Positive Real-time Polymerase Chain Reaction Research Articles

The effectiveness of liver function tests in the prediction of mortality in patients with COVID-19.

To evaluate the impact of liver function test abnormalities on mortality in critically ill coronavirus disease- 2019 patients. The single-centre, retrospective study was conducted at the Department of Anaesthesiology and Reanimation, Mersin City Training and Research Hospital, Turkiye, and comprised data from March 2020 to January 2022 of patients with positive real-time reverse transcription polymerase chain reaction test on nasopharyngeal swab sample for coronavirus disease-2019. Comorbidities, demographic data, admission to and discharge from the intensive care unit, Acute Physiology and Chronic Health Evaluation II scores, complete blood count on the first and second day of hospitalisation, coagulation parameters, biochemical analysis, 7-day, 28-day and total mortality of the patients in the intensive care unit were recorded. The patients were then divided into groups, with Group 1 having patients with normal liver enzymes, Group 2 having patients with abnormal liver enzymes, and Group 3 having patients with liver damage. Data was analysed using SPSS 20. Of the 940 subjects, 587(62.4) were males and 353(37.6) were females. The overall mean age of the patients was 67.11±16.65 years. There were 395(42%) patients in Group 1, 534(56.8%) in Group 2 and 11(1.2%) in Group 3. Gamma-glutamyl transferase-1s, aspartate aminotransferase-2nd and albumin-2nd were significant predictors of mortality (p<0.05). High gamma-glutamyl transferase, aspartate aminotransferase and low albumin levels in critically ill coronavirus disease-2019 patients could be considered indicators of high mortality rate.

Additional reporting of diffuse and homogeneous ROS-1 SP384 immunoreactivity enhances prediction of ROS1 fusion-positive non-small cell lung cancer.

ROS-1 immunohistochemistry (IHC) is a common method for screening ROS1 fusion in the clinical management of non-small cell lung cancer. The interpretation criteria for ROS-1 SP384 IHC, however, remain unestablished. Sixty-five non-small cell lung cancer cases underwent AmoyDx ROS1 fusion real-time polymerase chain reaction (PCR) study and ROS-1 SP384 IHC tests, which were retrieved for analysis. ROS-1 IHC tests were interpreted based on the established classifiers as well as the presence of diffuse homogeneous immunoreactivity. The diagnostic accuracies of these ROS-1 IHC interpretation methods were evaluated by comparing them with the ROS1 real-time PCR results. Previous ROS-1 IHC classifiers demonstrated high sensitivity for positive ROS1 real-time PCR results (100%), but they showed low specificities (25%-50%) and overall accuracies (58%-72%). In contrast, the diffuse homogeneous ROS-1 immunoreactivity predicted positive ROS1 real-time PCR results with much higher specificity (94%) and overall accuracy (95%), albeit with a slightly lower sensitivity (97%). Some cases that showed discrepancy between diffuse homogeneous ROS-1 immunoreactivity and real-time PCR results involved rare ROS1::LDLR fusion and suboptimal IHC staining. A 3-tier reporting system for ROS-1 SP384 IHC testing combining previous interpretation criteria and diffuse and homogeneous immunoreactivity may better predict ROS1 fusion status without decreasing specificity.

H1N1pdm09 infection in children: A case report of reemerging disease in COVID-19 pandemic

An outbreak of H1N1 infection was first declared by the World Health Organization in 2009 and confirmed in the post-pandemic phase in 2010. Amid the COVID-19 pandemic, we found a confirmed case of H1N1pdm09 in Bunda Women and Children Hospital Jakarta. A 13-year-old boy was referred to our hospital after four days of hospitalization due to worsening tachypnea following a productive cough and fever. The patient had severe dyspnea with inspiratory effort and oxygen desaturation to 80%, therefore admitted to our pediatric intensive care unit. On physical examination, the patient had increased work of breathing, looked irritable, had a respiratory rate of about 40x/minute with non-rebreathing mask support, and crackles were heard in both lungs. Chest x-ray showed right bronchopneumonia. There was a history of a generalized seizure for less than 1 minute, which stopped spontaneously in previous hospital care. The patient was diagnosed with mucopolysaccharidosis at age six years old and has never received enzyme replacement therapy. Laboratory results revealed thrombocytopenia, leukopenia, neutrophilia, monocytosis, high c-reactive protein and procalcitonin, and elevated liver enzymes. The investigation of etiology was performed using the respiratory panel test and showed a positive real-time polymerase chain reaction for H1N1pdm09 and Influenza A. The patient was given oxygen therapy with a high-flow nasal cannula with an oxygen fraction of 40% and a flow of 20 liters per minute, fluid maintenance while fasting, antibiotics, inhaled beta-2 agonists, and a neuraminidase inhibitor (oseltamivir). The patient's clinical and laboratory markers improved on the third day of treatment, and he was discharged two days later.

