Female COVID-19 Patients Research Articles

The relationship of age, sex and prothrombin time related to the severity of COVID-19 patients with diabetes mellitus: a systematic review and meta analysis

Background SARS-CoV-2 first appeared in Wuhan, China, in December 2019. Looking at the prevalence data in the world and in Indonesia, the highest mortality rate due to COVID-19 involves age, gender and comorbidities such as diabetes mellitus. Severity of the condition also refers to coagulation abnormalities, such as abnormal prothrombin time values. Methods This systematic review study and meta-analysis used online literature sourced from PubMed, Science Direct, EBSCO, Cochrane and Google Scholar. The literature used here is literature that has data on age, sex and prothrombin time of COVID-19 patients with diabetes mellitus whose quality is assessed by the NOS (Newcastle-Ottawa Scale) criteria and processing data using Review Manager 5.4. Results Out of 8711 literatures that were traced from various search sources, there were 46 literatures that were included in this study. The results of the analysis on age showed the Standardized Mean Difference (SMD) value of 0.45 and P <0.0001 (95% CI: 0.23–0.68), the gender analysis showed an Odds Ratio (OR) value of 3.28 and P = 0.01 (95% CI: 1.26–8.52) and the prothrombin time analysis showed SMD values of 0.41 and P = 0.07 (95%CI = -0.03–0.85). Conclusion Older and male COVID-19 patients have a higher risk of having diabetes compared to younger and female COVID-19 patients. As diabetes is a comorbidity in COVID-19, it can be concluded that old age and male sex are associated with a more severe disease.

The relationship of age, sex and prothrombin time related to the severity of COVID-19 patients with diabetes mellitus: a systematic review and meta analysis

Background SARS-CoV-2 first appeared in Wuhan, China, in December 2019. Looking at the prevalence data in the world and in Indonesia, the highest mortality rate due to COVID-19 involves age, gender and comorbidities such as diabetes mellitus. Severity of the condition also refers to coagulation abnormalities, such as abnormal prothrombin time values. Methods This systematic review study and meta-analysis used online literature sourced from PubMed, Science Direct, EBSCO, Cochrane and Google Scholar. The literature used here is literature that has data on age, sex and prothrombin time of COVID-19 patients with diabetes mellitus whose quality is assessed by the NOS (Newcastle-Ottawa Scale) criteria and processing data using Review Manager 5.4. Results Out of 8711 literatures that were traced from various search sources, there were 46 literatures that were included in this study. The results of the analysis on age showed the Standardized Mean Difference (SMD) value of 0.45 and P <0.0001 (95% CI: 0.23–0.68), the gender analysis showed an Odds Ratio (OR) value of 3.28 and P = 0.01 (95% CI: 1.26–8.52) and the prothrombin time analysis showed SMD values of 0.41 and P = 0.07 (95%CI = -0.03–0.85). Conclusion Older and male COVID-19 patients have a higher risk of having diabetes compared to younger and female COVID-19 patients. As diabetes is a comorbidity in COVID-19, it can be concluded that old age and male sex are associated with a more severe disease.

The relationship of age, sex and prothrombin time related to the severity and mortality of COVID-19 patients with diabetes mellitus: a systematic review and meta analysis

Background SARS-CoV-2 first appeared in Wuhan, China, in December 2019. Looking at the prevalence data in the world and in Indonesia, the highest mortality rate due to COVID-19 involves age, gender and comorbidities such as diabetes mellitus. Severity of the condition also refers to coagulation abnormalities, such as abnormal prothrombin time values. Methods This systematic review study and meta-analysis used online literature sourced from PubMed, Science Direct, EBSCO, Cochrane and Google Scholar. The literature used here is literature that has data on age, sex and prothrombin time of COVID-19 patients with diabetes mellitus whose quality is assessed by the NOS (Newcastle-Ottawa Scale) criteria and processing data using Review Manager 5.4. Results Out of 8711 literatures that were traced from various search sources, there were 46 literatures that were included in this study. The results of the analysis on age showed the Standardized Mean Difference (SMD) value of 0.45 and P <0.0001 (95% CI: 0.23–0.68), the gender analysis showed an Odds Ratio (OR) value of 3.28 and P = 0.01 (95% CI: 1.26–8.52) and the prothrombin time analysis showed SMD values of 0.41 and P = 0.07 (95%CI = -0.03–0.85). Conclusion Older and male COVID-19 patients have a higher risk of having diabetes compared to younger and female COVID-19 patients. As diabetes is a comorbidity in COVID-19, it can be concluded that old age and male sex are associated with a more severe disease.

