Confirmed COVID-19 Patients Research Articles

Covid-19 mortality risk factors: Survival analysis of the hospitalized cohort in Sahloul university hospital in Tunisia

Background Tunisia was one of the most affected nations with COVID-19 disease. The clinical features of this illness range from asymptomatic illness to death. Aim To analyse the survival of patients admitted to a Tunisian tertiary care center (Sahloul University Hospital) and identify independent predictive factors for hospital COVID-19 mortality. Methods A longitudinal study was conducted among confirmed COVID-19 patients hospitalized in Sahloul University Hospital between September 2020 and September 2022. Cox univariate regression was used to calculate the Hazard Ratio (HR) of death for patient characteristics regarding the time at risk. Risk factors with a p value of 0.2 or less in the univariate analysis were initially included in the multivariate Cox regression models. Results During the study at Sahloul Hospital, 1978 patients were hospitalized, averaging 55.65 years in age (± 21.39). Among them, 417 deaths occurred, with a median survival of 30 days (± 3.11) [23.904-36.096]. Factors significantly affecting the survival curve were: Age, male gender, comorbidities, diabetes, hypertension, endocrine diseases, obesity, intubation, and ICU admission Multilevel survival analyses revealed that hypertension (aHR 1.24; CI [1.02-1.52]; p=0.028), ICU admission (aHR 12.20- CI [9.56-15.57]; p<10-3), and male gender (HR 1.19; CI [0.98-1.46]; p=0.076) were independent factors associated with COVID-19 mortality. Conclusion Our study concluded the importance of the early identification of high-risk COVID-19 patients to decrease this virus mortality. A good understanding of the possible clinical factors associated with COVID-19 severity is helpful for clinicians in identifying patients who are at high risk and require prioritized treatment to minimize death.

Risk Factors for COVID-19 Mortality in Epidemic Treatment Centers: A Case-Control Study from Decentralized Regions of Senegal

Introduction: The COVID-19 pandemic is an emerging viral zoonosis caused by SARS-CoV2. It is responsible for a systemic infection in humans, primarily respiratory. In Senegal, the Thiès Region confirmed its first case on March 14, 2020. The second epidemic wave occurring in 2021 was marked by high fatality, justifying our study on the factors associated with deaths among COVID-19 patients hospitalized at the Epidemic Treatment Centers (CTE) of the Regional Health Directorate of Thiès (Senegal). Patients and Methods: Unmatched case-control study, 1 case to 2 controls, relating to COVID-19 deaths recorded in the Thiès Regional Health Directorate from January 1 to December 31, 2021. All patients who tested positive for COVID-19 (PCR/Antigenic test) hospitalized in CTEs were included. All confirmed COVID-19 patients who died were referred to as “cases,” and all recovered patients as “controls.” The sampling of deaths was exhaustive, standardized sociodemographic, clinical, therapeutic and evolutionary data collected from patient files after a pilot trial with quality control. The data was entered on kobo collect and analyzed on Epi info7. Quantitative variables (mean, standard deviation) and qualitative variables (proportions. Measures: odds ratio, chi2 or Fisher exact test, significance threshold set at p<0.05) were used. Results: A total of 348 patients were recruited in this study including 116 deaths and 232 recovered, the average age was 68.9 years +/- 14.24 for the deceased patients compared to 61.5 +/- 14.24 for the recovered, with male predominance in both groups. The most common clinical signs (cases/controls) were dyspnea (98.3/84.49%), fever (71.5/68.1%), asthenia (57.8/65.4%). and cough (52.6/58.1%). Complications were dominated by acute respiratory distress (87.9/3.8%), (11.2%/0.4%) and pulmonary embolism (03.5/0%). The factors associated with deaths found after multivariate analysis by logistic regression were male sex (OR: 4.11, 95% CI : 1.45 – 11.61 and p = 0.0076), patients aged over 60 years (OR=1.77, 95% CI: 1.0018-3.1438, p=0.049), complications such as stroke (OR=31.00; 95% CI: 5.69-168.73 and p=0 .0001), shock (OR22.61; 95% CI: 1.44-353.67 and p=0.026) and acute respiratory distress syndrome (OR: 204.09 95% CI : 70.44-591.30 and p = 0.000). Conclusion: The factors associated with COVID-19 deaths in the CTEs of Thiès Region are age, male gender, the presence of complications; stroke in particular, the state of Shock and ARDS.