Interleukin-6 and Interleukin-10 as a Predictor of Mortality in Elderly with COVID-19.

The age group at the most high risk for mortality due to SARS-CoV-2 infection was the elderly. This study aims to analyze markers that can predict the severity and mortality of elderly COVID-19 patients. This study used a cohort retrospective design. We include adult and elderly COVID-19 patients at Universitas Airlangga Hospital from March to August 2021. The sample used was 48 COVID-19 patients with positive real-time polymerase chain reaction swab results. We check the complete blood count and serum levels of interleukin-6 (IL-6) and IL-10 using enzyme-linked immunosorbent assay during admission. Data were analyzed using t -test, Mann-Whitney, Chi-square, Pearson, and Kendall Tau correlation. Leukocyte level (6.6 ± 2.5) was lowest in the severe-critical elderly group. Neutrophil level (75.3 ± 10.2) was highest in the mild-moderate elderly group. Lymphocyte level (18.8 ± 8.7) was highest in mild-moderate nonelderly group. Platelet level (279.0 ± 117.7) was highest in the mild-moderate elderly group. Neutrophil to lymphocyte ratio level (9.1 ± 9.4) was highest in the severe-critical nonelderly group, IL-6 level (98.6 ± 144.1) was highest in the severe-critical elderly group, IL-10 level (107.7 ± 47.7) was highest in the severe-critical elderly group and highest IL-6/IL-10 level (1.4 ± 1.7) was found in the mild-moderate elderly group no significant differences in biomarkers identification between the elderly and nonelderly groups. There was a substantial relationship between IL-10 levels and gender, IL-10 level, and hospital discharge condition. Female elderly patients and alive elderly patients were correlated with increased levels of IL-10.

Image Findings and Radiation Dose in Lung CT Scan of Patients With COVID-19 in Hamadan

Background: Computed tomography (CT) scan plays an important role in the diagnosis of the COVID-19. Lung involvement appears in different forms on CT images. Absorbed dose to the patients may exceed diagnostic reference levels. This study aimed to investigate clinical symptoms, findings of lung CT scan, and absorbed dose to the patients. Methods: This cross-sectional descriptive study was conducted in two CT scan centers in Hamadan: Besat and Sina. CT images of 163 patients with positive real-time polymerase chain reaction (PCR) tests were interpreted by six experienced radiologists. Volume CT dose index (CTDIvol), dose length product (DLP), and effective dose were calculated in both centers and compared using the Mann-Whitney statistical test. Results: The most common findings in the CT images were ground-glass opacification (GGO), consolidation, and the combination of GGO and consolidation. CTDIvol, DLP, and effective dose to the patients were respectively 1.64±5.24 mGy, 177.12±59.03 mGy.cm, and 3.01±1.00 mSv in Sina hospital and 4.58±1.91 mGy, and 2.60±1.02 mSv in Besat hospital. The difference between quantities in the two centers was statistically significant (P&gt;0.05). Conclusion: The most common findings in lung CT images of patients with positive polymerase chain reaction (PCR) tests were GGO and consolidation. Furthermore, there were differences in radiation dose to patients between hospitals, indicating the need for optimization.

