Prognosis Of COVID-19 Patients Research Articles

The Relationship of Some Biochemical Markers with Inflammatory Prognosis in COVID-19 Patients

Background and objectives: For COVID-19 patients who need effective management, it is necessary to identify the laboratory biomarkers of progression approaching morbidity and mortality. This study aims to demonstrate numerous biochemical tests that seriously afflicted individuals. Such as ferritin, Interleukin-6 (IL6), D-dimer, Uric acid (UA), Lactate dehydrogenase (LDH), and C-reactive protein (CRP) have been proposed as disease biomarkers. Materials and methods: Blood samples were collected from 30 healthy individuals. In addition, other 60 patients confirmed by RT-PCR as COVID-19 positive after 3 to 5 days followed up with them every five days for fifteen days from the beginning of symptoms for the above parameters. All patients attended Isolated Hospital in Tikrit City / Iraq from February to June 2021. Results: Ferritin, D-dimer, IL6, CRP, LDH, and UA gradually increased to the maximum mean (1138±782.7, 1155±400.42, 23.28±4.73, 104.86±53.69, 424.91±95.4 and 5.94±1.765.94±1.76) respectively after (8-10) days and return to normal range after 15 days. Conclusion: There is a significant association of these parameters with inflammatory prognosis in COVID-19 patients.

Initial TLC, NLR, LDH, CRP, D-Dimer, and Procalcitonin in Intubated vs Non Intubated COVID-19 Patients

COVID-19 is an acute respiratory disease caused by the SARS-CoV-2 virus that has caused a pandemic with symptoms of upper respiratory infection, respiratory failure, and even mortality. Several asymptomatic patients, with no shortness of breath, were found to experience impaired oxygenation in examination for objective data (happy hypoxia). Thus, objective data are needed, including data on inflammatory parameters (TLC, NLR, LDH, CRP, D-dimer and PCT) to monitor the severity and prognosis of COVID-19 patients. This study aimed to evaluate the inflammatory parameters in the initial days of treatment for COVID-19 patients between intubated and non-intubated patients during hospitalization. The study was conducted in the COVID isolation ward of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from July 2020 to July 2021. This was a retrospective cross-sectional comparative analytical observational study that involved patients’ first laboratory examination results. The statistical analysis was performed using Mann Whitney test for numerical data and Chi Square test for categorical data. There were significant differences in inflammatory parameters values in both groups (p<0.01). The TLC values of intubated patients were lower than those of non-intubated patients, while the NLR, LDH, CRP, D-dimer and PCT values of intubated COVID-19 patients were higher than those of non-intubated patients.

Predictive value of neutrophil-to-lymphocyte ratio for the fatality of COVID-19 patients complicated with cardiovascular diseases and/or risk factors

Previous studies have reported that a high neutrophil-to-lymphocyte ratio (NLR) is associated with disease severity and poor prognosis in COVID-19 patients. We aimed to investigate the clinical implications of NLR in patients with COVID-19 complicated with cardiovascular diseases and/or its risk factors (CVDRF). In total, 601 patients with known NLR values were selected from the CLAVIS-COVID registry for analysis. Patients were categorized into quartiles (Q1, Q2, Q3, and Q4) according to baseline NLR values, and demographic and clinical parameters were compared between the groups. Survival analysis was conducted using the Kaplan–Meier method. The diagnostic performance of the baseline and follow-up NLR values was tested using receiver operating characteristic (ROC) curve analysis. Finally, two-dimensional mapping of patient characteristics was conducted using t-stochastic neighborhood embedding (t-SNE). In-hospital mortality significantly increased with an increase in the baseline NLR quartile (Q1 6.3%, Q2 11.0%, Q3 20.5%; and Q4, 26.6%; p < 0.001). The cumulative mortality increased as the quartile of the baseline NLR increased. The paired log-rank test revealed significant differences in survival for Q1 vs. Q3 (p = 0.017), Q1 vs. Q4 (p < 0.001), Q2 vs. Q3 (p = 0.034), and Q2 vs. Q4 (p < 0.001). However, baseline NLR was not identified as an independent prognostic factor using a multivariate Cox proportional hazards regression model. The area under the curve for predicting in-hospital death based on baseline NLR was only 0.682, whereas that of follow-up NLR was 0.893. The two-dimensional patient map with t-SNE showed a cluster characterized by high mortality with high NLR at follow-up, but these did not necessarily overlap with the population with high NLR at baseline. NLR may have prognostic implications in hospitalized COVID-19 patients with CVDRF, but its significance depends on the timing of data collection.

