Serum D-dimer Levels Research Articles

Diagnostic potential of soluble ST2 and D-dimer for Stanford Type B aortic dissection and intramural aortic hematoma

ObjectiveType B aortic dissection (TBAD) and intramural aortic hematoma (IMH) are common manifestations of Acute Aortic Syndrome (AAS), exhibiting overlapping clinical features. The timely and accurate diagnosis and differentiation between TBAD and IMH are critical for appropriate management. Tumorigenicity 2 (sST2) and D-dimer have been shown to elevate levels in both TBAD and IMH, making them valuable as “rule-out” markers. Hence, we aimed to assess the diagnostic utility of sST2 and D-dimer in distinguishing TBAD from IMH. MethodsIn this retrospective study, we analyzed serum levels of sST2 and D-dimer in 182 AAS patients, comprising 90 TBAD cases, 92 IMH cases, and 90 non-AAS cases. Serial measurements were taken at 1 h, 6 h, 12 h, 24 h, and 72 h post-admission. Comparative analyses were conducted between TBAD and non-AAS cases, IMH and non-AAS cases, and TBAD and IMH cases. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic accuracy of sST2 and D-dimer in identifying TBAD or IMH cases. ResultsBoth TBAD and IMH patients displayed elevated levels of sST2 and D-dimer compared to non-AAS cases. Notably, sST2 levels were significantly higher in TBAD patients than in IMH patients, whereas D-dimer levels exhibited moderate differences. TBAD patients tended to exhibit elevated levels of either sST2 or D-dimer, with a modest correlation between the two (Pearson correlation coefficient = 0.3614). In contrast, IMH patients showed elevations in both markers, with a positive correlation between them (Pearson correlation coefficient = 0.6814). The ROC analysis revealed that both sST2 (AUC, 0.657; 95 % CI, 0.552–0.753; cutoff value, 27.54 ng/ml) and D-dimer (AUC, 0.695; 95 % CI, 0.591–0.787, cutoff value, 1.215 ng/ml) demonstrated favorable diagnostic performance for TBAD. sST2 exhibited a sensitivity of 80.92 % and a specificity of 75.00 %, while D-dimer showed a sensitivity of 80.92 % and a specificity of 75.00 %. For the diagnosis of IMH, the combined assessment of sST2 and D-dimer (AUC, 0.674; 95 % CI, 0.599–0.768; sensitivity, 69.20 %; specificity, 80.00 %) proved effective. ConclusionsOur results indicate that both sST2 and D-dimer show diagnostic potential for TBAD. Elevated levels of either serve as an indicator of TBAD onset. However, concurrent elevation of both markers seems to be indicative of IMH. The combination of increased sST2 and D-dimer levels demonstrates strong diagnostic performance in identifying IMH cases.

Changes in coagulation markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for Mycoplasma severity

BackgroundThis study investigates the correlation between coagulation levels and the severity of Mycoplasma pneumoniae pneumonia (MPP) in children. In addition, the study analyses the predictive value of coagulation abnormalities in MPP combined with necrotising pneumonia (NP).MethodsA total of 170 children with MPP who underwent treatment between June 2021 and February 2022 were selected for this study. The study population was divided into groups according to the severity of the disease to compare differences in the incidence of coagulation abnormalities between the groups. The participants were also divided into groups according to imaging manifestations to compare the differences in coagulation function among the different groups. All data information was processed for statistical analysis using SPSS Statistics 25.0 and GraphPad Prism 7.0 statistical analysis software.ResultsThe incidence of coagulation abnormalities in the children in the severe MPP (SMPP) group was significantly higher than that in the normal MPP (NMPP) group (P < 0.05). The multi-factor logistic regression analysis revealed that the D-dimer level is an independent risk factor for the development of NP in SMPP (P < 0.05). The receiver operating characteristic curve analysis revealed statistically significant differences (P < 0.05) in D-dimer, fibrinogen degeneration products (FDP), neutrophils, lactate dehydrogenase and serum ferritin for predicting SMPP combined with NP. Bronchoscopic manifestations of coagulation indicators (D-dimer and FDP levels) were significantly higher in the mucus plug group than in the non-mucus plug group, while the activated partial thromboplastin time levels were lower in the former than in the latter (P < 0.05).ConclusionThe degree of elevated D-dimer and FDP levels was positively correlated with the severity of MPP, with elevated serum D-dimer levels (> 3.705 mg/L) serving as an independent predictor of MPP combined with NP in children.