A new antigen test device for rapid influenza A and B detection

IntroductionTests for detection of influenza must demonstrate high sensitivity and specificity, affordability, and rapidness. MethodsThis study aimed to evaluate the performance of the LabOn-Time™ Influenza A + B Rapid test device (BMT Diagnostics, Ltd), as compared to Real-time polymerase chain reaction (RT-PCR), in identifying influenza A/B among 183 nasopharyngeal samples collected between February and April 2023 from patients with Influenza-like symptoms. ResultsOut of 70 participants with a positive RT-PCR result, 53 (75.7 %) had a positive LabOn-Time result. The LabOn-Time kit had a sensitivity of 75.7 % and specificity of 100 %. The odds ratio for showing a false negative LabOn-Time result for influenza B, compared to influenza A was 5.24 (95%CI: 1.35–20.31). All false negative LabOn-Time samples had a RT-PCT cycle threshold ≥20. Mean time from symptom onset was significantly lower in the false negative LabOn-Time cases compared to the positive cases (36 ± 15.3 vs. 42.6 ± 10.1, respectively). The mean number of symptoms reported per patient was significantly higher in positive compared to negative LabOn-Time cases (2.5 ± 0.5 vs. 1.9 ± 0.4, p < 0.001). ConclusionsThe LabOn-Time device, which is very simple and intuitive to operate, could significantly contribute to early detection of influenza A/B infection.

The pattern of neurological disorders requiring hospitalization during the COVID-19 era: an experience from Fayoum University Hospital, Egypt

BackgroundCoronavirus was primarily discovered in December 2019, causing pneumonia and severe acute respiratory syndrome. It was reported several neurological symptoms associated with COVID-19. Both the central and peripheral nervous systems could be affected which might result in a higher mortality rate in hospitalized patients. This study aimed to determine the spectrum of neurological clinical presentations among patients admitted to Fayoum University Hospital before, during, and after the COVID-19 era and to examine the influence of COVID-19 vaccines mandated by the Egyptian government on neurological disorders.MethodsThis is a historical cohort study that was conducted on patients admitted to the Neurology Department at Fayoum University Hospital before, during, and after COVID-19 outbreaks from January 1st, 2018, to July 31, 2022. All participants had undergone thorough history taking and neurological examination and the necessary investigations according to the suspected diagnosis. All hospitalized patients during the COVID-19 pandemic were positive for the virus, as determined by either a positive rapid antigen test or a positive real-time reverse transcription polymerase chain reaction (RT-PCR).ResultsIt was shown that the patients hospitalized during the COVID-19 era were notably older, smokers, and diabetic in comparison to other groups. Cerebrovascular disorders were more prevalent in the COVID-19 pandemic. Surprisingly, compared to prior times, individuals with autoimmune-mediated neurological diseases had higher hospitalization rates than those with other neurological disorders. Patients who were not vaccinated reported more vascular complications than those who got them. However, patients who received vaccination exhibited significantly higher neurological complications as regards, exacerbation of paroxysmal disorders.ConclusionIt was concluded that the frequency of hospitalizations with cerebrovascular disorders and autoimmune-mediated illnesses was significantly influenced during the pandemic era. Although COVID-19 vaccinations have potential adverse effects, they have played a crucial role in preventing serious neurological problems.

Comparison of nailfold capillaroscopy findings in COVID-19 survivors with and without rheumatic disease: a case-control study

Purpose: The aim of this study was to evaluate the nailfold capillaroscopy (NFC) findings of patients with rheumatic disease and healthy controls (HCs) who survived coronavirus disease 2019 (COVID-19).&#x0D; Materials and Methods: This study included patients with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and rheumatoid arthritis (RA) who recovered from COVID-19 and HCs. NFC was performed for all participants. NFC findings of the three groups [patients with COVID-19 (group 1), HCs with COVID-19 (group 2), and HCs without COVID-19 (group 3)] were compared.&#x0D; Results: A total of 142 individuals (group 1, n = 42; group 2, n = 50; group 3, n = 50) were included in the study. Hospitalization and oxygen therapy were more common in group 1 than in group 2. The median time from a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive real-time polymerase chain reaction (RT-PCR) test to NFC was 10.3 (6.3–24.4) weeks in group 1 and 17.1 (6.1–44.9) weeks in group 2. All NFC findings did not differ among the groups except for capillary ramifications, which were higher in group 1 than in groups 2 and 3. Underlying rheumatic disease was the only predictor that was significantly associated with capillary ramifications.&#x0D; Conclusion: The NFC findings of COVID-19 survivors with and without rheumatic disease were substantially similar to those of HCs who did not have COVID-19. Capillary ramifications may result from an underlying rheumatic disease in patients with axSpA, PsA, and RA.