The relationship of age, sex and prothrombin time related to the severity and mortality of COVID-19 patients with diabetes mellitus: a systematic review and meta analysis

Background SARS-CoV-2 first appeared in Wuhan, China, in December 2019. Looking at the prevalence data in the world and in Indonesia, the highest mortality rate due to COVID-19 involves age, gender and comorbidities such as diabetes mellitus. Severity of the condition also refers to coagulation abnormalities, such as abnormal prothrombin time values. Methods This systematic review study and meta-analysis used online literature sourced from PubMed, Science Direct, EBSCO, Cochrane and Google Scholar. The literature used here is literature that has data on age, sex and prothrombin time of COVID-19 patients with diabetes mellitus whose quality is assessed by the NOS (Newcastle-Ottawa Scale) criteria and processing data using Review Manager 5.4. Results Out of 8711 literatures that were traced from various search sources, there were 46 literatures that were included in this study. The results of the analysis on age showed the Standardized Mean Difference (SMD) value of 0.45 and P <0.0001 (95% CI: 0.23–0.68), the gender analysis showed an Odds Ratio (OR) value of 3.28 and P = 0.01 (95% CI: 1.26–8.52) and the prothrombin time analysis showed SMD values of 0.41 and P = 0.07 (95%CI = -0.03–0.85). Conclusion Older and male COVID-19 patients have a higher risk of having diabetes compared to younger and female COVID-19 patients. As diabetes is a comorbidity in COVID-19, it can be concluded that old age and male sex are associated with a more severe disease.

#1175 Hypertension, diabetes, CKD and acute kidney disorder risk in COVID-19 patients

Abstract Background and Aims Chronic kidney disease (CKD), hypertension and diabetes were the risk factors for acute kidney disorder, but the association between these disease and incident acute kidney disorder in patients with COVID-19 is unclear. Method From the UK Biobank, 14,424 participants with COVID-19 (defined as SARS-CoV-2 test positive or hospitalized with COVID-19 diagnosis from 1 January 2020 and 26 August 2021) were studied. We firstly investigated the association between hypertension, diabetes and CKD at baseline and the risk of acute kidney disorders incidence using Cox proportional hazard regression adjusting age at the index date (continuous), Townsend deprivation index (3 categories by quantile), sex (female or male), smoking status (never, previous, current or unknown), BMI (thin: < 18.5 kg/m2, normal: 18.5 ≤ BMI < 25 kg/m2, overweight: 25 ≤ BMI < 30 kg/m2, obese: ≥ 30 kg/m2, unknown), education (college or university degree, A levels /AS levels /O levels /GCSEs / GSEs or equivalent, other degree, unknown), income (ultra-high, high, medium, low or unknown). We further categorized the disease conditions at baseline into four groups: COVID-19 patients with 0, 1, 2 or 3 out of diseases of hypertension, diabetes and CKD. Then, the association between different disease conditions at baseline and subsequent risk of incident acute kidney disorder was explored with multivariable Cox model. Subgroup analyses were performed according to sex. Results During the 28-day follow-up, 523 (3.63%) participants developed acute kidney disorder among 14,424 COVID-19 patients (aged at 66.62 ± 8.50 and 51.64% were female). CKD (HR: 3.20, 95% CI: 2.62-3.90, P < 0.001), hypertension (HR: 2.31, 95% CI: 1.86-2.86, P < 0.001) and diabetes (HR: 2.40, 95% CI: 1.98-2.92, P < 0.001) at baseline associated with increased risk of acute kidney disorder incidence. When considering coexisting disease conditions of hypertension, diabetes and CKD at baseline, COVID-19 patients with all the three conditions were at the highest risks for subsequent acute kidney disorder (HR: 8.81, 95% CI: 6.32-12.28, P < 0.001) as compared with COVID-19 patients without any of these conditions at baseline. The HRs for acute kidney disorder in COVID-19 patients with 2 or 1 disease conditions at baseline were 4.13 (95% CI: 3.14-5.44, P < 0.001) and 2.00 (95% CI: 1.56-2.58, P < 0.001), respectively. In subgroup analysis, we observed that both male and female COVID-19 patients with disease conditions at baseline significantly associated with increased risks of following acute kidney disorder incidence. HRs of male COVID-19 patients with 1 to 3 disease conditions at baseline were 1.82 (95% CI: 1.33-2.49, P < 0.001), 4.21 (95% CI: 3.01-5.88, P < 0.001) and 7.34 (95% CI: 4.82-11.20, P < 0.001), separately. The impact of disease conditions at baseline for subsequent risk of acute kidney disorder was much higher in female COVID-19 patients, the HRs were 2.34 (95% CI: 1.53-3.60, P < 0.001), 3.88 (95% CI: 2.37-6.33, P < 0.001) and 11.76 (95% CI: 6.83-20.27, P < 0.001) for 1 to 3 disease conditions at baseline respectively. Conclusion Hypertension, diabetes and CKD at baseline significantly associated with subsequent risk of acute kidney disorder incidence. COVID-19 patients with coexisting of these three conditions at baseline were at the highest risk for following acute kidney disorder, and the impact of disease conditions were much higher in female COVID-19 patients. This study provides evidence for prevention and management of acute kidney disorder in COVID-19 patients.