The Impact of SSRI Use on the Clinical Outcome and Prognosis of COVID-19 Patients: A Single-Center Prospective Study

Background: Recent studies have found a link between the usage of selective serotonin reuptake inhibitors (SSRIs) and a lower mortality rate in COVID-19 cases. Objective: The goal of current research was evaluating the effectiveness of SSRI drugs on improvement of COVID-19 patients. Methods: This prospective case-control study, compared SSRI-treated patients with matched control patients not treated with SSRIs at Masih Daneshvari Hospital on a population of 350 patients diagnosed with COVID-19 from March 15th 2021 to March 16th 2022. Results: ICU admission rates were significantly more in the control group than in the case group (44.8% vs. 25.9%; p-value=0.0002; Odds Ratio (OR)= 2.32). Intubation was reported for more cases in the control group than the case group (26.7% vs. 11.4%; p-value=0.0002; OR=2.84). Mortality rate was found to be significantly more in the control group than the case group (23.0% vs. 10.8%; p-value=0.0002; OR=2.46). Furthermore, the subgroup analyses on Fluvoxamine and Sertraline showed that Hospitalization period, ICU admission rates, and intubation were all reported to be significantly smaller in each case subgroups as against the control group. Conclusion: Our assessments underlined the potential efficacy of SSRIs in improving COVID-19 patients’ prognosis, since the use of SSRIs were shown to be associated with shorter hospital stay and ICU stay, lower ICU admission rates and intubation rates, and ultimately decreased mortality rates.

Associations of Dynapenic Obesity and Sarcopenic Obesity with the Risk of Complications in COVID-19

Ageing is associated with changes in body composition, such as low muscle mass (sarcopenia), decreased grip strength or physical function (dynapenia), and accumulation of fat mass. When the accumulation of fat mass synergistically accompanies low muscle mass or reduced grip strength, it results in sarcopenic obesity and dynapenic obesity, respectively. These types of obesity contribute to the increased risk of cardiovascular disease and mortality in the elderly, which could increase the damage caused by COVID-19. In this review, we associated factors that could generate a higher risk of COVID-19 complications in dynapenic obesity and sarcopenic obesity. For example, skeletal muscle regulates the expression of inflammatory cytokines and supports metabolic stress in pulmonary disease; hence, the presence of dynapenic obesity or sarcopenic obesity could be related to a poor prognosis in COVID-19 patients.

Evaluation of D-dimer as a prognostic indicator in patients with severe COVID-19 disease

Background – COVID-19 has been a global pandemic since its inception more than two years ago due to rapid transmission in humans. It can cause severe respiratory illness which may lead to death. As it is a novel disease, there are many speculations regarding its diagnosis and management. Thus, this study was planned with an aim to evaluate the role of D-dimer as a marker in predicting poor prognosis in COVID-19 patients. Materials and methods – This was a prospective, observational study carried out for a duration of three months in Unique hospital. The patients of 18 years and above diagnosed with severe COVID-19 disease diagnosed by clinical and radiological picture by pulmonologist were included in the study. Their demographic details were recorded and blood samples were taken once on the day of admission and second time on 5th day. Routine laboratory tests along with D-dimer were performed. The data was statistically analyzed using receiver operating curves to evaluate cut-off values of D-dimer. The patients were divided into two groups based on cut-off values of D-dimer on day of admission and day 5 post admission.

Length of hospital stay and risk factors associated with prognosis in COVID-19 patients: surprising results.

