Prognosis Of Coronavirus Disease 2019 Research Articles

Immunological evaluation of patients with 2019 novel coronavirus pneumonia: CD4+ and CD16+ cells may predict severity and prognosis.

PurposeAvailable but insufficient evidence shows that changes may occur in the immune system following coronavirus disease 2019 (COVID-19). The present study aimed at evaluating immunological changes in patients with severe acute respiratory syndrome coronavirus‐2 (SARS-CoV-2) pneumonia compared with the control group.MethodThe present study was performed on 95 patients with COVID-19 (32 severe and 63 moderate cases) and 22 healthy controls. Relationship between immune cells, disease severity and lung involvement was assessed. Binary logistic regression and ROC curve tests were used for statistical analysis.ResultsA significant decrease was observed in CD20+ cell counts of the patients. To differentiate patients from healthy individuals, the cutoff point for the CD4+ cell count was 688 /μL, sensitivity 0.96, and specificity 0.84. An increase in CD4+ cells reduces the odds of severe disease (odds ratio = 0.82, P = 0.047) and death (odds ratio = 0.74, P = 0.029). CD4+ cells play a pivotal role in the severity of lung involvement (P = 0.03). In addition to CD4+ cells, Fc gamma receptor III (FcγRIII) (CD16) also played a significant prognosis (odds ratio = 0.55, P = 0.047). In severe cases, C-reactive protein, Blood urea nitrogen, and Creatine phosphokinase levels, as well as neutrophil counts, were significantly higher than those of moderate ones whereas lymphocyte count in severe cases was lower than that of moderate ones.ConclusionThe number of total T-cells and B-cells in patients with COVID-19 was lower than that of controls; however, their NK cells increased. FcγRIII and CD4+ cells are of great importance due to their association with COVID-19 prognosis.

Characterization of serotonin as a candidate biomarker of severity and prognosis of COVID-19 using LC/MS analysis

The coronavirus disease 2019 (COVID-19) pandemic has been associated with high mortality worldwide. Owing to its complicated pathophysiology, diagnostic and prognostic biomarkers for effective patient management remain scarce. We analyzed kynurenine, tryptophan, and serotonin levels in the serum of patients with COVID-19 via liquid chromatography/mass spectrometry analysis. Serum serotonin levels were decreased in patients with more severe COVID-19, along with increased kynurenine and decreased tryptophan concentrations. Patients with moderate disease who subsequently worsened showed significantly lower serotonin concentrations compared with those who did not experience severe disease. Serum serotonin levels may represent a valuable biomarker for COVID-19 severity and prognosis.

Coronavirus Disease: Subacute to Chronic Neuroimaging Findings.

Several neurologic disorders are associated with coronavirus disease 2019 (COVID-19). In this article, clinical syndromes typically occurring in the subacute to chronic phase of illness and their neuroimaging findings are described with discussion of their COVID-19 specific features and prognosis. Proposed pathogenic mechanisms of these neuroimaging findings and challenges in determining etiology are reviewed.

Effects of nutrients on immunomodulation in patients with severe COVID-19: Current knowledge.

Recent research has demonstrated that critically ill patients with coronavirus disease 2019 (COVID-19) show significant immune system dysregulation. Due to that, some nutrients that influence immunomodulation have been suggested as a form of treatment against the infection. This review collected the information on the impact of vitamins on the prognosis of COVID-19, with the intention of facilitating treatment and prevention of the disease risk status in patients. The collected information was obtained using the PubMed electronic database by searching for articles that relate COVID-19 and the mechanisms/effects of the nutrients: Proteins, glucose, lipids, vitamin B12, vitamin D, calcium, iron, copper, zinc, and magnesium, including prospective, retrospective, and support articles. The findings reveal an optimal response related mainly to omega-3, eicosapentaenoic acid, docosahexaenoic acid, calcium, and iron that might represent benefits in the treatment of critically ill patients. However, nutrient supplementation should be done with caution due to the limited availability of randomized controlled studies.