New onset or recurrence of uveitis following COVID-19 infection

BackgroundWhile the 2019 novel coronavirus disease (COVID-19) pandemic has resulted in millions of cases worldwide, there is increasing recognition of a wide range of ocular manifestations associated with the virus, including uveitis. Uveitis is an inflammatory condition of the uveal tract of the eye that can lead to permanent vision loss if not treated promptly. Here we report a retrospective observational study of patients who presented with new onset or recurrent uveitis following COVID-19 infection.MethodsThis is a retrospective observational study conducted at the Beijing Tongren Hospital. We identified patients who presented with symptoms of non-infectious active uveitis with positive real-time reverse transcription polymerase chain reaction (RT-PCR) of COVID-19 within 4 weeks. All patients received ophthalmic examinations, including anterior and posterior segment imaging, to assess the extent of ocular involvement.ResultsThe 18 patients with a total of 33 eyes included in this study presented with symptoms of active uveitis within 4 weeks of their positive COVID-19 RT-PCR test. Among them, 9 patients presented with the development of uveitis following COVID-19 infection, and 9 patients had relapsed uveitis after COVID-19 infection. Treatment with corticosteroids resulted in improvement of symptoms and resolution of inflammation in all cases. In this study, all patients did not experience any adverse drug reactions during treatment.ConclusionOur observational study highlights the potential for new onset or recurrence of uveitis following COVID-19 infection.Trial registrationhttps://www.chictr.org.cn/; identifier: ChiCTR2100044365, date: 03/17/2023.

Predicting Mortality of COVID-19 in Kidney Transplant Recipients With Developed Scores.

COVID-19 is a recently discovered β-subtype coronavirus infection due to SARS-CoV-2. Approximately 20% of COVID-19 patients have moderate to severe clinical manifestations and 5% progress to critical illness. Kidney transplant patients form a special group. In our study, we aimed to evaluate the success of the COVID-gram score and systemic immuno-inflammation index score in predicting the risk of mortality during hospitalization among kidney transplant patients. Our study included 50 kidney transplant patients with positive real-time reverse transcription polymerase chain reaction COVID-19 tests between March 2020 and March 2021. Risk scores were calculated using baseline clinical data collected retrospectively from the patient cohort. The mean age was 54.3 ± 10.2. The mortality rate was 12%. When we compared the COVID-gram and systemic immuno-inflammation index scores between survivors and nonsurvivors, we did not find any difference. Kidney and other solid-organ transplant patients are at greater risk of infection and mortality than other groups. Accurate risk-predicting tools are imperative for managing the COVID-19 pandemic with limited health resources.

Cytokine profile levels and their relationship with parasitemia and cardiomyopathy in people with Chagas disease in Spain. A prospective observational study

Immunoregulatory networks may have a role in controlling parasitemia in the chronic phase of human Chagas disease. The aim was to describe the serum cytokine profile of Trypanosoma cruzi in chronically infected patients and to evaluate its relationship with parasitemia and Chagas cardiomyopathy.This prospective observational study included adult patients with chronic Chagas disease. Demographic and clinical data were collected, and peripheral blood samples were used to perform T. cruzi real-time polymerase chain reaction (RT-PCR) and determine the serum cytokine profile.Fifty-eight patients were included; 17 (29.3%) had positive RT-PCR results. This group had a higher median concentration of TNF-α (p = 0.003), IL-6 (p = 0.021), IL-4 (p = 0.031), IL-1β (p = 0.036), and IL-17A (p = 0.043) than those with a negative RT-PCR. Patients with cardiac involvement had a higher median concentration of IL-5 (p = 0.016) than those without.These results reinforce the key role that cytokines play in Chagas disease patients with parasitemia and cardiac involvement.