In this study, we aimed to investigate the risk factors that may affect the prognosis and length of hospital stay of COVID-19 patients, particularly immunoglobulin A. Patients admitted to the relevant department or intensive care unit with a diagnosis of COVID-19 between April 2020 and January 2021 were included in the study. Demographic characteristics of the patients and blood type, immunoglobulin A (IgA), C-reactive protein, D-dimer, procalcitonin, ferritin, troponin I, complete blood count, biochemical, and COVID-19 (SARS-CoV-2) reverse transcription polymerase chain reaction test results were evaluated retrospectively from the hospital files and data system. A total of 164 COVID-19 patients were included in this study. The median age was 72 (range: 30-95) years and the gender distribution of women and men was 66/98 (40.2% vs. 59.8%, respectively). There was no statistically significant relationship between blood type and hospitalization time or mortality (p=0.497 and p=0.923, respectively). There was furthermore no statistically significant relationship between Rh group and the duration of hospitalization or prognosis (p=0.198 and p=0.827, respectively). There was no statistically significant correlation between IgA level and hospitalization time or prognosis (p=0.066, r=0.144). In the analysis of defined risk factors independently associated with death, the following were found to be significant indicators of mortality: leukopenia [beta: -2.973, OR (95% CI): 0.051 (0.003-0.891), p=0.041], glucose [beta: 0.014, OR (95% CI): 1.014 (1.001-1.028), p=0.037], D-dimer [beta: 0.001, OR (95% CI): 1.001 (1.000-1.001), p=0.023], duration of hospitalization [beta: -0.218, OR (95% CI): 0.804 (0.708-0.913), p=0.001], and duration of stay in the intensive care unit [beta: 0.348, OR (95% CI): 1.416 (1.186-1.690), p<0.001]. In our study, no relationship was found between IgA level and hospitalization time or mortality among COVID-19 patients. However, leukopenia and increased glucose, D-dimer, neutrophil count, urea, and durations of hospital and intensive care stays were found to be important predictors of mortality.

COVID-19 versus seasonal influenza: myocardial injury and prognostic importance

BackgroundAcute myocardial injury is associated with poor prognosis in respiratory tract infections. We aimed to highlight the differences in prevalence of myocardial injury and its impact on prognosis in patients with COVID-19 compared to those with seasonal influenza.MethodsThis was a single-center prospective cohort study with a historical control group. 300 age-/sex-matched SARS-CoV-2 and seasonal influenza positive patients were enrolled. Myocardial injury was assessed by electrocardiogram (ECG), transthoracic echocardiography and biomarkers including high-sensitivity troponin-I. All patients were followed-up for 30 days after enrollment for all-cause mortalitiy, admission to the intensive care unit (ICU) and mechanical ventilation.ResultsRight ventricular distress was more common in COVID-19 whereas pathological ECG findings and impaired left ventricular function were more prevalent among influenza patients. COVID-19 patients suffered from a higher percentage of hypertension and dyslipidaemia. Contrary to COVID-19, pericardial effusion at admission was associated with poor outcome in the influenza group. Severe course of disease and respiratory failure resulted in significantly higher rates of ICU treatment and mechanical ventilation in COVID-19 patients. Although distribution of myocardial injury was similar, significantly fewer cardiac catheterizations were performed in COVID-19 patients. However, number of cardiac catheterizations was low in both groups. Finally, 30-day mortality was significantly higher in COVID-19 compared to influenza patients.ConclusionsIn adults requiring hospitalization due to COVID-19 or seasonal influenza, cardiovascular risk factors and signs of myocardial distress differ significantly. Furthermore, cardiovascular comorbidities may impair prognosis in COVID-19 patients to a higher degree than in their influenza counterparts.

Role of C-reactive protein, lactate dehydrogenase, Vitamin D, and interleukin-6 in the prognosis of COVID-19 – A retrospective study in a tertiary care hospital in Tamil Nadu

Background: SARS-COV-2 is also known as coronavirus causes an infectious disease has caused a global concern due to its pandemic nature. In India, nearly 36 million cases and 5.1 lakh deaths have been recorded so far. Laboratory biomarkers play an important role in improving the clinical situational awareness by predicting risk stratification and by discriminating between severe and non-severe cases. There is no sufficient information available regarding the role of C-reactive protein (CRP), lactate dehydrogenase (LDH), Vitamin D, and interleukin-6 (IL-6) in the prognosis of COVID-19 patients in Southern part of India. Aims and Objectives: We aim to retrospectively analyze CRP, LDH, Vitamin D, and IL-6 in COVID-19 patients. Materials and Methods: The observational and retrospective study was carried out from the case records of 103 patients from November 2021 to February 2022 in which CRP, LDH, Vitamin D, IL-6, COVID-19 Reporting and Data System (CO-RADS), and CT sore were analyzed during admission and follow-up period in the hospital. Mean, mean difference, standard deviation, standard error difference, and P value were calculated. P&lt;0.05 was considered to be significant. Results: CRP, LDH, IL-6, Vitamin D, CO-RADS, and CT score were decreased during the follow-up period when these levels were compared at the time of admission in the hospital, while there is an increase in Vitamin D levels during the follow-up period. Conclusion: The use of reliable and easy to use assays such as CRP, LDH, Vitamin D, and IL-6 plays an important role in the diagnosis and prognosis of COVID-19.

