for 53.3% (n=16) of cases, and females accounted for 46.6% (n=14) of total cases. The most common presenting clinical features included arthralgia (100%, n=30), fever (100%, n=30), myalgia (96.6%, n=29), large joint arthritis (66.6%, n=20), sore throat (50%, n=15), hepatomegaly (40%, n=12), splenomegaly (23.3%, n=7), skin rash (36.6%, n=11) and pericarditis (20%, n=6). Furthermore, none of our patients had cervical lymphadenopathy. The most commonly reported laboratory findings include leukocytosis (100%, n=30), hyperferritinemia (90%, n=27), elevated erythrocyte sedimentation rate (100%, n=30) and abnormal liver function tests (76.6%, n=23). Chest x-rays performed in all patients revealed no abnormalities in 83% of patients (n=25). All patients in our study sample (n=30) tested negative for antinuclear antibodies and rheumatoid factor. It was also noted that the mean duration of diagnosis in our patients was 5.98 weeks. The mean hospitalization period in our patients was 12.5 days. Furthermore, 16.7% of patients (n=5) suffered from disease relapse. Conclusion Our study ascertains that the presence of certain clinical and laboratory findings strongly indicate a diagnosis of adult-onset Still's disease.
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Affiliation(s)
| | - Ali S Choudhry
- Internal Medicine, Lahore Medical and Dental College, Lahore, PAK
| | - Somia Jamal
- Internal Medicine, Abbasi Shaheed Hospital, Karachi, PAK
| | - Fahad N Sheikh
- Pathology, University of Illinois at Chicago, Chicago, USA
| | - Umar Farooque
- Neurology, Dow University of Health Sciences, Karachi, PAK
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Xie Y, Wang Z, Liao H, Marley G, Wu D, Tang W. Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic: Systematic Review and Meta-analysis. RESEARCH SQUARE 2020:rs.3.rs-28367. [PMID: 36575766 PMCID: PMC9793845 DOI: 10.21203/rs.3.rs-28367/v3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic has affected the world deeply, with more than 3,000,000 people infected and nearly 200,000 deaths. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic. METHODS We scoped for relevant literatures published during 1 st Dec 2019 to 23 rd Apr 2020 based on four databases using English and Chinese languages. We reviewed and analyzed the relevant clinic outcomes of COVID-19. RESULTS The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number (R 0 ) is 3.32 (95% CI:3.24-3.39), the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0℃), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 ℃, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 60 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region. CONCLUSIONS We provided a bird's-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease's future research, control and prevention.
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Affiliation(s)
- Yewei Xie
- University of North Carolina at Chapel Hill-China Project
| | - Zaisheng Wang
- University of North Carolina at Chapel Hill-China Project
| | - Huipeng Liao
- University of North Carolina at Chapel Hill-China Project
| | | | - Dan Wu
- London School of Hygiene and Tropical Medicine
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Ghayda RA, Lee J, Lee JY, Kim DK, Lee KH, Hong SH, Han YJ, Kim JS, Yang JW, Kronbichler A, Smith L, Koyanagi A, Jacob L, Shin JI. Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2020; 17:E5026. [PMID: 32668763 DOI: 10.3390/ijerph17145026] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022]
Abstract
(1) Background: The global threat of Coronavirus disease 2019 (COVID-19) continues. The diversity of clinical characteristics and progress are reported in many countries as the duration of the pandemic is prolonged. We aimed to perform a novel systematic review and meta-analysis focusing on findings about correlations between clinical characteristics and laboratory features of patients with COVID-19. (2) Methods: We analyzed cases of COVID-19 in different countries by searching PubMed, Embase, Web of Science databases and Google Scholar, from the early stage of the outbreak to late March. Clinical characteristics, laboratory findings, and treatment strategies were retrospectively reviewed for the analysis. (3) Results: Thirty-seven (n = 5196 participants) COVID-19-related studies were eligible for this systematic review and meta-analysis. Fever, cough and fatigue/myalgia were the most common symptoms of COVID-19, followed by some gastrointestinal symptoms which are also reported frequently. Laboratory markers of inflammation and infection including C-reactive protein (CRP) (65% (95% confidence interval (CI) 56–81%)) were elevated, while lymphocyte counts were decreased (63% (95% CI 47–78%)). Meta-analysis of treatment approaches indicated that three modalities of treatment were predominantly used in the majority of patients with a similar prevalence, including antiviral agents (79%), antibiotics (78%), and oxygen therapy (77%). Age was negatively correlated with number of lymphocytes, but positively correlated with dyspnea, number of white blood cells, neutrophils, and D-dimer. Chills had been proved to be positively correlated with chest tightness, lung abnormalities on computed tomography (CT) scans, neutrophil/lymphocyte/platelets count, D-dimer and CRP, cough was positively correlated with sputum production, and pulmonary abnormalities were positively correlated with CRP. White blood cell (WBC) count was also positively correlated with platelet counts, dyspnea, and neutrophil counts with the respective correlations of 0.668, 0.728, and 0.696. (4) Conclusions: This paper is the first systematic review and meta-analysis to reveal the relationship between various variables of clinical characteristics, symptoms and laboratory results with the largest number of papers and patients until now. In elderly patients, laboratory and clinical characteristics indicate a more severe disease course. Moreover, treatments such as antiviral agents, antibiotics, and oxygen therapy which are used in over three quarters of patients are also analyzed. The results will provide “evidence-based hope” on how to manage this unanticipated and overwhelming pandemic.
