COVID-19 Disease Severity Research Articles

A New Biomarker Copeptin in Determining Disease Severity in COVID-19.

Copeptin is released from the posterior pituitary gland into systemic circulation in response to various stimuli, including stress. We aimed to evaluate the role of copeptin in determining the severity of the disease in patients with COVID-19. The study was conducted prospectively in two centers between June 1, 2022, and October 1, 2022. Severe and mild-moderate COVID-19 patients were compared in terms of clinical, laboratory and imaging findings, and serum copeptin levels at hospitalization. A total of 90 patients were included in the study; 45 patients were in severe disease groups. Dyspnea, loss of appetite, and loss of smell were significantly more common in the severe disease group (p<0.001, p=0.025, and p<0.001, respectively). Among the tomography findings, the consolidation frequency was similar in both groups (p=0.259). C-reactive protein (CRP), D-dimer, ferritin, lactate dehydrogenase (LDH), procalcitonin, troponin and copeptin levels were higher in the severe group (p<0.05); hemoglobin, total protein and vitamin D levels were lower (p=0.05). The area under the curve (AUC) values for severe disease were 0.643 for copeptin (p=0.019), 0.656 for CRP (p=0.011), 0.684 for procalcitonin (p=0.004), 0.657 for ferritin (p=0.01), 0.72 for D-dimer (p=0), 0.688 for troponin (p=0.002), and 0.672 for age (p=0.005). In our study, copeptin was identified as a new prognostic biomarker indicating the severity of the disease in patients with COVID-19.

Distinct soluble immune checkpoint profiles characterize COVID-19 severity, mortality and SARS-CoV-2 variant infections.

Over the past four years, the COVID-19 pandemic has posed serious global health challenges. The severe form of disease and death resulted from the failure of immune regulatory mechanisms, closely highlighted by the dual proinflammatory cytokine and soluble immune checkpoint (sICP) storm. Identifying the individual factors impacting on disease severity, evolution and outcome, as well as any additional interconnections, have become of high scientific interest. In this study, we evaluated a novel panel composed of ten sICPs for the predictive values of COVID-19 disease severity, mortality and Delta vs. Omicron variant infections in relation to hyperinflammatory biomarkers. The serum levels of sICPs from confirmed SARS-CoV-2 infected patients at hospital admission were determined by Luminex, and artificial neural network analysis was applied for defining the distinct patterns of molecular associations with each form of disease: mild, moderate, and severe. Notably, distinct sICP profiles characterized various stages of disease and Delta infections: while sCD40 played a central role in all defined diagrams, the differences emerged from the distribution levels of four molecules recently found and relatively less investigated (sCD30, s4-1BB, sTIM-1, sB7-H3), and their associations with various hematological and biochemical inflammatory biomarkers. The artificial neural network analysis revealed the prominent role of serum sTIM-1 and Galectin-9 levels at hospital admission in discriminating between survivors and non-survivors, as well as the role of specific anti-interleukin therapy (Tocilizumab, Anakinra) in improving survival for patients with initially high sTIM-1 levels. Furthermore, strong associations between sCD40 and Galectin-9 with suPAR defined the Omicron variant infections, while the positive match of sCD40 with sTREM-1 serum levels characterized the Delta-infected patients. Of importance, this study provides a comprehensive analysis of circulatory immune factors governing the COVID-19 pathology, and identifies key roles of sCD40, sTIM-1, and Galectin-9 in predicting mortality.

Analiza różnic w stężeniu przeciwciał przeciw SARS-CoV-2 w przebiegu COVID-19 w zależności od ciężkości choroby, płci, wieku i statusu szczepienia

Introduction and objectiveThe role of immunoglobulin G antibodies in combating SARS-CoV-2 infection, modulation of COVID-19 disease severity, and persistence of humoral response after primary infection and vaccination is unclear. This study aimed to evaluate the role of antibodies in limiting the infection, modulating disease severity, and determining the durability of the immune response depending on the clinical status of patients, their age, sex, and vaccination status.Material and methodsThe study involved 156 patients, 99 men and 57 women, aged 58.3 ± 12.5 years old, hospitalised for pneumonia in the course of COVID-19, with infection confirmed by real-time polymerase chain reaction test. The concentration of anti-SARS-CoV-2 IgG antibodies was tested at 3, 6, and 9 months from the day of hospitalisation.ResultsThe concentration of anti-SARS-CoV-2 IgG antibodies in patients with severe COVID-19 was higher compared to the group of patients with mild to moderate disease. The level of anti-SARS-CoV-2 IgG antibodies was comparable in men and women. In patients over 60 years of age, a lower concentration of antibodies was observed than in patients under 60 years of age. In the vaccinated group, the level of antibodies was higher than in the unvaccinated group.ConclusionsThe study findings showed that the concentration of IgG anti-SARS-CoV-2 antibodies was not a parameter dependent on the sex of the patients, but rather on the severity of the disease and the age of the patients and their vaccination status.