Estimation of outpatient SARS-CoV-2 reinfection and recurrence rates and associated factors among COVID-19 hospitalized patients over one-year old: a multicenter retrospective cohort study

IntroductionReinfection with SARS-Cov-2 after recovery can occur that most of them don’t require hospitalization. The aim of this study is estimation of out-patient COVID-19 reinfection and recurrence rates and its associated factors among Iranian patients with history of confirmed SARS-Cov-2 infection and hospitalization.MethodsThis study is a retrospective cohort conducted from May 2021 to May 2022 in Iran. The national Medical Care Monitoring Center (MCMC) database, obtained from the Ministry of Health and Medical Education, includes all information about confirmed COVID-19 patients who are hospitalized and diagnosed during the pandemic. Using probability proportional to size sampling from 31 provinces, 1,532 patients over one years of age with a history of hospitalization in the MCMC data are randomly selected. After that, interviews by phone are performed with all of the selected patients using a researcher-made questionnaire about the occurrence of overall reinfection without considering the time of infection occurrence, reinfection occurring at least 90 days after the discharge and recurrence (occurring within 90 days after discharge). Univariate and multivariable Cox regression analyses are performed to assess the factors associated with each index. All of the analyses are performed using Stata software version 16.ResultsIn general, 1,532 phone calls are made, out of which 1,095 individuals are willing to participate in the study (response rate ≃ 71%). After assessing the 1,095 patients with a positive history of COVID-19, the rates of non-hospitalized overall SARS-Cov-2 reinfection, reinfection and recurrence are 122.64, 114.09, and 8.55 per 1,000 person-years, respectively. The age range of 19–64 years (aHR:3.93, 95%CI : 1.24–12.41) and COVID-19-related healthcare worker (aHR: 3.67, 95%CI: 1.77–7.61) are identified as risk factors for reinfection, while having comorbidity, being fully vaccinated, and having a partial pressure of oxygen (PaO2) ≥ 93 mmHg during the initial infection are identified as factors that reduce the risk of non-hospitalized reinfection.ConclusionReinfection due to COVID-19 is possible because of the weakened immune system for various reasons and the mutation of the virus. Vaccination, timely boosters, and adherence to preventive measures can help mitigate this risk.

Obesity Parameters as Predictor of Poor Outcomes in Hospitalized Patients with Confirmed Mild-to-Moderate COVID-19.

(1) Background: This study aims to assess visceral fat values, waist circumference (WC), body mass index (BMI), and body fat percentage for their ability to predict poor outcomes during COVID-19 patients' hospitalization; (2) Methods: This study was a prospective cohort of mild-moderate COVID-19 patients hospitalized at Dr. Cipto Mangunkusumo National General Hospital from December 2020 to March 2021. This study includes hospitalized patients over 18 diagnosed with COVID-19 using RT-PCR. Patients who do not have chest radiography, waist circumference, a bioimpedance analyzer (BIA) error, or are unable to stand or mobilize during the examination are excluded from this study. Cox regression was used for multivariate analysis; (3) Results: The study included two hundred sixty-one patients. The median visceral fat value was 10 (equivalent to 100 cm2), the WC was 93.4 cm, the BMI was 26.1 kg/m2, and the body fat percentage was 31.5%. Based on multivariate Cox regression, WC was statistically significant as an independent factor influencing poor outcomes in COVID-19 patients (RR 1.037 [95% CI 1.011-1.064]) along with COVID-19 degree of severity (RR 3.063 [95% CI 1.537-6.104]) and comorbidities (RR 2.123 [95% CI 1.017-4.435]); (4) Conclusions: Waist circumference can influence poor outcomes in confirmed COVID-19 patients during hospitalization.