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Ibrahim OR, Suleiman BM, Sanda A, Oloyede T, Bello SO, Bello UI, Yahaya S, Dawud A, Bashir SS. COVID-19 in children: a case series from Nigeria. Pan Afr Med J 2020; 35:53. [PMID: 33623578 PMCID: PMC7875722 DOI: 10.11604/pamj.supp.2020.35.2.23597] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction The global spread of COVID-19 remains unabated in the past few months with a rise in the number of available literature on the novel virus. There are very few paediatric studies and are mainly from developed countries with a paucity of information on the clinical manifestation of COVID-19 disease in African children, including Nigeria. Methods We described the clinical presentation, laboratory findings, treatment and outcome in a group of five Nigerian children managed at a COVID-19 isolation and treatment centre in Nigeria. Results We managed a total of five children with an age range of 3 months to 8 years in the last four weeks (16th April to 15th May 2020). Three of the five children were males. All the children had close contact with family members that tested positive for COVID-19. Out of the five children, one had moderate disease, three had mild symptomatic disease, and one was asymptomatic. Two out of the five children had lymphocytosis. Out of the four children who had chest radiograph, two had features of pneumonia. Conclusion COVID-19 is not uncommon in Nigerian children, and all had a confirmed family member with COVID-19. Besides, contrary to leucopaenia with lymphopaenia observed in the adult's population, we found lymphocytosis in this cohort and about 50.0% had pneumonic changes on chest radiograph.
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Affiliation(s)
| | | | - Abdallah Sanda
- Department of Medical Microbiology, Federal Medical Centre, Katsina, Nigeria
| | - Taofeek Oloyede
- Department of Internal Medicine, Federal Medical Centre, Katsina, Nigeria
| | | | - Umar Ibrahim Bello
- Department of Public Health, Katsina State Ministry of Health, Katsina, Nigeria
| | - Shamsudeen Yahaya
- Department of Public Health, Katsina State Ministry of Health, Katsina, Nigeria
| | - Adamu Dawud
- Department of Disease Control & Immunization, National Primary Health Care Development Agency, Abuja, Nigeria
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Öztürk R, Taşova Y, Ayaz A. COVID-19: pathogenesis, genetic polymorphism, clinical features and laboratory findings. Turk J Med Sci 2020; 50:638-657. [PMID: 32512673 DOI: 10.3906/sag-2005-287] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 05/22/2020] [Accepted: 06/06/2020] [Indexed: 11/03/2022] Open
Abstract
COVID-19 caused by a novel agent SARS-CoV-2 progressed to a pandemic condition and resulted in a major public health concern worldwide, leading to social and economic issues at the same time. The pathogenesis of COVID-19 starts with the bonding of the virus to ACE2 receptors expressed in many tissues, and the triggered excessive immune response plays a critical role in the course of the disease. The cytokine storm that occurs upon excessive production of pro-inflammatory cytokines is considered responsible for the severe progression of the disease and the organ damage. However, the accurate pathophysiological mechanism of the disease, which progresses with various clinical presentations, is still substantially unknown. While various studies have been conducted on the effect of genetic polymorphism on the course and severity of the disease, the presence of a significant effect has not been proven yet. The clinical course of the disease is variable, with clinical representation ranging from 81% mild course to 14% severe course along with 5% critical course in patients. Asymptomatic course is considered to be higher than expected, although its frequency is not known exactly. Older adults and those with comorbidities are exposed to a more severe disease course. The disease progress with various symptoms, such as fever, cough, dyspnea, malaise, myalgia, taste and smell dysfunctions, diarrhea, and headache. A range of complications (acute respiratory distress syndrome, thromboembolic conditions, arrhythmia and cardiac events, secondary infections) could be seen during the course of the disease. Varied laboratory tests are vital to determine these verity and prognosis of the disease, along with the condition and exposure of the affected systems during thecourse of COVID-19.