Area deprivation index, a marker of socioeconomic disadvantage, may predict severity of COVID-19 in patients and which families may experience worse symptoms of PTSD, anxiety, and depression post-ICU

BackgroundCOVID-19 disproportionately impacted marginalized populations early in the pandemic. Families of patients admitted to the intensive care unit (ICU) experienced significant psychological effects. Little is known about whether individual and patient psychological outcomes after a loved ones stay in the ICU differs by socioeconomic status, as measured by the area deprivation index (ADI).MethodsFamily members of patients with COVID-19 respiratory failure admitted to the ICU at twelve hospitals in five US states were enrolled in a larger study looking at rates of symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression in the months following their loved one's ICU stay. This secondary data analysis includes eight of the twelve hospitals in four of the five states. Each participant was assigned a number indicating a level of neighborhood disadvantage based on the patient’s zip code. Patient and family level characteristics as well as symptoms of anxiety, depression, and PTSD were assessed among each neighborhood.ResultsPatients from the most disadvantaged neighborhoods had the highest proportion of patients that needed to be intubated (p = 0.005). All the patients in the most disadvantaged neighborhoods were a race other than white (p = 0.17). At 12 months post-hospitalization, there was a statistically significant difference in the proportion of family members who experienced symptoms of PTSD, anxiety, and depression between the ADI groups.ConclusionsADI may be a predictor of COVID-19 disease severity for patients on presentation to the ICU. Patients and family members experience psychological effects after a loved one’s admission to the ICU, and these outcomes vary among individuals of different socioeconomic status’, as measured by the ADI. A larger study of family members’ incidence of anxiety, depression, and post-traumatic stress disorder is needed to understand the extent to which these symptoms are impacted by neighborhood level factors as measured by the ADI.

Missense variant rs75603675 within TMPRSS2 gene is associated with the increased risk of severe form of COVID-19

Host genetics among other factors play an important role in COVID-19 disease severity. TMPRSS2, a serine protease, facilitates the priming of the SARS-CoV-2 spike protein, which is essential for the virus to enter the host cell. Several studies had targeted the TMPRSS2 polymorphisms with respect to SARS-CoV-2 infection and COVID-19 disease severity. Initially, the Whole Exome Sequencing (WES) of 7 healthy individuals and 22 COVID-19 patients with different degrees of disease severity was conducted to find the mutational landscape in different genes. A total of 26 single nucleotide polymorphisms (SNPs) were identified of which six were within the exons of TMPRSS2 (four synonymous and two nonsynonymous variants) while the rest of the 20 SNPs were recognized within the flanking intronic regions of TMPRSS2 gene. The nonsynonymous SNPs, rs75603675 and rs12329760, were further evaluated for association with disease severity in a larger sample size of 120 individuals by PCR followed by Sanger sequencing. Neither allelic nor genotypic distributions of rs12329760 were significantly associated with COVID-19 disease severity. However, individuals harboring the A allele of rs75603675 was found to have higher risk of severe COVID-19 compared to the C allele [OR (95%CI): 1.95 (1.11–3.39), p = 0.019]. Also, the genotype A/A [OR (95%CI): 5.13 (1.00–26.38), p = 0.033] of rs75603675 was associated with increased risk of severe COVID-19 under the recessive genetic inheritance model. Although the impact of COVID-19 pandemic has waned due to vaccination and public health measures, continued research on the association of COVID-19 disease severity and infection susceptibility with host genetics is required to shed valuable insights on the future long-term health effects of COVID-19 and impact of new variants on different populations and enable implication of proper informed healthcare strategies during future public health crises.

Chemerin Levels in COVID-19 Are More Affected by Underlying Diseases than by the Virus Infection Itself.