Incidence, Risk Factors and Clinical Impact of Sars-Cov-2 Prolonged Viral Shedding in Patients Diagnosed with Hematologic Malignancies

Patients with hematologic malignancies (HM) infected by SARS-CoV-2 present a higher risk of prolonged viral shedding, severe infection and mortality. However, data regarding clinical outcomes and viral evolution of prolonged COVID-19 in HM are still scarce. Our aim was to describe the incidence, risk factors, clinical outcomes and viral evolution of the protracted SARS-CoV-2 infection in patients with HM. We collected clinical data and respiratory samples of patients with HM who consulted at Vall d´Hebron Universitary Hospital and were diagnosed with a laboratory-confirmed SARS-CoV-2 infection between March 2020 and March 2023. Prolonged COVID-19 was defined as a positive real-time reverse transcription polymerase chain reaction (rRT-PCR) with a cycle threshold (Ct) &amp;lt;35 beyond 30 days since microbiological diagnosis with the same genotyped viral variant. Whole-genome sequencing of the virus was performed following the ARTIC, v4.1 protocol on a MiSeq platform. We considered an exacerbation of persistent COVID-19 the reappearance of symptoms and/or a positive SARS-CoV-2 rRT-PCR after initial clinical improvement or a previous negative rRT-PCR. Results: Among a total of 400 patients with HM developed COVID-19, 269 patients (67.25%) were eligible for prolonged COVID-19 assessment, whereas 52 patients (13%) died due to COVID-19 before day 30 and 79 patients (19.5%) did not have follow-up rRT-PCR. Prolonged COVID-19 was documented in 126 of 269 evaluable patients (46.8%) with a median time of rRT-PCR positivity of 60 days (IQR 43-95). Median age of patients with prolonged COVID-19 was 68 years and 46.8% were female. The main HM was lymphoma (58.7%), the majority of patients were under active treatment (78.6%), and the most frequent active therapy was anti-CD20 monoclonal antibodies+/- chemotherapy (25.4%). In the univariate analysis, active treatment with bispecific T-cell engagers antibodies (BiTEs) (OR 9.2; p=0.048) and anti-CD38 monoclonal antibodies (mAb) (OR 4.9; p=0.02), heavily pretreated patients (&amp;gt; 2 previous lines of therapy) (OR 3.1; p=0.02), and severe/critical acute COVID-19 (OR 7.4; p=&amp;lt;0.01) were significantly associated with prolonged viral shedding. Vaccination (OR 0.2; p=&amp;lt;0.01) and the development of an optimal humoral vaccine-induced immunogenicity (anti-spike IgG &amp;gt;260 BAU/mL) (OR 0.1; p=&amp;lt;0.01) were significantly associated with an inferior risk of developing prolonged COVID-19. In the multivariate analysis, active treatment with anti-CD20 mAb, BiTEs, and BTK inhibitors; lack of vaccination; an impaired humoral vaccine-induced immunogenicity and severe acute COVID-19 remained significantly associated with prolonged COVID-19 (Figure 1). CAR T-cell therapy also showed a trend to develop prolonged COVID-19 but did not reach statistical significance (OR 14.4; p=0.08). Prolonged COVID-19 clinical spectrum in HM ranged from a chronic asymptomatic infection in 29.4% of cases (37/126) to severe infection and COVID-19 related death in 16.7% of cases (21/126). During prolonged COVID-19, 51.6% of patients (65/126) experienced an increase in the severity of the infection, 54% (68/126) patients suffered a delay/interruption of their hematologic treatment, and 22.2% (28/126) had to suspend it indefinitely. A 55.6% of patients (70/126) experienced an exacerbation of persistent COVID-19 with a median of 1 episode (IQR 1-2) per patient. Through those exacerbations, 84.3% (59/70) required hospital readmission with a median of 17 days of length of stay (IQR 9-27). To treat prolonged COVID-19, 55.6% of patients (70/126) required a median of 1 course of antiviral treatment and 31% (39/126) received convalescent plasma. Of note, 37.3% of prolonged COVID-19 patients (47/126) developed a pneumopathy being organizing pneumonia the most frequent one in 28.6% (36/126) of cases. Finally, data of the kinetics of viral load and intra-host viral mutations in prolonged COVID-19 patients with a positive rRT-PCR beyond 90 days will be available for the congress. In conclusion, prolonged COVID-19 is frequent in patients with HM and clinical repercussion are severe. Patients with risk factors for prolonged viral replication, particularly those with a suboptimal humoral vaccine-induced immunogenicity and acute severe disease, require a personalized diagnostic, therapeutic and follow-up.