Retrospective Study Of The Clinical Characteristics Of Cases With Covid-19

background: COVID-19 pandemic placed immense pressure on health systems. The disease is transmitted by inhalation or contact with infected droplets. The symptoms are usually fever, cough, sore throat, breathlessness, fatigue and malaise. The aim of this study was to determine the clinical characteristics of cases with covid-19. Design: Observational retrospective study was followed in this study. Study setting: This study was conducted at Tanta main university hospital and Itay El-baroud general hospital. Subjects: A purposeful sample of 100 adult isolated patients from the previosly mentioned settings was included in the study. Collection tools: one tool was used to collect data in this study "Covid-19 clinical characteristics assessment sheet" this tool consists of 2 parts: Part (1): Demograhic data of the studied cases with covid-19 Part (2): clinical characteristics of studied cases with covid-19. The results were as follow: the results indicated that around one third of the participants were dead and there was highly significant relationship between hypertension, diabetes mellitus, serum Ferritin level and blood group A and death (p<0.001). ICU admission rate was 71% and 35% of covid-19 cases needed invasive mechanical ventilation. Conclusion: it was concluded that the majority of confirmed covid-19 patients were old males. The highly reported signs and symptoms were fatigue, weakness, anorexia, tachypnea and fever. Hypertension and diabetes mellitus were the most reported comorbid diseases of confirmed covid-19 patients. Recommendations: Generalize the awareness of the most reported clinical characteristics of covid-19 to help health care providers to make the correct initial suspected diagnosis of COVID-19

A Correlation Study to Comprehend the SAR-CoV-2 Viral Load, Antiviral Antibody Titer, and Severity of COVID-19 Symptoms Post-infection Amongst the Vaccinated Population in Kamrup District of As sam, Northeast India.

As per the recommendation of the United States Food and Drug Administration, more research is needed to determine the antibody titer against COVID-19 vaccination. The study aimed to understand the relationship between the antibody titer to the demographics, infection severity, and cycle threshold (CT) values of confirmed COVID-19 patients. Initially, we obtained consent from 185 populations and included sixty RT-PCRpositive COVID-19 patients from Kamrup District in the Northeast State of Assam, India. The vaccination status was recorded and tested for the level of serum immunoglobulin (IgG). The CT values, gender, and clinical symptoms-based scoring (CSBS) correlated with their IgG value. Around 48% of participants gained an antibody titer more than the threshold value and showed CT values between 18-25. Moreover, the maximum distributed score above the average was found between the CT values 18-25. The IgG titer value differs significantly amongst the vaccinated population, which may depend upon their genetic and demographic variability.

Clinical symptoms and faecal shedding of SARS-CoV-2 RNA among hospitalized COVID-19 patients: Implication for transmission.

SARS-CoV-2 shedding in human stool has been suggested as a probable route for faeco-oral transmission of the virus due to the availing evidence on the infectivity and pathogenicity of similar highly infectious respiratory viruses. Determining association of SARS-CoV-2 shedding in stools and presenting clinical status might be useful for prediction of the viral transmission spectrum and disease outcome. This study involved a descriptive cross-sectional survey of 91 consenting hospitalized, confirmed COVID-19 patients in Infectious Disease Isolation Centre, Oyo State, Nigeria. Socio-demographic characteristics and other ancillary data were collected from patient's hospital records with the aid of a structured investigator administered questionnaire. The laboratory detection of SARS-CoV-2 RNA in the stool of patients was performed using RT-PCR method. 27 (29.7%) of the 91 COVID-19 patients shed SARS-CoV-2 in their stools. The frequency of male (38.3%) patients shedding the virus in stools was higher than female (12.9%) patients (P = 0.012). Higher proportion of patients who had symptoms (41.2%) at admission shed the virus in their stool (P <0.007); particularly, fever (0.001), fatigue (0.003), headache (0.003), catarrh (0.001), and loss of smell (0.009). The frequency of viral shedding in stool was higher among patients with loss of taste (p = 0.028). Viral shedding in stool was significantly associated with low CT values (47.2%) and moderate CT value (21.4%) (P<0.05). Multivariate analysis showed that patients with moderate CT-value (OR = 0.28, 95% CI: 0.08-0.94, P = 0.039) and high CT-value (OR = 0.08, 95% CI: 0.01-0.80, P = 0.033) were less likely to shed the virus in stool. The gastrointestinal tract could be a route of SARS-CoV-2 transmission irrespective of the patients' clinical status. The low and moderate CT values of the nasopharyngeal swab is associated with shedding of the virus in patients' stools, although infectivity will depend on viral activity obtainable from further laboratory test analyses, such as viral culture.