The Relationship of Comorbidities with Intensive Care Unit Admission and Mortality in Patients with COVID-19.

Objective:Comorbid conditions are known to be associated with poor prognosis in coronavirus disease 2019. This study aimed to investigate the effects of comorbidity burdens of inpatients, identified by the Charlson Comorbidity Index, on their mortalities. Methods:A total of 150 patients who presented to the emergency department of our hospital with various complaints and symptoms were diagnosed with coronavirus disease 2019 as a result of the testing and received inpatient treatment (87 males, mean age 61.6 ± 13.8 years) were included in the study. Charlson Comorbidity Index scores were calculated. Patients were classified into 2 groups based on the state of exitus: group 1, those who did not survive; 33 patients, 19 males; 68.3 ± 11.8 years and group 2, those who survived; 117 patients, 68 males; 59.7 ± 13.8 years. Results:In all patients, the exitus rate was 22%, the rate of intensive care follow-up was 46%, and the intubation rate was 37.3%. The Charlson Comorbidity Index scores were significantly higher in group 1 compared to group 2. Multivariate logistic regression analyses demonstrated that the Charlson Comorbidity Index score was an independent predictor of in-hospital mortality (odds ratio: 1.990, 95% CI: 1.314-3.015, P = .001). The cut-off value for the Charlson Comorbidity Index to predict in-hospital mortality was 5.5, with 81.8% sensitivity and 73.5% specificity.Conclusions:The Charlson Comorbidity Index score, which can be obtained at the time of admission, could be associated with the prognosis of coronavirus disease 2019 patients. Those with a Charlson Comorbidity Index score greater than 5.5 could be more associated with negative outcomes and mortality.

Efficacy of extracorporeal membrane oxygenation in pediatric COVID-19 and MIS-C cases: A single-center experience.

Background This study aimed to evaluate the need and the indication of extracorporeal membrane oxygenation (ECMO) in patients diagnosed with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) followed up in the pediatric intensive care unit by the demographic, clinical, and laboratory data and treatment response. Methods A total of 79 patients (43 males, 36 females; median age: 138 months; range, 6 to 210 months) with COVID-19 and MIS-C followed up between September 2020 - September 2021 were included in this retrospective study. Demographic and clinical data were retrospectively collected from patient files, and clinical data, laboratory findings, chest X-rays, and echocardiography results of six patients (1 male and 5 female, median age: 159 months, range, 13 to 210 months) who needed ECMO due to poor response to medical treatment were recorded before and after the ECMO therapy. Results Extracorporeal membrane oxygenation therapy was performed on one patient with a positive COVID-19 polymerase chain reaction test and five patients with MIS-C in our unit. Five patients were supported with venoarterial (v-a) ECMO, and one patient was supported with venovenous ECMO. Median hospitalization time was 29 (range, 24 to 50) days, median Pediatric Risk of Mortality score was 19.5 (range, 11 to 36), and median length of mechanical ventilation was 23.5 (range, 10 to 45) days. The median vasoactive inotropic score was 55.5 (range, 18 to 110) before ECMO, while the median vasoactive inotropic score was 11 (range, 0 to 34) after ECMO. Four patients were successfully weaned off ECMO, and one of these patients was lost due to brain death 15 days after the weaning. One patient infected with the delta variant of COVID-19, which remained positive during the clinical course, and one patient diagnosed with MIS-C was lost despite the v-a ECMO support. Three of the patients were discharged. Thrombosis developed in the superficial femoral artery of one patient on the cannulated side during v-a ECMO. No death due to complications of ECMO was recorded. Conclusion In our study, although the majority of our patients followed up with the diagnosis of COVID-19 and MIS-C showed a mild or moderate clinical course, it was observed that a severe clinical course could develop in a small number of patients and that ECMO treatment may be needed in these patients. In agreement with the ECMO studies with different indications in the literature, we conclude that ECMO therapy may markedly contribute to the prognosis in COVID-19 and MIS-C patients when the initiation and termination timing of therapy is correct.