Signatures of disease outcome severity in the intestinal fungal and bacterial microbiome of COVID-19 patients.

COVID-19, whose causative pathogen is the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was declared a pandemic in March 2020. The gastrointestinal tract is one of the targets of this virus, and mounting evidence suggests that gastrointestinal symptoms may contribute to disease severity. The gut-lung axis is involved in the immune response to SARS-CoV-2; therefore, we investigated whether COVID-19 patients' bacterial and fungal gut microbiome composition was linked to disease clinical outcome. In May 2020, we collected stool samples and patient records from 24 hospitalized patients with laboratory-confirmed SARS-CoV-2 infection. Fungal and bacterial gut microbiome was characterized by amplicon sequencing on the MiSeq, Illumina's integrated next generation sequencing instrument. A cohort of 201 age- and sex-matched healthy volunteers from the project PRJNA661289 was used as a control group for the bacterial gut microbiota analysis. We observed that female COVID-19 patients had a lower gut bacterial microbiota richness than male patients, which was consistent with a different latency in hospital admittance time between the two groups. Both sexes in the COVID-19 patient study group displayed multiple positive associations with opportunistic bacterial pathogens such as Enterococcus, Streptococcus, and Actinomyces. Of note, the Candida genus dominated the gut mycobiota of COVID-19 patients, and adult patients showed a higher intestinal fungal diversity than elderly patients. We found that Saccharomycetales unassigned fungal genera were positively associated with bacterial short-chain fatty acid (SCFA) producers and negatively associated with the proinflammatory genus Bilophila in COVID-19 patients, and we observed that none of the patients who harbored it were admitted to the high-intensity unit. COVID-19 was associated with opportunistic bacterial pathogens, and Candida was the dominant fungal taxon in the intestine. Together, we found an association between commensal SCFA-producers and a fungal genus that was present in the intestines of patients who did not experience the most severe outcome of the disease. We believe that this taxon could have played a role in the disease outcome, and that further studies should be conducted to understand the role of fungi in gastrointestinal and health protection.

INFLAMMATORY MARKER PROFILING IN COVID-19: UNRAVELING COMORBIDITY AND GENDER INFLUENCES

Background: The 2020 WHO-declared COVID-19 pandemic has left a profound global imprint. Notably, inflammatory markers have gained prominence in predicting disease severity, especially concerning the characteristic cytokine storm in severe cases. Alongside, comorbidities and gender have emerged as influential factors in disease outcomes. Thus, unraveling the intricate relationships between inflammatory markers, comorbidities, and gender is pivotal for optimal patient care. This study examines inflammatory marker roles in COVID-19, focusing on comorbidity presence and gender impacts. Methods: Conducted retrospectively at Bengalurus Abhaya Hospital from March 2020 to September 2021, this observational study examined C-reactive protein (CRP), lactate dehydrogenase (LDH), D-Dimer, creatine phosphokinase (CPK), Interleukin-6 (IL-6) and serum ferritin as inflammatory markers in COVID-19 patients. Patient cohorts with and without comorbidities, as well as male and female patients, underwent comparisons. Descriptive statistics, Kruskal-Wallis tests, and t-tests were used for data analysis. Results & Discussion: Among patients with and without comorbidities, no statistically significant differences in inflammatory markers were identified. This finding suggests a complex, indirect relationship between comorbidities and distinct inflammatory responses, as measured by these markers. In contrast, gender-based analysis demonstrated significant variations in CRP, IL-6, CPK, and Ferritin levels among male and female COVID-19 patients. Hormonal, genetic, and immunological variations potentially underlie these disparities, impacting disease severity. This study underscores the intricate interplay between inflammatory markers, comorbidities, and gender within the COVID-19 context. Conclusion: In conclusion, this study advances the comprehension of inflammatory markers in COVID-19 patients. While comorbidities did not exhibit marker-specific links, significant gender-based differences in CRP, IL-6, CPK, and Ferritin levels emerged. This underscores the need for gender-specific investigations in disease progression. Continued research is pivotal to unveil underlying mechanisms and to tailor treatment strategies based on these gender-specific disparities.