Complication acute limb ischemia in a COVID-19 confirmed patient

Introduction: COVID-19 is a condition carried upon by those infected with the SARS-COV-2 coronavirus. Hypercoagulability is one of the many signs of COVID-19. Although the etiology leading to this hypercoagulable state remains unclear, some studies have suggested that it may be linked to alterations in prothrombic factors and the disease's cytokine storm. One of the uncommon side effects brought on by a sudden drop in arterial limb perfusion is acute limb ischemia (ALI). Case description: A 64-year-old woman confirmed COVID-19 patient who has acute limb ischemia on the right lower extremities and is in serious condition. The patient had an above-knee amputation in addition to a thrombectomy. Conclusion: Acute limb ischemia is a threatened life condition that the presence of COVID-19 can aggravate. Early diagnosis and treatment of this therapy are necessary for a good prognosis.

A predictive model to explore risk factors for severe COVID-19

With the rapid spread of the novel coronavirus (COVID-19), a sustained global pandemic has emerged. Globally, the cumulative death toll is in the millions. The rising number of COVID-19 infections and deaths has severely impacted the lives of people worldwide, healthcare systems, and economic development. We conducted a retrospective analysis of the characteristics of COVID-19 patients. This analysis includes clinical features upon initial hospital admission, relevant laboratory test results, and imaging findings. We aimed to identify risk factors for severe illness and to construct a predictive model for assessing the risk of severe COVID-19. We collected and analyzed electronic medical records of confirmed COVID-19 patients admitted to the Affiliated Hospital of Jiangsu University (Zhenjiang, China) between December 18, 2022, and February 28, 2023. According to the WHO diagnostic criteria for the novel coronavirus, we divided the patients into two groups: severe and non-severe, and compared their clinical, laboratory, and imaging data. Logistic regression analysis, the least absolute shrinkage and selection operator (LASSO) regression, and receiver operating characteristic (ROC) curve analysis were used to identify the relevant risk factors for severe COVID-19 patients. Patients were divided into a training cohort and a validation cohort. A nomogram model was constructed using the “rms” package in R software. Among the 346 patients, the severe group exhibited significantly higher respiratory rates, breathlessness, altered consciousness, neutrophil-to-lymphocyte ratio (NLR), and lactate dehydrogenase (LDH) levels compared to the non-severe group. Imaging findings indicated that the severe group had a higher proportion of bilateral pulmonary inflammation and ground-glass opacities compared to the non-severe group. NLR and LDH were identified as independent risk factors for severe patients. The diagnostic performance was maximized when NLR, respiratory rate (RR), and LDH were combined. Based on the statistical analysis results, we developed a COVID-19 severity risk prediction model. The total score is calculated by adding up the scores for each of the twelve independent variables. By mapping the total score to the lowest scale, we can estimate the risk of COVID-19 severity. In addition, the calibration plots and DCA analysis showed that the nomogram had better discrimination power for predicting the severity of COVID-19. Our results showed that the development and validation of the predictive nomogram had good predictive value for severe COVID-19.

Petterns Of Drug Use During Self-Isolation By Confirmed COVID-19 Patients at the Asam Baru Health Center

Patients who are confirmed with COVID-19 with asymptomatic conditions with asymptomatic and mild conditions undergo isolation and monitoring with pharmacological treatment of vitamin C, vitamin D, supportive medicines both traditional and conventional and antivirals for mild conditions. This study aims to determine the pattern of drug use during self-isolation by confirmed COVID-19 patients at the Asam Baru Health Center for the January-July 2022 period, the relationship between the acquisition of therapy from health services with the effectiveness of therapy, and the relationship between the effectiveness of therapy and patient characteristics. The design of this study is observational with cross-sectional methods and retrospective data collection. The data obtained will be presented descriptively in the form of percentages as well as statistical analysis. The pattern of drug use during self-isolation by confirmed COVID-19 patients was vitamin C 56%, vitamin D 11.11%, and zinc 19.44%, azithromicyn 100% from 3 respondents, oseltamivir as much as 89% and favipirapir 11%, paracetamol 500mg 53%, cough medicine and sputum thinner 29%, and dexamethasone 0.5mg 18%. Traditional medicine is 60% ginger steeping and 40% temulawak steeping. There was no association between therapeutic gains from health services and therapeutic effectiveness with a significant value of 0.332. There is a significant relationship between the effectiveness of patient therapy and the patient's age with a significant value of 0.000. There was no significant relationship between the effectiveness of therapy with comorbid patient value 0.233, patient sex value 0.854, and vaccination in patients value 0.723.