COVIDx-US: An Open-Access Benchmark Dataset of Ultrasound Imaging Data for AI-Driven COVID-19 Analytics.

The Coronavirus Disease 2019 (COVID-19) pandemic continues to have a devastating effect on the health and well-being of the global population. Apart from the global health crises, the pandemic has also caused significant economic and financial difficulties and socio-physiological implications. Effective screening, triage, treatment planning, and prognostication of outcome play a key role in controlling the pandemic. Recent studies have highlighted the role of point-of-care ultrasound imaging for COVID-19 screening and prognosis, particularly given that it is non-invasive, globally available, and easy-to-sanitize. COVIDx-US Dataset: Motivated by these attributes and the promise of artificial intelligence tools to aid clinicians, we introduce COVIDx-US, an open-access benchmark dataset of COVID-19 related ultrasound imaging data. The COVIDx-US dataset was curated from multiple data sources and its current version, i.e., v1.5., consists of 173 ultrasound videos and 21,570 processed images across 147 patients with COVID-19 infection, non-COVID-19 infection, other lung diseases/conditions, as well as normal control cases. The COVIDx-US dataset was released as part of a large open-source initiative, the COVID-Net initiative, and will be continuously growing, as more data sources become available. To the best of the authors' knowledge, COVIDx-US is the first and largest open-access fully-curated benchmark lung ultrasound imaging dataset that contains a standardized and unified lung ultrasound score per video file, providing better interpretation while enabling other research avenues such as severity assessment. In addition, the dataset is reproducible, easy-to-use, and easy-to-scale thanks to the well-documented modular design.

Association of Prognostic Nutritional Index with Severity and Mortality of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis.

The associations of prognostic nutritional index (PNI) with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19) remain unclear. Electronic databases, including MEDLINE, EMBASE, Google scholar, and Cochrane Library, were searched from inception to 10 May 2022. The associations of PNI with risk of mortality (primary outcome) and disease severity (secondary outcome) were investigated. Merged results from meta-analysis of 13 retrospective studies (4204 patients) published between 2020 and 2022 revealed a lower PNI among patients in the mortality group [mean difference (MD): −8.65, p < 0.001] or severity group (MD: −5.19, p < 0.001) compared to those in the non-mortality or non-severity groups. A per-point increase in PNI was associated with a reduced risk of mortality [odds ratio (OR) = 0.84, 95% CI: 0.79 to 0.9, p < 0.001, I2 = 67.3%, seven studies] and disease severity (OR = 0.84, 95% CI: 0.77 to 0.92, p < 0.001, I2 = 83%, five studies). The pooled diagnostic analysis of mortality yielded a sensitivity of 0.76, specificity of 0.71, and area under curve (AUC) of 0.79. Regarding the prediction of disease severity, the sensitivity, specificity, and AUC were 0.8, 0.61, and 0.65, respectively. In conclusion, this study demonstrated a negative association between PNI and prognosis of COVID-19. Further large-scale trials are warranted to support our findings.

Lactate dehydrogenase and C-reactive protein as predictors of severity and prognosis in corona virus disease 2019 (COVID-19) in Iraqi patients

The Objective of the Study:-To estimate whether the initial C-reactive protein (CRP) and Lactate dehydrogenase (LDH) levels are able to act as markers of severity and prognosis in COVID-19 adult patients. Patients and Method: This cross sectional study was conducted in the Marjan medical teaching city during the period from January 2021 to augest2021. 100 Patients who complained from fever or chest symptoms were enrolled after laboratory confirmation of COVID19 via RT-PCR. Chest computed tomography scan(CT) was then performed to classify the patients into mild, moderate and severe, critical pneumonia groups according to world health organization(WHO)classification, initial plasma CRP level and LDH level were measured for all patients. Follow up and documentation were done for all patients. A thoracic radiologist interprets chest CT scan and produces a structured report. An informed written consent was obtained from each participant. Results: Cross sectional study of 100 cases with COVID 19 infection, mean age of patients (51.6 ± 15.5) years.51%are females and 49% are male, (79%) of patients admitted to hospital and then get well and discharged,16% died. CRP and LDH increase in complicated patients with COVID 19 infection. Critical cases have high LDH than other types of severity.