Chemerin is an adipokine involved in inflammatory and metabolic diseases, and its circulating levels have been associated with inflammatory parameters in various patient cohorts. Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, which causes COVID-19, triggers inflammatory pathways. However, the association between serum chemerin levels and COVID-19 disease severity and outcomes has not been definitively established. In this study, serum chemerin levels were analyzed in 64 patients with moderate COVID-19 and 60 patients with severe disease. The results showed that serum chemerin levels were comparable between these two groups and slightly higher than in healthy controls. Notably, COVID-19 patients with hypertension exhibited elevated serum chemerin levels, while those with liver cirrhosis had lower levels. When patients with these comorbidities were excluded from the analyses, serum chemerin levels in COVID-19 patients were similar to those in healthy controls. Positive correlations were observed between serum chemerin levels and markers such as alkaline phosphatase, C-reactive protein, eosinophils, and lymphocytes in the entire cohort, as well as in the subgroup excluding patients with hypertension and cirrhosis. Additionally, urinary chemerin levels were comparable between COVID-19 patients and controls, and neither hypertension nor dialysis significantly affected urinary chemerin levels. Both survivors and non-survivors had similar serum and urinary chemerin levels. In conclusion, this study suggests that comorbidities such as arterial hypertension and liver cirrhosis do have a more significant impact on serum chemerin levels than SARS-CoV-2 infection itself.

Emergence of dysfunctional neutrophils with a defect in arginase-1 release in severe COVID-19.

Neutrophilia occurs in patients infected with SARS-CoV-2 (COVID-19) and is predictive of poor outcomes. Here, we link heterogenous neutrophil populations to disease severity in COVID-19. We identified neutrophils with features of cellular aging and immunosuppressive capacity in mild COVID-19 and features of neutrophil immaturity and activation in severe disease. The low-density neutrophil (LDN) number in circulating blood correlated with COVID-19 severity. Many of the divergent neutrophil phenotypes in COVID-19 were overrepresented in the LDN fraction and were less detectable in normal-density neutrophils. Functionally, neutrophils from patients with severe COVID-19 displayed defects in neutrophil extracellular trap formation and reactive oxygen species production. Soluble factors secreted by neutrophils from these patients inhibited T cell proliferation. Neutrophils from patients with severe COVID-19 had increased expression of arginase-1 protein, a feature that was retained in convalescent patients. Despite this increase in intracellular expression, there was a reduction in arginase-1 release by neutrophils into serum and culture supernatants. Furthermore, neutrophil-mediated T cell suppression was independent of arginase-1. Our results indicate the presence of dysfunctional, activated, and immature neutrophils in severe COVID-19.

A quantitative content analysis of topical characteristics of the online COVID-19 infodemic in the United States and Japan

BackgroundThe COVID-19 pandemic has spurred the growth of a global infodemic. In order to combat the COVID-19 infodemic, it is necessary to understand what kinds of misinformation are spreading. Furthermore, various local factors influence how the infodemic manifests in different countries. Therefore, understanding how and why infodemics differ between countries is a matter of interest for public health. This study aims to elucidate and compare the types of COVID-19 misinformation produced from the infodemic in the US and Japan.MethodsCOVID-19 fact-checking articles were obtained from the two largest publishers of fact-checking articles in each language. 1,743 US articles and 148 Japanese articles in their respective languages were gathered, with articles published between 23 January 2020 and 4 November 2022. Articles were analyzed using the free text mining software KH Coder. Exploration of frequently-occurring words and groups of related words was carried out. Based on agglomeration plots and prior research, eight categories of misinformation were created. Lastly, coding rules were created for these eight categories, and a chi-squared test was performed to compare the two datasets.ResultsOverall, the most frequent words in both languages were related to health-related terms, but the Japan dataset had more words referring to foreign countries. Among the eight categories, differences with chi-squared p ≤ 0.01 were found after Holm-Bonferroni p value adjustment for the proportions of misinformation regarding statistics (US 40.0% vs. JP 25.7%, ϕ 0.0792); origin of the virus and resultant discrimination (US 7.0% vs. JP 20.3%, ϕ 0.1311); and COVID-19 disease severity, treatment, or testing (US 32.6% vs. JP 45.9%, ϕ 0.0756).ConclusionsLocal contextual factors were found that likely influenced the infodemic in both countries; representations of these factors include societal polarization in the US and the HPV vaccine scare in Japan. It is possible that Japan’s relative resistance to misinformation affects the kinds of misinformation consumed, directing attention away from conspiracy theories and towards health-related issues. However, more studies need to be done to verify whether misinformation resistance affects misinformation consumption patterns this way.