Clinical Characteristics and Risk Factors of Mechanical Ventilation Among COVID-19 Patients on High-Flow Nasal Oxygen (HFNO).

COVID-19is a viral infection affecting the respiratory system, primarily. It has spread globally ever since it first appeared in China in 2019. The use of high-flow nasal oxygen (HFNO) for the treatment of COVID-19 has not been well established. The primary objectives of this study are to observe the success of HFNO in preventing escalation to mechanical ventilation (MV) and to measure the prevalence of HFNO in King Abdulaziz Medical City (KAMC). The secondary objective is to describe patients who received HFNO clinically. This is a retrospective cohort study of all polymerase chain reaction (PCR)-confirmed COVID-19 patients who require oxygen therapy in KAMC, Jeddah between March 1st, 2020, and December 31st, 2020. Any patients requiring MV on admission were excluded. 259 patients fit the inclusion criteria, and 25.5% of those included received HFNO. The number of non-survivors is 47 (18.1%). Mortality for HFNO, MV, and intensive care unit (ICU)are 30 (45.5%), 31 (60.8%), and 24 (32%), respectively. Their demographic was as follows; 160 were males, with a mean age of 60.93±15.01. Regarding the types of oxygen, low-flow nasal oxygen(LFNO) was administered to 243 out of the 259 patients, 66 received HFNO, 42 received MV, and 49 received other modes of ventilation. Additionally, 43.9% received HFNO escalated to MV. Patients who did not receive HFNO or MV were 178 (68.7%) in total. The use of HFNO in COVID-19 patients could showbetter outcomes than MV in addition to preventing the use of MV. Larger studies are required to determine the efficacy of HFNO in COVID-19 patients.

Detection the Genetic Polymorphisms of the Programmed Cell Death Gene PD1.3 G/A (rs11568821) in Coronavirus Disease Patients

Abstract Background: Programmed cell death-1 protein (PD-1, Pcd1), a receptor from the CD28/CTLA-4 group, inhibits antigen receptor signaling by attracting protein tyrosine phosphatase in response to an interaction with any of the two ligands, PD-L1 or PD-L2. Human phenotypic variations can be attributed to both genetic and environmental influences. Objectives: Because SNPs (single nucleotide polymorphisms) are not absolute indicators of disease progression, in this work, the PD-1 gene polymorphism in coronavirus disease (COVID-19) patients was examined to assess the presence of SNPs in viral infections, in particular COVID-19 is the main goal of this investigation. Materials and Methods: Sixty confirmed COVID-19 patients were recruited to this study; 30 of them had severe COVID-19, whereas the other patients showed moderate sickness, who were admitted to the COVID-19 specialized ward in Salahuddin province, and all of them were over the age of 18 years. Also 30 healthy subjects were recruited for the purpose of the comparison. Blood was drawn from all the subjects for polymerase chain reaction (PCR) using the restriction fragment length (RFLP)-PCR for the assessment of the G/A SNP genotype of PD1.3 and ELISA test for the estimation of PD-1 and PD-L-1 serum level. Results: The examined PD-1 SNPs did not correlate with the incidence of COVID-19, according to a data analysis. Both the dominant and recessive models used in the research failed to detect a connection with the risk of COVID-19 severity. The PD1.3 genotypes frequency between the two groups did not show significant differences (P &gt; 0.05). Only AG was substantially and mainly linked to COVID-19 susceptibility. This study compared the concentrations of immune check point inhibitors PD-1, PD-L-1 to find possible association with genotype frequency, and approved that PD-1 did not have any significant differences in the three groups of genotypes, whereas the difference was highly significant (0.048) in PDL-1 and AA genotype. Conclusion: Among all calculated haplotypes were unrelated to the disease’s prognosis (P &gt; 0.05) concluded that the frequency of AA genotype in patients group decreed the expiation of PD-L-1, leads to immune inhibitions. Future research may clarify the relationship between some immune checkpoint molecule polymorphisms.

Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran

Background: Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined. Objective: To investigate the association between CAC score and in-hospital mortality of COVID-19 patients Method: This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes. Results: The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70–10.33, P value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13–1.53, P value &lt; 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47–2.77, P value &lt; 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79–18.29, P value: 0.003), and history of respiratory diseases (95% CI: 2.18–40, P value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 (P value &lt; 0.001). Conclusion: Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.

Trajectories of chronic multimorbidity patterns in older patients: MTOP study

BackgroundMultimorbidity is associated with negative results and poses difficulties in clinical management. New methodological approaches are emerging based on the hypothesis that chronic conditions are non-randomly associated forming multimorbidity patterns. However, there are few longitudinal studies of these patterns, which could allow for better preventive strategies and healthcare planning. The objective of the MTOP (Multimorbidity Trajectories in Older Patients) study is to identify patterns of chronic multimorbidity in a cohort of older patients and their progression and trajectories in the previous 10 years.MethodsA retrospective, observational study with a cohort of 3988 patients aged > 65 was conducted, including suspected and confirmed COVID-19 patients in the reference area of Parc Taulí University Hospital. Real-world data on socio-demographic and diagnostic variables were retrieved. Multimorbidity patterns of chronic conditions were identified with fuzzy c-means cluster analysis. Trajectories of each patient were established along three time points (baseline, 5 years before, 10 years before). Descriptive statistics were performed together with a stratification by sex and age group.Results3988 patients aged over 65 were included (58.9% females). Patients with ≥ 2 chronic conditions changed from 73.6 to 98.3% in the 10-year range of the study. Six clusters of chronic multimorbidity were identified 10 years before baseline, whereas five clusters were identified at both 5 years before and at baseline. Three clusters were consistently identified in all time points (Metabolic and vascular disease, Musculoskeletal and chronic pain syndrome, Unspecific); three clusters were only present at the earliest time point (Male-predominant diseases, Minor conditions and sensory impairment, Lipid metabolism disorders) and two clusters emerged 5 years before baseline and remained (Heart diseases and Neurocognitive). Sex and age stratification showed different distribution in cluster prevalence and trajectories.ConclusionsIn a cohort of older patients, we were able to identify multimorbidity patterns of chronic conditions and describe their individual trajectories in the previous 10 years. Our results suggest that taking these trajectories into consideration might improve decisions in clinical management and healthcare planning.Trial registration numberNCT05717309.

Exploring inflammatory markers of COVID-19 severity in Moroccans

IntroductionThe global impact of the SARS-CoV-2-induced COVID-19 pandemic has reached Morocco. Early identification of factors contributing to severity is imperative for effective management. There is, however, a notable research gap, as only a limited number of studies have systematically investigated the importance of inflammatory biomarkers in assessing COVID-19 severity in the Moroccan context. No study has included the dosage of IL-6 which represents one of the main inflammatory agents responsible for the inflammatory storm. This study attempts to fill this gap by exploring the role of inflammatory biomarkers in the severity of COVID-19 in Moroccan patients. Material and methodsThis prospective cross-sectional study was conducted at the Medical Immunology Laboratory of Ibn Rochd University Hospital in Casablanca, between November 2, 2020, and December 1, 2021. Data on demographic characteristics, underlying comorbidities, and laboratory tests were collected from medical records. The patients were divided into non-severe and severe groups. we performed an assay of il-6 using an automated chemiluminescence. technique. ResultsThe study analyzed 371 confirmed COVID-19 patients and found that lymphopenia, hyperneutrophilia, increased NLR, CRP, and IL-6 were associated with the severity of COVID-19. Significant positive correlations were found between IL-6 and other immune-inflammatory parameters, including neutrophil count, CRP, and NLR. Conclusionour study provides evidence that NLR, CRP are potential biomarkers for predicting COVID-19 severity in Moroccans. This finding could help with the early identification of severe cases, which can lead to better management and outcomes.