COVID-19 Prognosis in Association with Antidepressant Use.

Various subtypes of severe acute respiratory syndrome coronavirus 2 and variations among immune systems in different ethnicities need to be considered to understand the outcomes of coronavirus disease 2019 (COVID-19). This study aimed to provide evidence for the association between the use of antidepressants and the severity of COVID-19. We used the National Health Information Data-COVID database. Patients with one or more prescriptions of any antidepressant were selected as the exposure group. Detailed analyses were performed to determine the type of medication associated with the prognosis. The use of selective serotonin reuptake inhibitors (SSRIs) was associated with a lower risk of severe outcomes of COVID-19, whereas the use of tricyclic antidepressants (TCAs) increased the risk of poor prognosis of COVID-19. Detailed analyses showed that escitalopram was significantly associated with better clinical outcomes, and nortriptyline was linked to more severe COVID-19 outcomes. This study revealed an association between antidepressants and COVID-19 prognosis. SSRIs were significantly associated with a lower risk of severe outcomes, whereas TCAs were related to the poor prognosis of COVID-19.

Identification of novel drug targets for the risk and prognosis of COVID-19.

BackgroundSince the epidemic continues, there is a pressing need to improve our understanding of coronavirus disease 2019 (COVID-19). Mendelian randomization (MR) studies provide us with a method to explore the causality between circulating proteins and COVID-19 susceptibility and severity. We aim to find new perspectives on the pathological mechanism of the disease and possible drug targets for treatment based on this study.MethodsWe conducted a phenome-wide MR study to prioritize circulating proteins causally associated with COVID-19 susceptibility, which was defined as “patients tested positive for COVID-19 vs. population controls”, and severity, which was defined as “patients hospitalized with COVID-19 vs. population controls”. And we repeated the analysis for different definition of COVID-19 susceptibility, severity and control groups.ResultsAssociation of three circulating proteins with COVID-19 susceptibility and severity were demonstrated via our study. C-C motif chemokine 4 (OR =1.887, 95% CI: 1.608–2.165, P=8.04×10−6) and 2'-5'-oligoadenylate synthase 1 (OR =0.511, 95% CI: 0.266–0.757, P=8.51×10−8) were found respectively positively and negatively correlated with increased COVID-19 severity. Tissue factor, contrary to previous studies, was found associated with decreased COVID-19 susceptibility (OR =0.667, 95% CI: 0.484–0.850, P=1.47×10−5) and decreased COVID-19 severity (OR =0.459, 95% CI: 0.132–0.786, P=3.01×10−6).ConclusionsGenetic evidence supports C-C motif chemokine 4 as a risk factor for COVID-19 severity, and 2'-5'-oligoadenylate synthase 1 as a protective factor for COVID-19 severity. The causal association between tissue factor and COVID-19 is contrary to the previous studies, needing further analyses. Further research is warranted to assess the viability of C-C motif chemokine 4 and 2'-5'-oligoadenylate synthase 1 as well as their downstream pathways as drug targets for anti-inflammatory and anti-virus treatment in severe cases.

Assessment of some Physiological Biomarkers in COVID-19 Patients in Thi-Qar, Iraq.