Thyroid Function Test Abnormalities in Children and Adolescents with COVID-19: A Case-Control Study

Background: There is a lack of conclusive evidence regarding thyroid function test (TFT) abnormalities in COVID-19, especially among children. Objectives: This study aimed to investigate TFT abnormalities in COVID-19 pediatric patients compared to healthy children. Methods: This study was conducted on 37 COVID-19-positive children who were admitted to Namazi Hospital from January 21 to March 1, 2022, compared with 37 healthy children. Within 48 h of positive real-time polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus 2, a blood sample was taken to measure serum levels of thyroid-stimulating hormone (TSH) and total thyroxine (tT4) in the two groups. Additional tests, including free and total triiodothyronine, free T4, and thyroperoxidase antibodies, were also conducted on cases. The chi-square, Pearson correlation coefficient, and analysis of variance tests were used for data analysis. Results: Twenty-five patients were male, and 49 were female, with a mean age of 7.99 ± 5.02. The abnormal TFT and TSH frequency was significantly higher in the case group than in the control group. Nevertheless, there was no significant difference between the case and control groups regarding tT4 abnormalities. We could not establish an association between the mean of TSH and tT4 and age groups in the two groups and between abnormalities of TFTs and COVID-19 severity. Conclusions: Although abnormalities of TFT were significantly more common among COVID-19 children, they were not associated with the disease severity. However, studies with larger sample sizes are recommended to evaluate thyroid abnormalities and their clinical course in COVID-19 children.

A Population-Based Test-Negative Matched Case-Control Analysis of SARS-CoV-2 Vaccine Effectiveness Among Pregnant People in Ontario, Canada

ObjectivePregnancy is a risk factor for severe SARS-CoV-2 infection, which can result in adverse pregnancy outcomes, thus making understanding vaccine effectiveness (VE) in this population important. This study aimed to assess the VE of mRNA COVID-19 vaccines against symptomatic SARS-CoV-2 infection and COVID-19-related hospitalization in pregnant people. MethodsPopulation-based matched test-negative case-control study of pregnant people aged 18–49 years, of 12 or more weeks gestation in Ontario, Canada, symptomatic with possible SARS-CoV-2 infection, and having at least 1 positive (n = 1842) or negative (n = 8524) real-time polymerase chain reaction (RT-PCR) SARS-CoV-2 test between December 14, 2020, and December 31, 2021. The exposure was receipt of ≥1 dose of mRNA COVID-19 vaccine versus no vaccination. Exposure was further stratified by number and recency of doses. The primary outcome was a positive SARS-CoV-2 RT-PCR test. As a secondary outcome, VE for COVID-19-related hospitalization was assessed. ResultsIn the primary outcome analysis, there were 1821 positive cases, matched to 1821 negative controls. The mean (SD) maternal age was 31 (5) years. When compared to those unvaccinated, receipt of ≥1 dose was associated with an estimated VE of 39% (95% CI 29%–48%) for symptomatic infection, and 85% (95% CI 72%–92%) for COVID-19 hospitalization. VE estimates demonstrated waning with increased time since last vaccination. ConclusionsmRNA COVID-19 vaccines provide protection against symptomatic COVID-19 illness and are highly effective at preventing severe illness in pregnant people. The observed effect of vaccine waning highlights the importance of booster doses to provide optimal protection for pregnant people.

Biochemical Analysis of Ferritin and D-dimer in COVID-19 Survivors and Non-survivors.