The effect of main pulmonary artery diameter on the prognosis of COVID-19 patients in the ICU

Aim: The aim of this study was to examine the effect of main pulmonary artery diameter (MPAD), which is evaluated in patients when first admitted to the intensive care unit due to COVID-19, on mortality.&#x0D; Material and Method: Thoracic computed tomography examinations performed during the initial admission to hospital of patients who were treated in the intensive care unit between October 1, 2020, and June 1, 2021, were evaluated retrospectively. Cox regression analysis was performed with the program R-Project to evaluate the relationship between MPAD and mortality.&#x0D; Results: No significant correlation was found between MPAD and mortality in models used with or without adjusting for age and sex (respectively P: 0.890 and P: 0.920). &#x0D; Conclusion: The MPAD value measured at the initial admission of COVID-19 patients hospitalized in the intensive care unit is not a parameter that can be used to predict mortality.

Clinical Characteristics and Prognosis of COVID-19 patients in Syria: A cross-sectional multicenter study

BackgroundCOVID-19 ignited a global pandemic that, in Syria, further strained a nation and its healthcare system already ravaged by years of war and sanctions. The first case in Syria was reported on March 22, 2020, and this is the first study that aimed to describe the clinical characteristics, comorbidities, and prognosis of COVID-19 patients in Syria. Materials and methodsDemographic and clinical data for this cross-sectional prospective study were collected on COVID-19 patients with positive polymerase chain reaction tests who were admitted to Al Assad and Al Mouwasat university hospitals between April 1 and January 31 of 2021. ResultsThis study included 701 patients. The majority were over age 60 (59%) and male (67.9%). The commonest symptoms were fever (86.6%) and shortness of breath (75.6%). The commonest comorbidities were hypertension (53.9%) and diabetes mellitus (41.5%). On multivariable analysis, risk factors found to be significantly associated with poor outcomes were advanced age (≥60 years); male gender; high respiratory rate (>35); respiratory failure (PaO₂/FiO₂ ratio<100); heart failure; chronic lung disease; elevated white blood cell counts, lactate dehydrogenase, c-reactive protein; prolonged international normalized ratio; and low lymphocyte counts. The clinical outcomes of our patients were as follows: 59.2% improved and were discharged from the hospital, 3.5% were discharged with persistent symptoms and 37.2% died. ConclusionSeveral biomarkers can serve as early warning and prognostic indicators of severe illness and mortality from COVID-19 in the highest risk patients, especially males with multiple comorbidities over 60 years of age. In the context of a national healthcare system stretched thin by years of civil war and sanctions, and high COVID-19 mortality rates as a consequence, extra care should be taken to use the predictive power of these biomarkers to stratify high-risk patients in the earliest possible stages of the disease to minimize severe illness and reduce fatalities.

Dysregulated Interferon Response and Immune Hyperactivation in Severe COVID-19: Targeting STATs as a Novel Therapeutic Strategy.

A disease outbreak in December 2019, caused by a novel coronavirus SARS-CoV-2, was named COVID-19. SARS-CoV-2 infects cells from the upper and lower respiratory tract system and is transmitted by inhalation or contact with infected droplets. Common clinical symptoms include fatigue, fever, and cough, but also shortness of breath and lung abnormalities. Still, some 5% of SARS-CoV-2 infections progress to severe pneumonia and acute respiratory distress syndrome (ARDS), with pulmonary edema, acute kidney injury, and/or multiple organ failure as important consequences, which can lead to death. The innate immune system recognizes viral RNAs and triggers the expression of interferons (IFN). IFNs activate anti-viral effectors and components of the adaptive immune system by activating members of the STAT and IRF families that induce the expression of IFN-stimulated genes (ISG)s. Among other coronaviruses, such as Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV, common strategies have been identified to antagonize IFN signaling. This typically coincides with hyperactive inflammatory host responses known as the “cytokine storm” that mediate severe lung damage. Likewise, SARS-CoV-2 infection combines a dysregulated IFN response with excessive production of inflammatory cytokines in the lungs. This excessive inflammatory response in the lungs is associated with the local recruitment of immune cells that create a pathogenic inflammatory loop. Together, it causes severe lung pathology, including ARDS, as well as damage to other vulnerable organs, like the heart, spleen, lymph nodes, and kidney, as well as the brain. This can rapidly progress to multiple organ exhaustion and correlates with a poor prognosis in COVID-19 patients. In this review, we focus on the crucial role of different types of IFN that underlies the progression of SARS-CoV-2 infection and leads to immune cell hyper-activation in the lungs, exuberant systemic inflammation, and multiple organ damage. Consequently, to protect from systemic inflammation, it will be critical to interfere with signaling cascades activated by IFNs and other inflammatory cytokines. Targeting members of the STAT family could therefore be proposed as a novel therapeutic strategy in patients with severe COVID-19.