It is believed that many biomarkers and factors could be linked to the prognosis of coronavirus disease 2019 (COVID-19). Therefore, this study aimed to evaluate the association of lactate dehydrogenase (LDH), D-Dimer, vitamin D, and ferritin statuses with the prognosis of COVID-19; moreover, it was attempted to investigate its prevalence according to age, employment status, body mass index (BMI), and place of residency in a population sample of hospitalized patients in Thi-Qar, Iraq. This study evaluated 200 COVID-19 patients and 100 controls. The BMI of all individuals was calculated, and such demographic characteristics as age, gender, place of residency, and occupational status were collected from all participants. Blood samples were taken and used to estimate D-Dimer, LDH, vitamin D, ferritin, oxygen, and pulse rate. The mean age of the patients approached the fifth decade, and 72% of the cases were more than 40 years of age. In addition, 60% of the patients were living in the countryside, and 52% of the participants were employed, compared to only 8% of the cases who were students. The BMI of the patients was obtained at 31.44±10.2 kg/m2; accordingly, 47% and 40% of the cases were obese and overweight, respectively, compared to only 12% of the patients who had normal weight (P˂0.05). There were significantly lower vitamin D levels in the patients; however, the concentrations of LDH, serum ferritin, and D-Dimer were significantly higher in the patients, compared to the control group (P˂0.05). Not only age and body weight but also employment status and place of residency maybe also the important risk factors for COVID-19 distribution. LDH, D-dimer, vitamin D, and ferritin statuses could be used as good biomarkers for this disease and its severity.

Nazal Polipli Hastalarda COVID-19 İnsidansının ve Prognozunun Değerlendirilmesi

Objective: Coronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Type 2 immune response accompanied by type 2 cytokines such as IL-4, IL-5, IL-13, and eosinophilic inflammation, may have a potential protective effect against COVID-19 in chronic rhinosinusitis patients with nasal polyps (CRS + P). In the study, it was aimed to investigation the prevalence and prognosis of COVID-19 in chronic rhinosinusitis patients with nasal polyps (CRS + P). Materials and Methods: Patients between the ages of 15-65 operated for CRS + P and were compared with the control group in terms of incidence and disease severity. Results: Covid RT-PCR test was positive in 5.04% of CRS + P patients. This rate was 8.96% in the control group, and the difference between both groups was statistically significant. When the two groups were compared in terms of disease severity, no significant difference was found. Conclusions: The incidence of COVID-19 was lower in patients with CRS + P. However, further prospective studies are needed to research the relationship between nasal polyp and COVID-19.

Multiple sclerosis in the era of COVID-19: disease course, DMTs and SARS-CoV2 vaccinations.

As of January 21st 2022, over 340 million are confirmed cases of coronavirus disease 2019 (COVID-19), including nearly 5.6 million deaths. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is neurotropic and affects the neural parenchyma through direct viral invasion from the nasal mucosa and postinfectious cytokine storm. Further challenges of SARS-CoV-2 infection are nowadays linked to variants of concern. Multiple sclerosis is an inflammatory and progressive degenerative disorder of the central nervous system commonly affecting young adults and potentially generating irreversible disability. Since the beginning of the SARS-CoV-2 pandemic, people with multiple sclerosis (pwMS) have been considered 'extra' vulnerable because of the immune-mediated nature of the disease, the disability status, and the immunomodulatory therapies potentially increasing the risk for viral infection. Today multiple sclerosis neurologists are faced with several challenges in the management of pwMS to both prevent SARS-CoV-2 infection and protection from disease worsening. We aimed to highlight today's most relevant facts about the complex management of pwMS in the COVID-19 era. The incidence of COVID-19 among pwMS does not differ from the general population. The prognosis of COVID-19 among pwMS is driven by older age, male sex, nonambulatory status, comorbidity as in the general population, as well as by corticosteroid treatment and B-cell depleting agents which decrease seropositivity from SARS-CoV-2 infection and immune responses to SARS-CoV-2 vaccination. Disease modifying treatments (DMTs) should be regularly continued in relation to SARS-CoV-2 vaccination, but an ad hoc timing is required with B-cell depleting agents. SARS-CoV-2 vaccination is recommended in pwMS with willingness improving through health education programs. Multiple sclerosis does not seem to worsen after SARS-Cov2 vaccination but COVID-19 may enhance disease activity.

Relationship between Selective IgA Deficiency and COVID-19 Prognosis.