SARS-CoV-2 infection and vaccination in patients with pituitary diseases: the experience of a Brazilian reference center.

To evaluate the prevalence and characteristics of SARS-CoV-2 infection, and the prevalence, efficacy, and safety of anti-SARS-CoV-2 vaccination in patients with pituitary diseases. Observational, cross-sectional study of adult patients with pituitary diseases followed in a reference center. Clinical data were collected and a questionnaire about SARS-CoV-2 infection, vaccination and its possible adverse effects was applied. COVID-19 disease severity was defined as mild, moderate, and severe according to the WHO classification. 145 patients were studied (79 women; age 50 ± 15.8 years; duration of pituitary disease 16.8 ± 11.5 years), the cause of pituitary disease was tumoral in 74.5%, and 45.9% were on glucocorticoid replacement due to ACTH deficiency. SARS-CoV-2 infection was confirmed in 51 patients (35.2%; 32 women; age 53.8 ± 14.8 years, 22 before vaccination), with 28 (54.9%), 17 (33.3%) and 6 (11.8%) cases of mild, moderate, and severe disease, respectively, and hospitalization was indicated in 7 (14%) cases. One mild case presented pituitary apoplexy after SARS-CoV-2 infection. Advanced age was a risk factor for COVID-19. Patients with moderate and severe forms of COVID-19 had higher prevalence of dyslipidemia and duration of pituitary disease. All but one of the participants were vaccinated against COVID-19, and 60.4% had adverse events, the most common local pain (54.0%), fever (33.3%), and headache (18.4%), with one case of alopecia and two of persistent fatigue. The prevalence of SARS-CoV-2 infection in our cohort was 35.2%, including 14% of moderate and severe cases requiring hospitalization. The vaccination was universal and safe.

Acute-phase proteins as indicators of disease severity and mortality in COVID-19 patients

The aim of the study was to conduct of relationship of acute-phase proteins (APPs) with the severity of COVID-19 defined by National Institutes of Health and according to the criteria of MEWS scale, with the presence of a cytokine storm, oxygen therapy and patient survival. We enrolled 96 patients with COVID-19 and 30 healthy people. The samples were taken on the day of admission and after 9 days on average. Not only commonly used APPs such as CRP, procalcitonin and ferritin and also rarely assayed proteins such as transferrin, haptoglobin, α1-acid glycoprotein and α1-antitrypsin, were tested in the study. The levels of APPs depends on the severity of COVID-19 disease, on the presence of cytokine storm and used oxygen therapy. The greatest APPs changes occurred in the most advanced form of the disease, with the presence of a cytokine storm and the most intense oxygen therapy. The results obtained from MEWS scale were not consistent with National Institutes of Health scores. Studies in the second samples showed the quenching of the acute phase reactions and the effectiveness of oxygen therapy. Only two of the examined APPs i.e. procalcitonin and transferrin, differed between surviving and non-surviving patients, and these two predispose to the role of prognostic factors in Covid-19. In conclusion, the concentration of not all acute-phase proteins depends on the severity of COVID-19 disease, presence of cytokine storm, the used of oxygen therapy and only some of them (procalcitonin and transferrin) are related to the survival outcomes. Of the newly tested acute-phase proteins, only transferrin shows significance as a marker of disease severity and mortality in COVID-19 disease.

Association between Hematological Parameters and Severity of COVID-19 disease.

This study aimed to determine the relationships between hematological parameters- hemoglobin, Total Leucocyte Counts (TLC), platelet counts, Absolute Neutrophil Counts (ANC), Absolute Lymphocyte Counts (ALC), Neutrophil Lymphocyte Ratio (NLR), Systemic Immune Inflammatory Index (SII), Neutrophil Monocyte Ratio (NMR), Platelet Lymphocyte Ratio (PLR) and the severity of COVID-19 disease and their use in predicting severity of COVID-19 disease. This was a prospective, observational, single-center study of 573 symptomatic adult inpatients of COVID 19 admitted to our tertiary care center. The above-mentioned hematological parameter levels were noted and compared between the two categories of COVID-19 disease, namely non-severe and severe COVID-19 using logistic regression methods. Their cut-off values were detected using the ROC curve. The median TLC, ANC, NLR, SII, NMR, PLR were notably higher in patients with severe COVID-19 than in those with non-severe COVID-19. Logistic regression analysis showed that NMR (OR=1.029, p=0.006) and ALC (OR=0.999, p=0.002) were statistically significant independent predictors of COVID-19 severity. The hematological parameters mentioned, can be used for predicting severe COVID-19 disease at admission. ALC and NMR levels could be used as hematological markers to predict severity of COVID-19 in adult patients with their cut off values being < 1105 cells/cubic millimeter and > 10.434 respectively.