Immunological Misfiring and Sex Differences/Similarities in Early COVID-19 Studies: Missed Opportunities of Making a Real IMPACT.

COVID-19-associated intensive care unit (ICU) admissions were recognized as critical health issues that contributed to morbidity and mortality in SARS-CoV-2-infected patients. Severe symptoms in COVID-19 patients are often accompanied by cytokine release syndrome. Here, we analyzed publicly available data from the Yale IMPACT cohort to address immunological misfiring and sex differences in early COVID-19 patients. In 2020, SARS-CoV-2 was considered far more pathogenic and lethal than other circulating respiratory viruses, and the inclusion of SARS-CoV-2 negative patients in IMPACT cohorts confounds many findings. We ascertained the impact of several important biological variables such as days from symptom onset (DFSO); pre-existing risk factors, including obesity; and early COVID-19 treatments on significantly changed immunological measures in ICU-admitted COVID-19 patients that survived versus those that did not. Deceased patients had 19 unique measures that were not shared with ICU patients including increased granzyme-B-producing GzB+CD8+ T cells and interferon-γ. Male COVID-19 patients in ICU experienced many more changes in immunological and clinical measures than female ICU patients (25% vs. ~16%, respectively). A total of 13/124 measures including CCL5, CCL17, IL-18, IFNα2, Fractalkine, classical monocytes, T cells, and CD4Temra exhibited significant sex differences in female vs. male COVID-19 patients. A total of nine measures including IL-21, CCL5, and CD4Temra differed significantly between female and male healthy controls. Immunosuppressed patients experienced the most decreases in CD4Temra and CD8Tem cell numbers. None of the early COVID-19 treatments were effective in reducing levels of IL-6, a major component of the cytokine storm. Obesity (BMI >30) was the most impactful risk factor for COVID-19-related deaths and worst clinical outcomes. Our analysis highlights the contribution of biological sex, risk factors, and early treatments with respect to COVID-19-related ICU admission and progression to morbidity and mortality.

Biochemical and Hematological Patterns of Hospitalized COVID-19 Patients in Mongolia

Objectives: The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. This study aimed to analyze how the clinical and laboratory characteristics reflect the disease process and progression of COVID-19 cases in hospitalized patients of Mongolia, which could be informative in managing patients with COVID-19. Methods: A cross-sectional study was conducted on the prescription patterns of drugs given to hospitalized patients diagnosed with COVID-19. A total of 1012 participants were recruited in the study. These were identified from the reported positive cases by polymerase chain reaction or antigen reactivity performed in Ulaanbaatar. Result: A total of 1096 patients participated in this study. The mean age was 51.86 ± 16.98 for male patients and 52.23 ± 16.4 for female patients. It has been revealed that there are statistically significant differences between male and female patients. RBC was 4.56 ± 0.79 M/ UL and 5.08 ± 1.36 M/UL, men and women respectively. The levels of C-reactive protein (CRP) in female COVID-19 patients were significantly higher (46.75 ± 72.83 mg/dL) compared to male patients (33.94 ± 47.96 mg/dL). The platelet count (PLT) was 245.32 ± 77.71 for male patients, while there was a significant reduction in PLT count in female patients (229.30 ± 71.59). Conclusions: Patients with COVID-19 in Mongolia appeared to remain in the hospital for 6.86 ± 2.43 days, shorter than in other countries. Hematological analysis showed that female patients had elevated C-reactive protein levels and decreased PLT count.