The prevalence and mortality rates of coronavirus disease 2019 (COVID-19) widely vary among populations. Mucosal immunity is the first barrier to the pathogen's entry into the body. Immunoglobulin A (IgA) is the primary antibody responsible for mucosal immunity. We explored the relationship between selective IgA deficiency (SIgAD) and COVID-19 severity. We included 424 patients (203 women) with COVID-19. Eleven patients had SIgAD. Laboratory data of patients with SIgAD and normal IgA levels were compared. The relationship between SIgAD and severe COVID-19 infection was explored using logistic regression analysis. In the univariate logistic regression analysis, the risk of severe COVID-19 disease in patients with SIgAD was approximately 7.7-fold higher than that in other patients (odds ratio [OR], 7.789; 95% confidence interval [CI], 1.665-36.690, P = 0.008), while it was 4-fold (OR, 4.053; 95% CI, 1.182-13.903, P = 0.026) higher in the multivariate logistic regression analysis. Serum IgA levels were positively correlated with total lymphocyte counts and negatively correlated with C-reactive protein levels, which was a risk factor for severe COVID-19. In patients with SIgAD, the number of severe acute respiratory coronaviruses 2 that pass through mucosal membranes may be increased, leading to complications such as cytokine storm syndrome and acute respiratory distress syndrome.

Patients with hemodialysis-induced hypoxemia had a poor prognosis of COVID-19

BackgroundWe experienced that some hemodialysis (HD) patients with coronavirus disease 2019 (COVID-19) exacerbated hypoxemia during HD. Though HD-induced hypoxemia has been reported, there have been no reports of HD-induced hypoxemia in patients with COVID-19 and its effect on prognosis of COVID-19.MethodsEleven HD patients admitted with COVID-19 from August 2020 to April 2021 were classified into the patients whose oxygen demand increased by more than 3 L/min with mask during HD (worsened group, n = 5) and others (not-worsened group, n = 6). The background, laboratory findings, severity of COVID-19 and prognosis were compared between the two groups. In addition, blood gases were measured before and after dialysis among HD patients admitted with COVID-19 on April 2021 (n = 3).ResultsThere were no significant differences in backgrounds, except for a higher proportion of diabetes mellitus in worsened group (p = 0.04). Although laboratory findings were not significantly different on admission day, albumin and LDH levels 7 days after admission were significantly lower and higher in worsened group, respectively (p = 0.03 and < 0.01). The severity of COVID-19 and survival rate were significantly worse in worsened group (p = 0.01 and 0.03). The alveolar-arterial oxygen pressure difference (Aa-DO2) opened during HD in a patient with HD-induced hypoxemia, but did not open in patients without HD-induced hypoxemia.ConclusionsThere is a close relationship among HD-induced hypoxemia and poor prognosis of COVID-19. The HD-induced hypoxemia of patients with COVID-19 may be caused by ventilation/perfusion mismatching.

Predictive Factors For Severe And Critical Coronavirus Disease-19 In Young Adults

Predictive Factors For Severe And Critical Coronavirus Disease-19 In Young Adults Abstract Objective: Advanced age is associated with a poor prognosis in Coronavirus disease-2019 (COVID-19). The present study was conducted with the aim of investigating the predictive factors for disease severity in young adults. Materials and Methods: A total of 399 patients with COVID-19 aged under 60 who had been hospitalized at our hospital were retrospectively evaluated. Patients were stratified into mild, moderate, severe, and critical groups according to their respiratory rate, SpO2, and PaO2/FiO2 levels. The relationship between the signs and symptoms on hospital admission and the disease severity was evaluated. Results: The patients were classified as mild (n:112), moderate (n:192), severe and critical (n:95) according to disease severity. The mean age was 44. 43 of 399 patients were followed in the intensive care unit and 17 patients died. According to the binary logistic regression analysis, advanced age, hypertension, dyspnea on admission, elevated CRP, decreased lymphocyte and eosinophil count, presence of multiple bilateral ground glass appearance and consolidation were independently predicted the severity of disease. Conclusion: The signs and symptoms should be evaluated in detail also in young patients with COVID-19 and if risk factors are detected, they should be monitored more closely for predicting a poor prognosis.

Prevalence and Outcomes of Pancreatic Enzymes Elevation in Patients With COVID-19: A Meta-Analysis and Systematic Review.