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Affiliation(s)
- Recep Öztürk
- Department of Infectious Diseases and Clinical Microbiology, Medical School, İstanbul Medipol University, İstanbul, Turkey
| | - Yeşim Taşova
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Akif Ayaz
- Department of Medical Genetics, Medical School, Istanbul Medipol University, İstanbul, Turkey
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Cildag S, Kara Y, Cakir E, Cildag MB, Senturk T. Comparison of Clinical and Laboratory Findings in Patients with Systemic Lupus Erythematosus with Regard to Age at Onset. Eurasian J Med 2019; 51:17-21. [PMID: 30911250 DOI: 10.5152/eurasianjmed.2018.18022] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/22/2018] [Indexed: 12/18/2022] Open
Abstract
Objective Systemic lupus erythematosus (SLE) rarely has a late onset. Late-onset SLE (LSLE) has a milder course and less organ involvement. The purpose of the present study was to compare the clinical and laboratory (lab) findings of SLE regarding age at onset. Materials and Methods Seventy-two patients with SLE were included in the study. The age at onset was considered adult-onset SLE (ASLE) if it was <50 years and LSLE if it was ≥50 years. Lab parameters and clinical findings were compared accordingly. Results Overall, 41 (56.9%) patients had ASLE, and 31 (43.05%) patients had LSLE based on the age at onset. The ratio of female-to-male patients was higher in ASLE, and no significant difference was found with regard to gender distribution (12.6:1 and 5.2:1 for ASLE and LSLE, respectively; p=0.239). While malar rash and fever were more common in ASLE, no difference was found regarding the other clinical findings. Only IgG anti-cardiolipin was more common in LSE between the lab parameters. Conclusion Although it is known that LSLE has a milder course and less organ involvement, there are differences in clinical and lab findings and organ involvement in various studies. The results of our study showed no significant difference in organ involvement between ASLE and LSLE.
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Affiliation(s)
- Songul Cildag
- Department of Immunology-Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Yasemin Kara
- Department of Immunology-Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ersin Cakir
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Mehmet Burak Cildag
- Department of Radiology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Taskin Senturk
- Department of Immunology-Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
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Takahashi A, Arinaga-Hino T, Ohira H, Abe K, Torimura T, Zeniya M, Abe M, Yoshizawa K, Takaki A, Suzuki Y, Kang JH, Nakamoto N, Fujisawa T, Tanaka A, Takikawa H. Non-alcoholic fatty liver disease in patients with autoimmune hepatitis. JGH Open 2018; 2:54-58. [PMID: 30483564 PMCID: PMC6207019 DOI: 10.1002/jgh3.12046] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/10/2018] [Indexed: 12/12/2022]
Abstract
Background and Aim The incidence of non‐alcoholic fatty liver disease (NAFLD) is increasing all over the world. NAFLD develops in patients with liver disease, including patients with autoimmune hepatitis (AIH). NAFLD and AIH have some similar laboratory and histological findings. The aim of this study was to elucidate the characteristics of AIH patients with NAFLD. Methods We re‐evaluated the nationwide survey performed in Japan in 2015 of AIH patients diagnosed between 2009 and 2013. Results A total of 1151 subjects (144 men and 1007 women) were enrolled in the present study. The overall prevalence of NAFLD was 17.0%. Compared to AIH without NAFLD, AIH patients with NAFLD had the following characteristics: (i) low female‐to‐male ratio, (ii) older age, (iii) mild elevation in hepatobiliary enzymes, (iv) histologically progressive fibrosis and mild plasma cell infiltration or mild lobular hepatitis, (v) lower prevalence of prednisolone administration and higher prevalence of ursodeoxycholic acid administration, (vi) higher levels of hepatic enzymes and immunoglobulin G after treatment, and (vii) similar prevalence of autoimmune and malignant complications. Conclusion AIH patients with NAFLD have many features that are different from AIH patients without NAFLD. Understanding these differences is essential for the proper diagnosis and treatment of AIH patients with NAFLD.