Effects of Immunotoxicity biomarkers, essential elements and vitamin D levels on the severity levels of COVID-19 disease in Turkey.

Many mechanisms are thought to play a role in the pathogenesis of the COVID-19 pandemic, which started in 2019 and affected the whole world. It has been claimed that a deficiency in the immune system can significantly affect the severity of COVID-19 disease. It is important that the levels of essential elements and vitamin D are at certain levels for the healthy functioning of the immune system. Therefore, in this study, it was aimed to evaluate immunotoxicity biomarkers (tumor necrosis factor-alpha (TNF-α), interleukin (IL)-10, interferon (IFN)-γ, monocyte chemotactic protein-1 (MCP-1)), vitamin D, and essential element levels in COVID-19 patients in Turkey. According to the results of the study, it was found that the magnesium (Mg), zinc (Zn), and selenium (Se) levels decreased as the severity of the disease worsened, while the iron (Fe), and copper (Cu) levels were similar to the mild group and the control group, and the levels decreased as the disease worsened. It has also been found that vitamin D levels decrease as the severity of the disease worsens. Compared to the control group, TNF-α, MCP-1, and IFN-γ levels were found to decrease as the severity of the disease worsened. Also, it was observed that there was a significant relationship between essential metal levels and disease progression in most of the patient groups.

Examining the impact of SARS-CoV-2 infection and COVID-19 disease severity on the placental renin-angiotensin system

Examining the impact of SARS-CoV-2 infection and COVID-19 disease severity on the placental renin-angiotensin system

A Randomized Placebo-Controlled Trial of Leronlimab in Mild-To-Moderate COVID-19

PurposeEarly in the course of the SARS-CoV-2 pandemic it was hypothesised that host genetics played a role in the pathophysiology of COVID-19 including a suggestion that the CCR5-Δ32 mutation may be protective in SARS-CoV-2 infection. Leronlimab is an investigational CCR5-specific humanized IgG4 monoclonal antibody currently in development for HIV-1 infection. We aimed to explore the impact of leronlimab on the severity of disease symptoms among participants with mild-to-moderate COVID-19. MethodsThe TEMPEST trial was a randomized, double-blind, placebo-controlled study in participants with mild-to-moderate COVID-19. Participants were randomly assigned in a 2:1 ratio to receive subcutaneous leronlimab (700 mg) or placebo on days 0 and 7. The primary efficacy endpoint was assessed by change in total symptom score based on fever, myalgia, dyspnea, and cough, at end of treatment (day 14). FindingsOverall, 84 participants were randomized and treated with leronlimab (n = 56) or placebo (n = 28). No difference was observed in change in total symptom score (P = 0.8184) or other pre-specified secondary endpoints between treatments. However, in a post hoc analysis, 50.0% of participants treated with leronlimab demonstrated improvements from baseline in National Early Warning Score 2 (NEWS2) at day 14, compared with 20·8% of participants in the placebo group (post hoc; p = 0.0223). Among participants in this trial with mild-to-moderate COVID-19 adverse events rates were numerically but not statistically significantly lower in leronlimab participants (33.9%) compared with placebo participants (50.0%). ImplicationsAt the time the TEMPEST trial was designed although CCR5 was known to be implicated in COVID-19 disease severity the exact pathophysiology of SARS-CoV-2 infection was poorly understood. Today it is well accepted that SARS-CoV-2 infection in asymptomatic-to-mild cases is primarily characterized by viral replication, with a heightened immune response, accompanied by diminished viral replication in moderate-to-severe disease and a peak in inflammatory responses with excessive production of pro-inflammatory cytokines in critical disease. It is therefore perhaps not surprising that no differences between treatments were observed in the primary endpoint or in pre-specified secondary endpoints among participants with mild-to-moderate COVID-19. However, the results of the exploratory post hoc analysis showing that participants in the leronlimab group had greater improvement in NEWS2 assessment compared to placebo provided a suggestion that leronlimab may be associated with a lower likelihood of people with mild-to-moderate COVID-19 progressing to more severe disease and needs to be confirmed in other appropriately designed clinical trials.ClinicalTrials.gov number, NCT04343651 https://classic.clinicaltrials.gov/ct2/show/NCT04343651