Evaluation of blood pressure variation in recovered COVID-19 patients at one-year follow-up: a retrospective cohort study

BackgroundCoronavirus disease 2019 (COVID-19) has various sequelae, one of which might be hypertension. We aimed to evaluate COVID-19’s impact on blood pressure (BP) in non-hospitalized patients at one-year follow-up.MethodA total of 7,950 consecutive COVID-19 patients regularly visiting our cardiology clinic were retrospectively screened. Patients’ electronic medical records including demographics, comorbidities, vital signs, treatments, and outcomes, were reviewed by two physicians. Individuals with at least one BP measurement in the three months preceding COVID-19 and one measurement in 12 months or more following recovery were included. BP levels before and after COVID-19 were compared using the paired t-test.Results5,355 confirmed COVID-19 patients (mean age 55.51 ± 15.38 years) were included. Hypertension (56.9%) and diabetes mellitus (34%) were the predominant comorbidities, and 44.3% had prior major adverse cardiovascular events. Both systolic (126.90 ± 20.91 vs. 139.99 ± 23.94 mmHg, P < 0.001) and diastolic BP (80.54 ± 13.94 vs. 86.49 ± 14.40 mmHg, P < 0.001) were significantly higher post-COVID-19 vs. pre-COVID-19. Notably, 456 (14%) hypertensive patients experienced exacerbated hypertension, while 408 (17%) patients developed new-onset hypertension, overall 864 (16%) of patients had exacerbation or new hypertension. Linear regression analysis revealed that advanced age, smoking, previous cardiovascular events, hypertension, and diabetes mellitus predict increased BP following COVID-19 (P < 0.001).ConclusionCOVID-19 raised systolic and diastolic BP in the long term in non-hospitalized patients, with over one-sixth developing new-onset or exacerbated hypertension. All patients should be evaluated regarding BP, following COVID-19 recovery, particularly those with the mentioned predictive factors. (clinicaltrial.gov: NCT05798208)

Gender disparities in lymphocyte counts and cytokine expression in COVID-19

Background: This study seeks to assess gender differences in the severity of COVID-19 infection, which have been noted in different regions during the early stages of the pandemic. Methods: A cross-sectional study conducted at Baquba Teaching Hospital in Diyala, Iraq, from October 1st to December 31st, 2020, included 132 confirmed COVID-19 patients. These patients underwent a comprehensive set of routine laboratory tests, including complete blood count, blood biochemistry, and D-dimer assessment. Statistical analysis was carried out using SPSS-20, with significance set at p &lt; 0.05. Results: The study included patients with a mean age of 45.61 (±11.32) years, predominantly male (63.0%), residing in urban areas (57.6%), and presenting with comorbidities (78.8%). All patients exhibited positive results on CT scans (100%) and CRP tests (100%). However, PCR testing confirmed COVID-19 infection in 87.2% of cases, with 12.8% testing negative. Among males, there was a significant increase in IL-6 and IL-10 levels (42.57 ± 7.64 pg/ml and 255.27 ± 21.03 pg/ml) compared to females (16.43 ± 4.19 pg/ml and 187.48 ± 20.35 pg/ml), with p-values &lt;0.001 and 0.003, respectively. Conversely, there was no significant difference in IFN-ɣ levels between males (165.73 ± 16.54 pg/ml) and females (176.12 ± 17.10 pg/ml), with a p-value of 0.105. However, lymphocyte levels were significantly lower in males (4.79 ± 0.85%) compared to females (14.01 ± 1.36%), with a p-value &lt;0.001. Conclusion: Overall, COVID-19 affects males more severely than females, with males showing weaker immune responses and higher levels of inflammatory cytokines like IL-6 and IL-10. While IFN-ɣ levels do not differ significantly between genders, males have lower lymphocyte counts compared to females.

Outcomes of corticosteroid treatment in critically ill COVID-19 patients

Objective: This study aims to examine the impact of low-dose and high-dose corticosteroids on the clinical outcomes and mortality of critically ill patients with COVID-19 in intensive care units. Material and Methods: This study was conducted on 197 confirmed COVID-19 patients who received corticosteroid therapy in the intensive care unit (ICU) between June 1st and December 31st, 2020. Patients were divided into two groups for low- and high-dose corticosteroid therapy. Both groups were compared according to demographic features, comorbid conditions, laboratory parameters, as well as the ordinal scale for clinical improvement (OSCI), hospital mortality, and length of stay in the intensive care unit. Results: A total of 140 patients received low-dose corticosteroids, while 57 patients received high-dose corticosteroid therapy. Our findings revealed a significantly higher median length of stay in the ICU and mortality in the group that received high-dose corticosteroid therapy. We observed a significant reduction in ferritin and D-dimer levels in the group receiving high-dose corticosteroid therapy (p &lt; 0.003, p &lt; 0.012, respectively). Furthermore, OSCIs on admission, day 5, and day 10 after corticosteroid therapy were higher in the group receiving high-dose corticosteroids. Conclusion: The results of this study indicate that high-dose corticosteroid therapy in critically ill patients with COVID-19 is associated with high mortality rates and prolonged intensive care stays.