Background COVID-19 is a major cause of illness and mortality. The management of COVID-19-related illnesses might change if variables connected to their severity and the requirement for ICU admission could be found. The severity of COVID-19 might be efficiently predicted with several laboratory measures, such as ferritin levels and D-dimer analysis. Objectives This study aimed to evaluate the association between serum D-dimer and ferritin levels and their effects on mortality in patients with COVID-19. Methods This retrospective observational study included all patients with positive real-time polymerase chain reaction (RT-PCR) results for COVID-19 who were hospitalized in the Ministry of Health South Al-Qunfudah General Hospital between March and September 30, 2020. Their laboratory parameters, serum D-dimer, and ferritin levels were evaluated. IBMSPSSStatistics for Windows, Version 26.0 (released 2019; IBM Corp., Armonk, New York, United States) was used to analyze the data. Results A total of 318 COVID-19 patients were analyzed; 56.9% (n=181) were male and 43.1% (n=137) were female. Of these, 78.6% (n=250) survived, including 58% of men and 42% of women. The mean D-dimer was 2.1 mcg/mL (SD=3.16) and the mean ferritin was 698.59 ng/mL (SD=603.11). Non-recovered patients were substantially older (66.16 years old) and had higher D-dimer (5.46) mcg/mL and ferritin levels (992.96) ng/mL. Intubation length and gender did not affect survival. Of the non-survivors, 95.6% (n=239) were admitted to the ICU, and 50% (n=34) required mechanical ventilation. Conclusions COVID-19 infection mortality dramatically increased with older age and increased mean ferritin and plasma D-dimer values, which were significantly higher in COVID-19 non-survivors than in survivors. Therefore, assessing and monitoring these laboratory markers in the early stages of the disease may have a significant impact on preventing disease progression and death.

Lösemi tanısı ile takipli çocuk hastalarda COVID-19 enfeksiyonunun değerlendirilmesi

Aims: The coronavirus disease 2019 (COVID-19) has been the cause of a global health crisis since the end of 2019. The aim of this study was to evaluate the clinical findings and treatment results of COVID-19 disease in pediatric patients with leukemia.&#x0D; Methods: All the children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive real-time polymerase chain reaction (PCR) and the presence of underlying leukemia were included in the study.&#x0D; Results: A total of 44 leukemia patients with COVID-19 infection were included in the study. Their primary diseases were as follows: 36 patients were newly diagnosed with acute lymphoblastic leukemia (ALL), four patients were relapsed ALL, two patients were refractory ALL, and two patients were acute myeloblastic leukemia. The mean age of patients was 104± 62 months. COVID-19 was asymptomatic in 11.4% of patients, mild in 84%, and moderate in 4.5% whereas none of our patients had a severe infection. No severe complications and/or death were observed in our study group.&#x0D; Conclusion: It has been found that the clinical course of COVID-19 is mild in children and adolescents with leukemia and undergoing chemotherapy or immunosuppressive therapy.

COVID-19 pneumonia; predictors of severity and outcome in Erbil city hospitals

Background and objective: Corona infections disease nowadays is one of the major burden on national health institutes. The aim of the study is to identify the parameters that can predict the mortality in moderate to severely ill COVID-19 infected patients. Methods: A prospective cross sectional study was carried out in Erbil Hospitals, Kurdistan region/Iraq from December 2020 to December 2021 on a sample of 100patients with positive real-time polymerase chain reaction. The data of enrolled patients were collected by direct interview with patients or with their relatives and filled in a prepared questionnaire. The patients were followed up from their admission to hospital until their discharge alive or dead. Results: The mortality rate of hospitalized patients was 44% for 100 patients. Budesonide nebulizer were given to all of the patients. The mortality rate was significantly higher in old COVID-19 patients. The COVID-19 patients presented with dyspnea, hypertension and renal failure were significantly associated with higher mortality rates. High respiratory rate, low oxygen saturation and high C-reactive protein level were accompanied with higher mortality rates of COVID-19 patients. Conclusion: The early predictors of mortality in patients with moderate to severe COVID-19 infection were elderly age, clinical presentation of dyspnea, clinical co-morbidity with hypertension and renal failure, high respiratory rate, low oxygen saturation and elevated levels of C-reactive protein.

General Hospitalization and Intensive Care Unit-Related Factors of COVID-19 Patients in Northeastern Colombia: Baseline Characteristics of a Cohort Study.