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Affiliation(s)
- Atsushi Takahashi
- Department of Gastroenterology Fukushima Medical University School of Medicine Fukushima Japan
| | | | - Hiromasa Ohira
- Department of Gastroenterology Fukushima Medical University School of Medicine Fukushima Japan
| | - Kazumichi Abe
- Department of Gastroenterology Fukushima Medical University School of Medicine Fukushima Japan
| | - Takuji Torimura
- Department of Medicine Kurume University School of Medicine Fukuoka Japan
| | - Mikio Zeniya
- Sanno Medical Center International University of Health and Welfare Tokyo Japan
| | - Masanori Abe
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
| | - Kaname Yoshizawa
- Department of Gastroenterology National Hospital Organization, Shinshu Ueda Medical Center Ueda City Japan
| | - Akinobu Takaki
- Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama City Japan
| | | | - Jong-Hon Kang
- Center for Gastroenterology Teine Keijinkai Hospital Sapporo Japan
| | - Nobuhiro Nakamoto
- Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Tomoo Fujisawa
- Department of Pediatric Hepatology and Gastroenterology Saiseikai Yokohama Tobu Hospital Yokohama City Japan
| | - Atsushi Tanaka
- Department of Medicine Teikyo University School of Medicine Tokyo Japan
| | - Hajime Takikawa
- Department of Medicine Teikyo University School of Medicine Tokyo Japan
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Lu QB, Li H, Zhang PH, Cui N, Yang ZD, Fan YD, Cui XM, Hu JG, Guo CT, Zhang XA, Liu W, Cao WC. Severe Fever with Thrombocytopenia Syndrome Complicated by Co-infection with Spotted Fever Group Rickettsiae, China. Emerg Infect Dis 2018; 22:1957-1960. [PMID: 27767921 PMCID: PMC5088031 DOI: 10.3201/eid2211.161021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
During 2013–2015 in central China, co-infection with spotted fever group rickettsiae was identified in 77 of 823 patients infected with severe fever with thrombocytopenia syndrome virus. Co-infection resulted in delayed recovery and increased risk for death, prompting clinical practices in the region to consider co-infection in patients with severe fever with thrombocytopenia syndrome.
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Abstract
PURPOSE Neurobrucellosis (NB) is a rare complication of brucellosis. NB presents with avariety of clinical manifestations, and the symptoms are always atypical. Our aim was to analyze the demographic characteristics, clinical manifestations, laboratory findings, imaging findings, treatments and outcomes of patients with NB. MATERIAL AND METHOD We retrospectively reviewed the data from 17 patients with NB hospitalized at the Chinese People's Liberation Army General Hospital between 1 January 2005 and 31 October 2016. RESULTS The following symptoms were recorded: 10/17 (59%) patients had fever, and 9/17 (53%) patients had a disorder affecting urination and defecation. Involvement of the cranial nerves was documented in 12/17 (71%) patients. The positivity rates of the tests were as follows: serum standard tube agglutination (STA), 15/17 (88.2%); cerebrospinal fluid STA, 10/17 (59%). The radiologic findings were categorized into four types: normal, white matter changes, vascular insult and inflammatory changes. Patients were treated with different combinations of rifampicin, doxycycline, ceftriaxone sodium and sulphamethoxazole for a total of six months. Two (12%) patients deteriorated, and two (12%) patients were lost to follow-up. The remaining patients (76%) were cured, but sequelae occurred in six patients. CONCLUSIONS NB should be kept in mind in patients with autonomic dysfunction, especially disorders of urination and defecation. Hearing loss due to vestibulocochlear nerve injury seems to be typical for NB. The high incidence of sequelae may be related to a long disease course and the involvement of the central nervous system. Early detection, diagnosis and treatment could decrease mortality and sequelae.