Serum Ferritin Levels for the Prediction of Mortality among COVID-19 Patients in an Indonesia’s National Referral Hospital

BACKGROUND: Early identification of clinical outcomes is necessary for risk classification in COVID-19 patients. This study help in evaluating the progression of the disease and the patient’s therapy. AIM: This study aims to determine serum ferritin levels for the prediction of mortality among COVID-19 patients in an Indonesia’s National Referral Hospital. METHODS: A retrospective cohort study was conducted on 142 confirmed positive COVID-19 patients between March 2020 until March 2021 at Dr. M. Djamil General Hospital as a National Referral Hospital in Indonesia. Data obtained from medical record documents and examination of ferritin levels was carried out at the beginning of treatment. The Chi-square test and survival analysis with the log-rank test and Kaplan–Meier methods were used to analyze the data. The SPSS version 15 was used to analyze the data. RESULTS: The serum ferritin cutoff point for COVID-19 patients that can be used to predict poor outcomes was &gt;651.02 ng/mL with sensitivity 79.3%, specificity 80.5%, and accuracy 85.0%. Age, comorbid diabetes mellitus, number of comorbidities, symptoms of trouble breathing, oxygen saturation, severity, and mortality outcome were all associated to ferritin levels &gt;651.02 ng/mL. The Kaplan–Meier curve showed that ferritin levels &gt;651.02 ng/mL were associated for risk of poor outcome COVID-19 patients (HR = 8.84, [95% CI 3.59–21.73]). CONCLUSION: The ferritin cutoff point for predicting poor prognosis in COVID-19 patients was 651.02 ng/mL. However, ferritin serum levels cannot be used as a single predictor in determining the poor outcome of COVID-19.

Laboratuvar parametreleri ve oranlarının COVID-19 enfeksiyonunda prognoz ve mortalite ile ilşkisi

Objective:In this study, to evaluate the clinical course and prognosis in COVID-19 patients, to evaluate the hematological and biochemical parameters at the time of admission to the hospital.&#x0D; Methods:This retrospective study was performed in a multicenter study in April and October 2020. Demographic characteristics, clinical features, age, gender and length of stay of patients who exitus (EX) and were discharged due to COVID-19 were examined.&#x0D; Results:Of the patients (n:180) included in the study, 89 were female and 91 were male. There was a significant difference between the patients who were discharged from the hospital and died gender and complaints at the time of admission (p0.05). While the length of stay, platelet (PLT), mean corpuscular volume (MCV), serum C-reactive protein (CRP), albumin, lymphocyte, monocyte, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase (LDH), ferritin, international normalized ratio, procalcitonin (PCT), troponin, and white blood cell counts are all increased in EX. There is a statistically significant difference in red blood cell distribution width (RDW) between EX and discharge patients (p0.05). While the RDW, monocyte/albumin, procalcitonin/albumin, CRP/albumin, LDH/albumin, and ürea/albumin ratios are increased in EX patients, the PCT/PLT and MPV/PLT ratios are increased in discharged patients.&#x0D; Conclusion: In this study, we demonstrated that hematological and biochemical markers may be utilized as an early prognostic indicator for patients identified with COVID-19.