Effectiveness of Vaccines Booster Against Infection, Severe Disease and Death Related to COVID-19 : A Systematic Review and Meta-Analysis

COVID-19 is an infectious disease as a result of a kind of corona virus. COVID-19 is now a pandemic affecting many countries. This study aims to know the effectiveness of booster vaccines to reduce the severity of illness, confirm infection, hospitalization, death in humans infected with COVID-19. For Specific purpose, to analyze the severity of COVID-19 disease in humans by booster and without booster. The design of this study was a systematic review and meta-analysis based on observational studies, published in databases such as Pubmed, Embase, MedRxiv, Nature and Scopus. In the search for articles, the limitations of 2021 to 2022 are used. This research was analyzed quantitatively through the Review Manager 5.4.1 program. Study was taken from 13 journals that met the criteria for a meta-analysis. With the population aged over 18 years, and using the type of vaccine BNT162b2 or mRNA. The population of this study came from Israel, Italy, England, Qatar, Brazil, Turkey, Puerto-Rico, Northern Bangkok, Vicinities and Thailand. Significant results were obtained for each outcome. The OR values of BNT162b2 booster vaccine against confirmed infection OR 0.16 (95% CI 0.06 – 0.45), against symptomatic disease 0.22 (95% CI 0.11 – 0.44), against asymptomatic disease OR 0.72 (95% CI 0.69 – 0.74), against hospitalization OR 0.12 (95% CI 0.06 – 0.22), against severe disease OR 0.15 (95% CI 0.07 – 0.33), and against death OR 0.10 (95% CI 0.04 – 0.31). Administration booster vaccines is effective in reducing infection rates, disease severity, and deaths from COVID-19.

Spatial nonstationarity and the role of environmental metal exposures on COVID-19 mortality in New Mexico

Worldwide, the COVID-19 pandemic has been influenced by a combination of environmental and sociodemographic drivers. To date, population studies have overwhelmingly focused on the impact of societal factors. In New Mexico, the rate of COVID-19 infection and mortality varied significantly among the state's geographically dispersed, and racially and ethnically diverse populations who are exposed to unique environmental contaminants related to resource extraction industries (e.g. fracking, mining, oil and gas exploration). By looking at local patterns of COVID-19 disease severity, we sought to uncover the spatially varying factors underlying the pandemic. We further explored the compounding role of potential long-term exposures to various environmental contaminants on COVID-19 mortality prior to widespread applications of vaccinations. To illustrate the spatial heterogeneity of these complex associations, we leveraged multiple modeling approaches to account for spatial non-stationarity in model terms. Multiscale geographically weighted regression (MGWR) results indicate that increased potential exposure to fugitive mine waste is significantly associated with COVID-19 mortality in areas of the state where socioeconomically disadvantaged populations were among the hardest hit in the early months of the pandemic. This relationship is paradoxically reversed in global models, which fail to account for spatial relationships between variables. This work contributes both to environmental health sciences and the growing body of literature exploring the implications of spatial nonstationarity in health research.

Correlations between level of vitamin D serum and disease severity COVID-19

Background: Corona virus disease (COVID-19) Was a respiratory disease. Severity of the disease was related to inflammation process. SCAP scoring system can be used to asses COVID-19 severity. Asses the severity of the disease is an important thing to determine the management. Vitamin D is shown to have anti-inflammatory effect. Vitamin D can downregulate cytokines storm and also induce innate immune activity. Here we want to know about the correlation between level of vitamin D and disease severity of COVID-19. Methods: Cross sectional study was observed 68 patient COVID-19 in Prof. Dr. I. G. N. G Ngoerah Denpasar hospital. They were asses with SCAP scoring system dan measured their vitamin D level at the same time. The correlation between two variable was analyze by Spearman correlation. Results: Among those 68 Sample, the median age of the sample is 64 years old, and 52.9 % of them are male. There is correlation between level of vitamin D and severity of COVID-19, the coefficient correlation was -0.47 with p&lt;0.001. Conclusions: There is correlation between level of vitamin D and severity of COVID-19.