Background:Although coronavirus disease 2019 (COVID-19) is considered to be a disease that mainly involves the respiratory system, an increasing number of studies have reported that COVID-19 patients had pancreatic enzymes (PE) elevation and even pancreatic injury. The study aims to determine the prevalence of PE elevation, and the relationship between elevated PE and prognosis in COVID-19 patients.MethodsA comprehensive literature search was conducted according to the PRISMA guideline in PubMed, Embase, Scopus, Web of Science, and Google Scholar for studies reporting PE elevation in patients with COVID-19 from 1st January 2020 to 24th November 2021.ResultsA total of 13 studies (24,353 participants) were included in our review. The pooled prevalence of PE elevation in COVID-19 patients was 24% (18%–31%), the pooled odds ratio (OR) of mortality was 2.5 (1.7–3.6), the pooled OR of ICU admission was 4.4 (2.8–6.8), and the pooled OR of kidney injury, respiratory failure and liver injury were 3.5 (1.6–7.4), 2.0 (0.5–8.7), and 2.3 (1.4–3.9) respectively. In addition, the subgroup analysis revealed that although PE elevated to > 3 × upper normal limit (ULN) was significantly related to the mortality (OR = 4.4, 2.1–9.4), it seemed that mild elevation of PE to 1–3 ULN also had a considerable risk of mortality (OR = 2.3, 1.5–3.5).ConclusionsPE elevation was a common phenomenon in patients with COVID-19, and was associated with poor clinical outcomes. However, due to the limited numbers of included studies, the result of our study still needed to be validated.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=295630, identifier: CRD42021295630.

Advance in research on application of endotoxin adsorption membrane in treatment of coronavirus disease 2019

The new type coronavirus disease 2019 (COVID-19) is a contagious disease of severe lung inflammation induced by 2019 novel coronavirus (2019-nCoV). The World Health Organization (WHO) nomenclature of the newly discovered coronavirus was 2019-nCoV and the disease caused by 2019-nCoV was named COVID-19 on January 12, 2020. After 2019-nCoV invasion into a human body, it can stimulate the human immune system and engender a large number of cytokines, triggering a cytokine storm, resulting in severe infection, acute lung injury, multiple organ dysfunction, etc. Therefore, theoretically, the removal of over-production of cytokines can avoid the occurrence of cytokine storm and reduce the incidence of severe critical COVID-19 and serious poor prognosis. In this review, the authors systematically reviewed the past published reports related to the occurrence of cytokine storm in sepsis resulting in deterioration of disease situation, and recently they analyzed the therapeutic effects of patients with severe critical COVID-19 using endotoxin adsorption membrane for treatment in the disease course, further providing the effective clinical evidence of applying endotoxin adsorption membrane for treatment of COVID-19.

Laboratory Biomarkers for Diagnosis and Prognosis in COVID-19.

Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) causes a wide spectrum of clinical manifestations, with progression to multiorgan failure in the most severe cases. Several biomarkers can be altered in coronavirus disease 2019 (COVID-19), and they can be associated with diagnosis, prognosis, and outcomes. The most used biomarkers in COVID-19 include several proinflammatory cytokines, neuron-specific enolase (NSE), lactate dehydrogenase (LDH), aspartate transaminase (AST), neutrophil count, neutrophils-to-lymphocytes ratio, troponins, creatine kinase (MB), myoglobin, D-dimer, brain natriuretic peptide (BNP), and its N-terminal pro-hormone (NT-proBNP). Some of these biomarkers can be readily used to predict disease severity, hospitalization, intensive care unit (ICU) admission, and mortality, while others, such as metabolomic and proteomic analysis, have not yet translated to clinical practice. This narrative review aims to identify laboratory biomarkers that have shown significant diagnostic and prognostic value for risk stratification in COVID-19 and discuss the possible clinical application of novel analytic strategies, like metabolomics and proteomics. Future research should focus on identifying a limited but essential number of laboratory biomarkers to easily predict prognosis and outcome in severe COVID-19.