Correlation of C-Reactive Protein (CRP) Levels with D-Dimer Levels in COVID-19 Patients

Coronavirus disease 2019 is caused by SARS-CoV-2 infection. COVID-19 causes increased levels of proinflammatory cytokines, so CRP and d-dimer levels in COVID-19 patients tend to increase. This study aimed to analyze the correlation between C-Reactive Protein (CRP) levels and D-dimer levels in COVID-19 patients. This research method is analytic observational by using cross-sectional secondary data. The population of this study were all COVID-19 inpatients at Budhi Asih Hospital, East Jakarta, with a sample of 338 patients and were taken by random sampling. The results of this study found that female and male COVID-19 patients had the same risk of being infected with female patients as much as 52,7% and male patients amounting to 47,3%. Most COVID-19 patients occurred at the age of ≥60 years, namely 32,2%. All patients, which is 100% patients had high CRP levels, with a mean of 76,06 mg/L. As for D-dimer levels, 47,9% of patients had normal D-dimer levels and 52,1% had high D-dimer levels with an average of 721,48 ng/mL. The results of the Spearman's correlation test obtained a p value = 0,000, so it can be seen that there is a correlation between C-Reactive Protein (CRP) levels and D-dimer levels in COVID-19 patients with a correlation strength of 0,300 (medium). An increase in CRP levels followed by an increase in D-dimer levels but evaluation of other laboratory examination parameters also needs to be considered.

Effects of SARS-CoV-2 on Hemodynamics and Arterial Stiffness in Female Long COVID-19 Patients

Effects of SARS-CoV-2 on Hemodynamics and Arterial Stiffness in Female Long COVID-19 Patients

Gender differences in comorbidities of patients with COVID-19: An Italian local register-based analysis

In the current COVID-19 pandemic scenario, it is still necessary to understand if differences exist between genders in terms of patients’ characteristics and clinical outcomes. For this reason, we retrospectively analyzed data obtained from a local register-based dataset of all SARS-CoV-2 positive patients diagnosed in the province of Catania (Italy). The main aim of this analysis was to understand any differences between genders in the distribution of previous medical conditions, and to evaluate which of them posed individuals at higher risk of death.With this purpose, we analyzed data from 1424 patients with at least one underlying medical condition, who were tested positive for SARS-CoV-2 infection from February 2020 to December 2021. Overall, males were 59.5% of the total population and significantly younger than females (median ages: 68 years vs. 72 years; p = 0.011). The age distribution of cases by gender confirms that individuals from 70 to 79 years were the most affected in both genders. The comparison of underlying comorbidities by gender shows significant differences for diabetes (p < 0.001), other metabolic diseases (p = 0.006), and obesity (p = 0.019). Accordingly, multivariable logistic regression analysis confirmed that diabetes was more likely to be present in males than in females (p = 0.001), while other metabolic diseases and obesity were less likely to be present (p = 0.003 and p = 0.005, respectively). Although no difference in mortality was evident between genders (p = 0.141), both male and female COVID-19 patients had a significantly higher risk of death if they had comorbidities such as CVDs, kidney diseases, or chronic neurological diseases. Moreover, diabetes and chronic respiratory diseases were significant risk factors for COVID-19 mortality among men, whereas cancer was a significant contributor among women. Our findings confirm gender-differences in pre-existing medical conditions of COVID-19 patients, which may influence the risk of death. Further studies, however, are needed to understand physiological and pathological mechanisms underpinning these differences.

The Association of Angiotensin-Converting Enzyme 2 Polymorphism and SARS-CoV-2 Infection in the Iraqi Population.

The quick and advancing prevalence of the new coronavirus SARS-CoV-2 produced a global crisis surge with a profound impact on human health and worldwide economic constancy. The virus is known as one strain of coronavirus, which causes the respiratory infection responsible for the current pandemic of COVID-19. The virus spike protein has a high binding affinity to human ACE2, depending on crystallization analysis and biochemical interaction studies. Studies consistently reveal that rs2285666, a polymorphism found in ACE2, diverse significantly between Europeans and Asians, changing ACE2 expression. The alternating allele TT of rs2285666 SNP increased gene expression to 50%; thus, it may have a role in SARS-COV-2 infection vulnerability. This study aimed to investigate rs2285666 SNP association with SARS-CoV2 infection as a first report in the Iraqi population. Fifty (20 Male/30 Female) Covid-19 patients with severe symptoms with mean age (of 41.5±10.7) and 50 (20 Male/30 Female) healthy people as a control group with mean age (of 41.5±10.7) were included in this study. Sample of a patient tested as a mutant genotype (TT) by RFLP assay. The results reveal a MAF value of 0.3 for this gene in Iraqi samples, more than Europeans (0.2) and less than East Asians (0.55). The codominant model had significant OR of both alleles CT and TT (OR=4.26 & 6.7; P-value=0.012 & 0.023 respectively). In conclusion, there is an association between increased severity of SARS-Cov-2 infection and rs2285666 polymorphism of the codominant genotype model of the Iraqi population. However, several other factors may affect disease severity, such as ethnic group differences, sex, comorbidity, virus strain, and others.