A Policy Examination of Covid-19 Impact on the Radiology Department Standard Operating Procedures (SOPs): The Malaysian Experience

The purpose of this paper is to review the new management policy in medical imaging of the Covid-19 post-pandemic transition. This paper discussed the Standard Operating Procedure (SOP) introduced by the Ministry of Health (MoH) Malaysia to prevent and control intrahospital transmissions of Covid-19. A conceptual framework is proposed to highlight the key areas in the national SOP for preventing Covid-19 intrahospital transmissions in the radiology department. The key areas were classified into four categories: planned requests (patient appointments), (ii) open-access management (walk-in patient workflow and the triage system), (iii) direct contact (during radiology procedures), and (iv) exit policy and disinfection (post imaging conduct). The paper ends with a summary of diagnostic imaging classifications based on chest radiographs (CXR) and Computed Tomography (CT) images of suspected and confirmed Covid-19 patients. The Covid-19 SOP for the radiology department by the MoH was found to retain most of the patient quarantine and isolation guidelines by the Centre for Disease Control and Prevention (CDC) and incorporated several international policies on patient triage and disinfection of radiological equipment. The majority of the SOP is also sustained, like the SOP during the pandemic, except for the SOP that has been proven to be insignificant by recent research. The Covid-19 SOP for the radiology department plays an important role in reducing the intrahospital spread of Covid-19, with some areas needing improvement. Health workers in the radiology department should continue implementing the Covid-19 SOP and increase their knowledge in identifying Covid-19 signs on radiographic images to help safeguard themselves and the patients from intrahospital transmissions.

Descriptive Analysis Of Electrolyte Imbalance In Relation To Severity Of Illness In Covid-19 Pediatric Patients Admitted In A Tertiary Care Hospital In Rawalpindi Pakistan

Objective To determine the frequency of electrolyte imbalance in pediatric COVID-19 patients and their impact on the severity of disease and outcome. Methods: A retrospective observational study was done from January 2021 to July 2021 on 61 children admitted in Benazir Bhutto Hospital Rawalpindi, a tertiary care teaching hospital affiliated with Rawalpindi Medical University (RMU) Pakistan. The age of the patients ranged from infants to 12 years. All the children who were PCR positive or those whose HRCT was suggestive of COVID-19 were included in the study. Results: During the study period of 7 months, 61 confirmed COVID-19 patients were admitted. 37(60.7%) were males and 24 (39.3%) were females. The age of the patients ranged from infants to 12 years with a mean age of 27.25 months. Out of 61 admitted cases, 28 children (45.9%) had moderate &amp; 33(54.1%) patients had severe disease. 46(75%) patients were discharged while 15(25%) patients expired. A number of electrolyte abnormalities were observed. A total of 30 patients (49.2%) were hyponatremic &amp;13 patients (21.3%) were hypernatremic. Hypokalemia was observed in 34(55.7%) &amp; hyperkalemia was found in 2 patients (3.3%), hypochloremia was observed in 13(21.3%) while hyperchloremia was present in 3(4.9%) patients. Hypocalcemia was found in 9(14.7%) patients. 11(18%) patients with Hyponatremia and 6(9.8%) patients with hypernatremia expired. The potassium abnormalities were also associated with significant mortality.14(22.9%) patients with hypokalemia and 2(3.2%) with hyperkalemia expired. Hypocalcemia was found in 9(4.9%) patients who expired. Conclusion: Hypokalemia and hyponatremia were frequent electrolyte disorders in children with COVID-19. These electrolyte abnormalities were associated significantly with severity of disease and a higher risk of death in children with COVID-19 Keywords: COVID-19, Electrolytes, Hypokalemia, Hyperkalemia, Hyponatremia, Hypernatremia, Hypocalcemia