The FLARE Score and Circulating Neutrophils in Patients with Cancer and COVID-19 Disease.

Inflammation and neutrophils play a central role in both COVID-19 disease and cancer. We aimed to assess the impact of pre-existing tumor-related inflammation on COVID-19 outcomes in patients with cancer and to elucidate the role of circulating neutrophil subpopulations. We conducted a multicenter retrospective analysis of 524 patients with cancer and SARS-CoV-2 infection, assessing the relationship between clinical outcomes and circulating inflammatory biomarkers collected before and during COVID-19 infection. Additionally, a single-center prospective cohort study provided data for an exploratory analysis, assessing the immunophenotype of circulating neutrophils and inflammatory cytokines. The primary endpoints were 30-day mortality and the severity of COVID-19 disease. Prior to COVID-19, 25% of patients with cancer exhibited elevated dNLR, which increased to 55% at the time of COVID-19 diagnosis. We developed the FLARE score, incorporating both tumor- and infection-induced inflammation, which categorized patients into four prognostic groups. The poor prognostic group had a 30-day mortality rate of 68%, significantly higher than the 23% in the favorable group (p < 0.0001). This score proved to be an independent predictor of early mortality. This prospective analysis revealed a shift towards immature forms of neutrophils and higher IL-6 levels in patients with cancer and severe COVID-19 infection. A pre-existing tumor-induced pro-inflammatory state significantly impacts COVID-19 outcomes in patients with cancer. The FLARE score, derived from circulating inflammatory markers, emerges as an easy-to-use, globally accessible, effective tool for clinicians to identify patients with cancer at heightened risk of severe COVID-19 complications and early mortality who might benefit most from immediate and intensive treatment strategies. Furthermore, our findings underscore the significance of immature neutrophils in the progression of COVID-19 in patients with cancer, advocating for further investigation into how these cells contribute to both cancer and COVID-19 disease.

Fecal Calprotectin as a Marker of Severity of COVID-19 Disease: A Hospital-based Study

Fecal Calprotectin as a Marker of Severity of COVID-19 Disease: A Hospital-based Study

Can Opportunistic Use of Computed Tomography Help Reveal the Association Between Hepatic Steatosis and Disease Severity in Hospitalized COVID-19 Patients?

To measure hepatic steatosis (HS) in hospitalized COVID-19 patients using unenhanced chest computed tomography (CT) imaging and to evaluate the relationship between disease severity and prognosis in adult patients.This retrospective study included 152 consecutive hospitalized COVID-19 patients with a positive reverse transcriptase polymerase chain reaction (RT-PCR) test. The COVID-19 Reporting and Data System (CO-RADS) and the chest CT score were evaluated. HS measurements were performed based on CT images using a single region of interest placed on the right liver lobe (segments V-VII). HS was defined as a liver attenuation value <40 Hounsfield units. Data were collected and compared with the patients' prognostic parameters.Of the 152 inpatients, 137 patients (90.1%) had a CT score ≥3 and 109 patients (71.7%) had a CO-RADS score ≥4, 43 (28.2%) had HS. All patients with HS (100%) and 94/109 (86.2%) patients without HS had a CT score ≥3. There was a statistically significant difference between the two groups in terms of chest CT score (p=0.006). There was no statistically significant difference between the two groups in terms of CO-RADS score (p=0.291). The median CRP levels were significantly increased in patients with HS compared to patients without HS (p=0.023). There was no significant difference in ICU hospitalization and mortality due to the presence of HS (p>0.05).The current study revealed significantly higher chest CT scores in COVID-19 patients with HS measured on CT compared to those without HS. Opportunistic use of CT images for the detection of HS can be considered as an adjunctive tool in the risk analysis of COVID-19 patients hospitalized due to COVID-19 pneumonia.The severity of COVID-19 disease is increased in hospitalized patients with hepatosteatosis compared to patients with a normal liver. Density measurements for the evaluation of HS using opportunistic CT applications can be considered as an adjunctive tool in the prognostic evaluation of hospitalized patients with COVID-19 pneumonia. · Parlak AE, Erdem Toslak İ, Turkoglu Selcuk N. Can Opportunistic Use of Computed Tomography Help Reveal the Association Between Hepatic Steatosis and Disease Severity in Hospitalized COVID-19 Patients?. Fortschr Röntgenstr 2024; DOI 10.1055/a-2369-8377.