Objective This study aims to describe demographic and clinical characteristics and the factors associated with the risk of COVID-19 general hospitalization and intensive care unit (ICU) care of patients who consulted in a third-level hospital in Santander, Colombia. Methods We used baseline data from an ambidirectional cohort study. We included all patients with positive real-time polymerase chain reaction (PCR) tests for COVID-19 who came to the emergency room (ER) for respiratory symptoms related to COVID-19. Information regarding patients' baseline characteristics and symptoms was collected through telephone interviews and review of medical records. Vital signs were extracted from medical records as well. Results We enrolled 3,030 patients, predominantly men, with a median age of 60(interquartile range (IQR): 44-73). Symptoms of the acute phase varied between men and women. Men presented with more respiratory symptoms, and women had general symptoms. Hypertension, obesity, and diabetes were common risk factors for hospital admission. Antibiotic consumption may also play a role in hospital admission. Conclusions Male sex, older age,hypertension, obesity, prior thrombotic events, and self-medicated antibiotics were associated with general hospitalization. Hypertension, obesity, diabetes, and cancer were associated with ICU admission. The Charlson comorbidity index (CCI) is a powerful tool for evaluate the impact of pre-existing health conditions on COVID-19 hospital admission. We highlight the importance of these findings as possible predictors in our region.

The Assessment of Neurological Development of the Infants with Prenatal COVID-19 Exposure

Objective: The effects of prenatal coronavirus 2019 disease (COVID-19) exposure on the infantile neurological development are unknown. It has been considered that the inflammatory, thrombotic, and vascular changes occurred in the placentas taken from pregnant women diagnosed with COVID-19 and the inflammatory nature of COVID-19 infection may lead to negative obstetric and neurological events. We aimed to assess the potential neurological effects of prenatal COVID-19 exposure on the infant.&#x0D; Methods: The present study included 2–12-month-old infants born to women with positive real-time reverse transcription polymerase chain reaction test results for COVID-19 from the population of pregnant patients under routine follow-up. The neurological examinations and the Denver II Developmental Screening Test (DDST II) were performed for 41 infants aged 2–12 months to assess the neurological effects of prenatal COVID-19 exposure.&#x0D; Results: The average gestational age of the infants was 38.7 ± 1.9 weeks, and the average birth weight was 3198 ± 543 g. Eight of the infants had a history of hospitalization in the neonatal intensive care unit. The neurological examination and the neuromotor development of 40 (96%) infants were normal for their age group. Only one infant had abnormal neurological examination and DDST II result.&#x0D; Conclusion: The findings of the study suggest that prenatal COVID-19 exposure has no negative neurological impact on infants. Long-term prospective studies with larger sample sizes are needed for more comprehensive assessment of the neurological effects of prenatal COVID-19 exposure on the infants.

The effect of diabetes mellitus on COVID-19 mortality among patients in a tertiary-level hospital in Bandung, Indonesia.

Immune system dysregulation in people with diabetes mellitus (DM) increases the risk of acquiring severe infection. We compared the clinical characteristics and laboratory parameters of coronavirus disease 2019 (COVID-19) patients with and without DM and estimated the effect of DM on mortality among COVID-19 patients. A retrospective cohort study collecting patients' demographic, clinical characteristics, laboratory parameters and treatment outcomes from medical records was conducted in a hospital in Bandung City from March to December 2020. Univariable and multivariable logistic regression was performed to determine the association between DM and death. A total of 664 COVID-19 patients with positive real-time reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 were included in this study, of whom 147 were with DM. Half of DM patients presented HbA1c ≥10%. DM patients were more likely to present with comorbidities and severe to critical conditions at admission (P <0.001). Laboratory parameters such as neutrophil-lymphocyte count ratio, C-reactive protein, D-dimer, ferritin, and lactate dehydrogenase were higher in the DM group. In the univariate analysis, variables associated with death were COVID-19 severity at baseline, neurologic disease, DM, age ≥60 years, hypertension, cardiovascular disease, and chronic kidney disease. DM remained associated with death (aOR 1.82; 95% CI 1.13-2.93) after adjustment with sex, age, hypertension, cardiovascular disease, and chronic kidney disease. In conclusion, COVID-19 patients with DM are more likely to present with a very high HbA1c, comorbidities, and severe-critical illness. Chronic inflammation in DM patients may be aggravated by the disruption of immune response caused by COVID-19, leading to worse laboratory results and poor outcomes.