Right Ventricular Assessment in Critically Ill COVID-19 Patients and its Prognostic Importance

Background; Cardiac injury is a prevalent complication and is associated with worse prognosis in COVID-19 patients. The increased cardiac workload resulting from respiratory failure and hypoxemia is a common mechanism of cardiac injury and the right ventricle may bear the brunt of its impact. The aim of the present study was to determine the incidence and prognostic value of RV dysfunction in COVID-19 patients admitted to ICU using conventional echocardiography parameters.Patients were subjected to full history taking, and clinical examination, Computed Tomography of chest was done for all patients to assess severity of lung infiltration, all patients received standard treatment according to Ministry of Health and Population COVID19 treatment protocol recommendations. Echocardiographic assessment was done to all patients.The mean age of the patients was 61.10±9.64years (range 42-80years).There were 36 (60%) male and 24 (40%) female. The non-survivor group consisted of 28 patients (46.7%) and survivors consisted of 32 patients (53.3%). There was statistically significant association between mortality and RV function regarding TAPSE, FAC%, RV basal diameter and EPAP. We concluded that in COVID-19 patients, RV function must be assessed and its prognostic importance recognized. RV dysfunction is not only a symptom of high pulmonary pressures, but it also contributes to cardiac insufficiency.

The effect of diabetes mellitus on disease prognosis in COVID-19 patients.

BackgroundIn this study, we aimed to evaluate and compare the clinical characteristics, laboratory findings, and outcomes of hospitalized patients with and without diabetes along with poorly vs. well-controlled diabetes.MethodsA total of 341 hospitalized patients with COVID-19 confirmed by RT-PCR and/or chest imaging suggestive of COVID-19 infection were retrospectively included in this study. The patients were divided into 2 groups as diabetic (n = 120) and non-diabetic (n = 221). Demographic data, symptoms, comorbidities, and laboratory values were recorded. The patients were classified according to the clinical stages defined by guidance of the WHO for COVID-19. The percentage of patients with severe disease was higher in diabetic group (n = 57) 47.5% compared to non-diabetic group (n = 61) 27.8% (p = 0.001). The percentage of patients requiring oxygen therapy was significantly higher in 61 (51.2%) diabetic group than non-diabetic group 65 (29.4%) (p = 0.001). The median duration of hospitalization in the diabetic group was 8 days [IQR 6–11.5] that was significantly higher than the non-diabetic group as 7 days [IQR 5–10] (p = 0.009). The median duration of hospitalization in poorly controlled diabetic group was 9 days [IQR 6.00–16.00] that was significantly higher than well-controlled diabetic group 8 days [IQR 6.00–11.00] (p = 0.006).ResultsPatients with diabetes were more susceptible to COVID-19 infection and the infection was more severe in patients with diabetes compared to patients without diabetes. However, the mortality rate was similar between diabetic and non-diabetic group. Diabetic COVID-19 patients without other comorbidities were not prone to severe infection.ConclusionPatients with diabetes and comorbidities, apart from the glycemic control, should receive intensive monitoring and disease management.

A Retrospective and Multicenter Study on COVID-19 in Inner Mongolia: Evaluating the Influence of Sampling Locations on Nucleic Acid Test and the Dynamics of Clinical and Prognostic Indexes.

COVID-19 is spreading widely, and the pandemic is seriously threatening public health throughout the world. A comprehensive study on the optimal sampling types and timing for an efficient SARS-CoV-2 test has not been reported. We collected clinical information and the values of 55 biochemical indices for 237 COVID-19 patients, with 37 matched non-COVID-19 pneumonia patients and 131 healthy people in Inner Mongolia as control. In addition, the results of dynamic detection of SARS-CoV-2 using oropharynx swab, pharynx swab, and feces were collected from 197 COVID-19 patients. SARS-CoV-2 RNA positive in feces specimen was present in approximately one-third of COVID-19 patients. The positive detection rate of SARS-CoV-2 RNA in feces was significantly higher than both in the oropharynx and nasopharynx swab (P < 0.05) in the late period of the disease, which is not the case in the early period of the disease. There were statistically significant differences in the levels of blood LDH, CRP, platelet count, neutrophilic granulocyte count, white blood cell number, and lymphocyte count between COVID-19 and non-COVID-19 pneumonia patients. Finally, we developed and compared five machine-learning models to predict the prognosis of COVID-19 patients based on biochemical indices at disease onset and demographic characteristics. The best model achieved an area under the curve of 0.853 in the 10-fold cross-validation.