A sex-biased imbalance between Tfr, Tph, and atypical B cells determines antibody responses in COVID-19 patients

Sex-biased humoral immune responses to COVID-19 patients have been observed, but the cellular basis for this is not understood. Using single-cell proteomics by mass cytometry, we find disrupted regulation of humoral immunity in COVID-19 patients, with a sex-biased loss of circulating follicular regulatory T cells (cTfr) at a significantly greater rate in male patients. In addition, a male sex-associated cellular network of T-peripheral helper, plasma blasts, proliferating and extrafollicular/atypical CD11c+ memory B cells was strongly positively correlated with neutralizing antibody concentrations and negatively correlated with cTfr frequency. These results suggest that sex-specific differences to the balance of cTfr and a network of extrafollicular antibody production-associated cell types may be a key factor in the altered humoral immune responses between male and female COVID-19 patients.

Differences in some hematological parameters in adult male and female COVID-19 patients: A retrospective study

COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). Depending on the severity of the disease, fever, cough, shortness of breath, more severe pneumonia and death may occur. The aim of this study is to compare some blood parameters between adult male and female patients with COVID-19 to understand the effect of gender on disease pathogenesis. For this purpose, the levels of blood serum the D-dimer, white blood cells, monocyte, lymphocyte, platelet, glucose, hemoglobin and Prothrombin Time/INR were measured in a total of 3101 COVID-19 patients whose 1649 were males and 1452 were females. Statistically significant differences were observed in platelet, white blood cells, Prothrombin Time/INR, hemoglobin and monocyte levels while no differences were detected in lymphocyte, D-dimer, and blood glucose levels between male and female patients. The results indicate that platelet, white blood cells, Prothrombin Time/INR, hemoglobin and monocyte levels were significantly higher in males as compared to female patients with COVID-19.

Retroperitoneal hematoma: An unexpected complication of anticoagulant therapy in COVID-19 patients

Introduction. Coronavirus disease 2019 (COVID-19) is associated with high inflammatory response, hemostatic disturbances, and high thrombotic risk. Despite thromboprophylaxis, a high incidence of thromboembolic events has been reported with a consequent increase in anticoagulant therapy from standard to intermediate or even therapeutic doses. However, published evidence on the incidence and outcome of the hemorrhagic complications of applied therapy is still limited. Outlines of cases. We present two female COVID-19 patients, treated with anticoagulant therapy who suffered from major spontaneous bleeding and retroperitoneal hematoma. The first, a 64-year-old patient, treated with non-invasive ventilation protocol in the Intensive Care Unit due to respiratory failure received a therapeutic dose of anticoagulant therapy adjusted to the anti-Xa assay. The cumulative dose of nadroparin was 150 IU/kg body weight/day. The second, a 60-year-old patient with the moderate clinical presentation on low flow oxygen support was treated with therapeutic doses of anticoagulant therapy calculated according to the body weight. Emergency open surgery was performed due to massive bleeding. No active surgical bleeding was detected, and retroperitoneal hematomas were assumed to be complications of the applied anticoagulant therapy. Both patients were discharged and fully recovered. Conclusion. Although rare, severe hemorrhage requires attention when considering anticoagulant therapy in COVID-19. Uncommon sites of spontaneous bleeding suggest additional evaluation on a case-by-case basis, given that a diagnosis is often delayed due to a lack of specific presenting symptoms. Further studies are needed to verify the risk-benefit ratio of different regiments of anticoagulant therapy in patients with COVID-19.