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Affiliation(s)
- Na Zheng
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Wei Wang
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Jia-Tang Zhang
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Ya Cao
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Long Shao
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Jiao-Jiao Jiang
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Xu-Sheng Huang
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Cheng-Lin Tian
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
| | - Sheng-Yuan Yu
- a Department of Neurology , General Hospital of the People's Liberation Army , Beijing , China
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Kaminski M, Grummel V, Hoffmann D, Berthele A, Hemmer B. The spectrum of aseptic central nervous system infections in southern Germany - demographic, clinical and laboratory findings. Eur J Neurol 2017. [PMID: 28636287 DOI: 10.1111/ene.13335] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Aseptic infections of the central nervous system (CNS) are frequently observed in Germany. However, no study has systematically addressed the spectrum of aseptic CNS infections in Germany. METHODS Data on 191 adult patients diagnosed from January 2007 to December 2014 with aseptic meningitis or encephalitis/meningoencephalitis at our hospital were collected by chart review and analyzed for demographic, clinical and laboratory findings. Patients were stratified according to the causative virus and findings were compared between groups. RESULTS In our cohort, meningitis was caused in 36% by enterovirus (EV), 15% by herpes simplex virus (HSV), 12% by varicella zoster virus (VZV) and 5% by tick borne encephalitis (TBE). Encephalitis/meningoencephalitis was caused in 13% by HSV, 13% by VZV, and three out of 11 tested patients were positive for TBE. The highest incidence of EV infections was between 25 and 35 years and of HSV infections between 30 and 60 years. VZV infections had a bimodal distribution peaking below 30 and above 70 years. VZV and EV infections were more frequently observed during summer, whereas HSV infections showed no seasonal preference. Inflammatory changes in cerebrospinal fluid (CSF) were highest in HSV and lowest in EV infections. CONCLUSIONS Polymerase chain reaction tests for HSV, VZV and EV in CSF and TBE serology determined the causative virus in over 60% of tested patients. The age of affected patients, seasonal distribution, disease course and inflammatory changes in CSF differ between groups of patients affected by the most common viral infections.
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Affiliation(s)
- M Kaminski
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - V Grummel
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - D Hoffmann
- Institute of Virology, Technische Universität/Helmholtz Zentrum München, Munich, Germany
| | - A Berthele
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - B Hemmer
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Tavakoli HR, Hull M, Michael Okasinski L. Review of current clinical biomarkers for the detection of alcohol dependence. Innov Clin Neurosci 2011; 8:26-33. [PMID: 21487543 PMCID: PMC3074194] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Alcohol dependence is often seen in a variety of clinical settings and requires attention to reduce medical complications, set up appropriate treatments, and minimize utilization of healthcare resources. Patient responses to questionnaires are often used to screen for alcohol problems, but can be misleading in the context of altered mental states or in a patient hesitant to disclose a pattern of alcohol use. Identifying the biochemical consequences of alcohol dependence has led to further study, including correlating laboratory findings to increase accuracy of identifying problem drinkers. Understanding the normal function, mechanism of abnormal findings, sensitivity, and specificity of the current laboratory studies can substantiate clinical suspicion of alcohol use. In this article, we provide results from our literature search regarding laboratory abnormalities in alcohol dependence, review options available to complement a thorough history and physical, and provide a brief overview of future biomarkers for detection of alcohol use.
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Affiliation(s)
- Hamid R Tavakoli
- Dr. Tavakoli is Chief, Consultation-Liason Service, Naval Medical Center, Portsmouth, Virginia, and Assistant Professor, Eastern Virgina Medical School
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Abstract
BACKGROUND Dengue is the most important mosquito borne viral infection in the world. Nearly 90% of infections occur in children. At present, prospective information on clinical and laboratory findings in South Asian children with dengue is generally lacking. AIM To describe patterns of clinical disease in a cohort of children hospitalised with dengue during a major dengue epidemic in Sri Lanka. RESULTS A total of 104 children were studied during a three month period. Eighteen had dengue fever (DF) and 86 had dengue haemorrhagic fever (DHF). Of those with DHF, 34, 23, 27, and 2 had DHF grade I, II, III, and IV respectively. Based on dengue serology testing, 13 of the DF patients had a primary infection and 5 had secondary dengue infections. In contrast, 68 of the children with DHF had secondary and 18 had primary dengue infections. Oral candidiasis was seen in 19 children. The odds ratio for children with secondary dengue infection to develop DHF was 9.8 (95% CI 3.1 to 31.2). CONCLUSION Studies on patterns of paediatric dengue disease in different regions should help clinicians and health administrators make more informed and evidence based health planning decisions. It should also help towards mapping out dengue trends on a global scale. Oral candidiasis has not been previously documented in children suffering with acute dengue in Sri Lanka or elsewhere. Studying underlying reasons for this manifestation during future dengue epidemics may provide useful leads in understanding overall dengue pathogenesis.
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Affiliation(s)
- G N Malavige
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayawardenapura, Sri Lanka
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