Clinical Factors and Characteristics that Affect Prognosis of COVID-19 Patients

Background: COVID-19 disease has been linked to severe and deadly respiratory disease in various age groups. In team of COVID-19 disease prognosis and mortality, age is a key factor. The chance of mortality climbs from 0.66 percent to 7.8 percent in those over the age of 80. Males have a greater COVID-19 prevalence rate than females. Furthermore, even in the absence of additional comorbidities, sex was an essential biological determinant in prognosis and death risk among COVID-19 positive people. Another factor that influences the prognosis of COVID-19 illness is comorbidity. It's critical to comprehend the clinical characteristics and variables that influence the prognosis of COVID-19 illness patients. Objective: To describe the clinical factors and characteristics that affect COVID-19 patients’ prognosis. Methods: Retrospective research performed at Queen Alia Military Hospital by examining clinical characteristics of hospitalized individuals with a verified diagnosis of COVID-19 disease, as confirmed by polymerase-chain-reaction (PCR) assay. The research comprised laboratory outcomes, demographic features, chest imaging, and clinical data. Participants were categorized into the progression category and the improvement/stabilization group. Results: A total of 51 participants with a mean age of 33.6 years were involved in the research. Forty-six participants (90.2%) were categorized as an improvement/stabilization group, and five patients were classified as a progression group (9.8%). Fever, diarrhea, breath shortness, and cough were the most common signs and symptoms. Significant differences were detected between groups concerning age, comorbid diseases (diabetes and hypertension), disease severity, length of stay in the hospital, WBCs, creatinine, total bilirubin, ALP, LDH, CRP, albumin, oxygen saturation, and pulmonary consolidation (P &lt; 0.05). Moreover, multivariate logistic regression determined age (OR, 1.79; CI: .950 3.28; P = 0.035), diabetes (OR, 1.62; CI: 1.02 - 4.19; P 0.012), hypertension (OR, 1.13; CI: 1.04 - 3.62; P =0.023), increased creatinine (OR, 3.57; CI: 2.30 - 6.71; P = 0.01), and increased total bilirubin (OR, 2.82; CI: 1.72 - 3.28; P = 0.031) as risk factors for disease progression. Conclusion: Chronic disease and abnormal creatinine and bilirubin level including other factors contribute to poor prognosis of COVID-19 patients. This study shows that the clinical characteristics of the patient should be prioritized in disease management.

COVID-19 Vaccination Limits Systemic Danger Signals in SARS-CoV-2 Infected Patients.

Vaccination with an mRNA COVID-19 vaccine determines not only a consistent reduction in the risk of SARS-CoV-2 infection but also contributes to disease attenuation in infected people. Of note, hyperinflammation and damage-associated molecular patterns (DAMPs) have been clearly associated with severe illness and poor prognosis in COVID-19 patients. In this report, we revealed a significant reduction in the levels of IL-1ß and DAMPs molecules, as S100A8 and High Mobility Group Protein B1 (HMGB1), in vaccinated patients as compared to non-vaccinated ones. COVID-19 vaccination indeed prevents severe clinical manifestations in patients and limits the release of systemic danger signals in SARS-CoV-2 infected people.

Análisis comparativo de la radiografía de tórax y la ecografía pulmonar para predecir el pronóstico intrahospitalario de pacientes ingresados por neumonía secundaria a SARS-CoV-2 (COVID-19)

BackgroundPoint of care lung ultrasound (POCUS) has been recently used to assess prognosis in COVID-19 patients. However, there are no data comparing POCUS and chest-X ray, a technique widely used. Patients and methodsRetrospective analysis in stable COVID-19 patients. Schalekamp radiological lung scale and LUZ-Score ultrasound scale were compared. Primary end-point was in-hospital death and/or need for Intensive Care Unit admission. ResultsA total of 138 patients were included. Median Schalekamp scale was 2 (2) and median LUZ-Score scale was 21 (10). No significant correlation was observed between both techniques. Patients with a LUZ-Score ≥21points at admission had worse lung function and higher concentrations of LDH, CRP and Interleuquine-6. Schalekamp scale failed to identify patients at a higher risk at admission for the primary end-point. Addition of POCUS to a previous clinical model, improved risk prediction (AUC 0.805 [95%CI: 0.662-0.948]; P=<.001). ConclusionsChest X-ray and POCUS showed no correlation at admission in this analysis. Only POCUS identified a group of patients with greater clinical and analytical involvement. POCUS improved, previous clinical model, while chest X-ray did not add relevant predictive information for the primary endpoint.