Menstruation and Sex Hormones in Covid-19: Effects in Women of Child-Bearing Age

Numerous studies have examined the effects of the COVID-19 pandemic on women’s mental health and menstrual cycles. However, most of these studies only included outpatients with COVID-19, whereas information on hospitalised women is minimal. ACE 2 is essential for the SAR-CoV2 virus to enter human cells and the human ovary. Since it stimulates steroid secretion, aids in follicle development and oocyte growth, influences ovulation, and maintains the corpus luteum, it stimulates steroid secretion and aids in follicle development and oocyte growth. Hospitalised female COVID-19 patients exhibit menstrual changes and heightened symptoms of mental health disorders. Length of isolation was the most influential factor in overall menstrual changes and mental health in female COVID-19 hospitalised patients. Infection with COVID-19 may affect the menstrual cycle in females. Further prospective research is required to confirm these findings and determine the duration of these menstrual irregularities.

Comparative study of Apelin and Glucose levels in COVID-19 patients

A novel coronavirus, known as Severe Acute Respiratory Syndrome- Coronavirus 2, has just emerged as an epidemic danger to worldwide public health, Diabetes increases the severity and mortality rate of COVID-19. Adipokines perform a hormonal function including apelin is the newest finding among adipokines and has drawn much Research interest about its functions. This study aimed to estimate the level of apelin hormone in Covid-19 patients and the relationship of this hormone to the level of glucose. The study included 65 patients and 23 healthy as a control group. Apelin hormone was determined by ELISA technique, the level of the hormone Apelin elevated in male and female Covid-19 patients (3752.8571±81.60529, and 3786.3333±96.92097 respectively pg\ml) when compared to the control group for males and females (112.8462±7.79287, and 151.3000±22.20913 respectively pg\ml), High level of glucose in male and female patients (122.2000±9.703, 145.6667±11.55 mg/dl respectively) when compared to healthy males and females (90.8462±6.346, 102.3000±7.701 mg /dl respectively). This study shows a very high increase of apelin hormone in Covid-19 patients compared to healthy. it can be used as a predictive biomarker for the risk of deterioration and disease progression. also, It has an important role in managing COVID-19 patients.

Comparative study of Resistin and Glucose levels in COVID-19 patients

Since the end of 2019, coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 has spread worldwide, it causes risks to public health. Adipokines perform a hormonal function and the most important adipokines that have received research interest are resistin, which is an important link between insulin resistance, and diabetes. This study aimed to estimate the level of Resistin and level of glucose and their relationship to diabetes in Covid-19 patients. The study was conducted on 65 patients with covid-19 and 23 healthy individuals in a control group, Resistin was assessed by the ELISA technique, it was resistin levels in male and female Covid-19 patients high(737.5714±103.44982, 638.5000±85.20096 respectively pg\ml) when compared to healthy males and females (363.7692±26.83405, 394.0000± 30.59412 respectively pg\ml).An elevated glucose level was observed in male and female patients (122.2000±9.703, 145.6667±11.55 mg/dl respectively)when compared to healthy males and females (90.8462±6.346, 102.3000±7.701 mg /dl respectively), This research found a high level of Resistin in Covid-19 patients.Therefore, it can be used as an important indicator to signify the complications of COVID-19 disease as well as for diagnosis, this hormone may have a relationship in causing new diabetes after infection Covid-19.

Menstrual cycle changes and mental health states of women hospitalized due to COVID-19.

PurposeMany studies have evaluated the impact of the COVID-19 pandemic on women’s mental health and menstrual changes. However, most of these studies only included nonhospitalized COVID-19 patients, while information on hospitalized women is very limited. Thus, this study aimed to examine the mental health status and menstrual changes in hospitalized female COVID-19 patients.MethodsA survey was administered to female COVID-19 patients in the isolation ward of a national referral hospital in Indonesia between January and August 2021, and the women were followed up 3 months after discharge. The survey evaluated menstrual patterns and mental health using the Self Reporting Questionnaire-29 (SRQ-29).ResultsThe study enrolled 158 female patients. There was an increase in patients who had a cycle length of > 32 or < 24 days, and significant increases in menstrual irregularity and heavy menstrual bleeding were noted. Overall, 37.3% of the patients reported a change in menstrual pattern after infection with COVID-19. Based on SRQ-29 scores, 32.3% of the women had neurotic symptoms, 12.7% had psychotic symptoms, and 38.0% had symptoms of posttraumatic stress disorder. Patients with symptoms of mental health disorders were twice as likely to report a menstrual change (OR 2.17, 95% CI 1.12–4.22; p = 0.021).ConclusionMenstrual changes and increased symptoms of mental health disorders occur in hospitalized female COVID-19 patients. The length of isolation was the key factor affecting overall menstrual changes and mental health in hospitalized female COVID-19 patients.