Recognition of refractory Mycoplasma pneumoniae pneumonia among Myocoplasma pneumoniae pneumonia in hospitalized children: development and validation of a predictive nomogram model

BackgroudThe current diagnostic criteria for refractory Mycoplasma pneumoniae pneumonia (RMPP) among Mycoplasma pneumoniae Pneumonia (MPP) are insufficient for early identification, and potentially delayed appropriate treatment. This study aimed to develop an effective individualized diagnostic prediction nomogram for pediatric RMPP.MethodsA total of 517 hospitalized children with MPP, including 131 with RMPP and 386 without RMPP (non-RMPP), treated at Lianyungang Maternal and Child Health Care Hospital from January 2018 to December 2021 were retrospectively enrolled as a development (modeling) cohort to construct an RMPP prediction nomogram. Additionally, 322 pediatric patients with MPP (64 with RMPP and 258 with non-RMPP, who were treated at the Affiliated Hospital of Xuzhou Medical University from June 2020 to May 2022 were retrospectively enrolled as a validation cohort to assess the prediction accuracy of model. Univariable and multivariable logistic regression analyses were used to identify RMPP risk factors among patients with MPP. Nomogram were generated based on these risk factors using the rms package of R, and the predictive performance was evaluated based on receiver operating characteristic (ROC) curves and using decision curve analysis (DCA).ResultsMultivariate analysis revealed five significant independent predictors of RMPP among patients with MPP: age (hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.08–1.33, P = 0.038), fever duration (HR 1.34, 95%CI 1.20–1.50, P < 0.001), lymphocyte count (HR 0.45, 95%CI 0.23–0.89, P = 0.021), serum D-dimer (D-d) level (HR 1.70, 95%CI 1.16–2.49, P = 0.006), and pulmonary imaging score (HR 5.16, 95%CI 2.38–11.21, P < 0.001). The area under the ROC curve was 90.7% for the development cohort and 96.36% for the validation cohort. The internal and external verification calibration curves were almost linear with slopes of 1, and the DCA curve revealed a net benefit with the final predictive nomogram.ConclusionThis study proposes a predictive nomogram only based on five variables. The nomogram can be used for early identification of RMPP among pediatric patients with MPP, thereby facilitating more timely and effective intervention.

Performance of classical serum inflammatory markers in healed and unhealed treated patients with joint and prosthetic joint infections

BackgroundSerum markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and D-dimer, are currently used by clinicians and orthopedic surgeons in diagnosing and managing joint infections (JI), although conflicting results exist on their performance. The aim of this study was to evaluate their performance in assessing healing or unhealing of patients with JI or with prosthetic joint infection (PJI). MethodsESR, CRP and D-dimer serum levels were evaluated before, during and after antibiotic treatment in 61 patients (65.1 ± 12.6 years): 49 affected by PJI and 12 by JI, between 2020 and 2022. These patients had undergone orthopedic surgery and were treated with antibiotics. ResultsESR, CRP and D-dimer were significantly lower after treatment than before (p value: 0.001, 0.001 and 0.003, respectively) in healed and unhealed patients. A moderate correlation was found between the three inflammatory markers. ConclusionsUsing a cut off value of 25 mm/h for ESR, 0.5 mg/L for CRP, and 700 ng/ml for D-dimer, it might be possible to discriminate healed from unhealed patients (PPV and NPV: ESR 65.5% and 68.8%, CRP 71.9% and 79.3%, D-dimer 76.9% and 81.8%). The combined use of these three inflammatory markers might be useful in the management of joint infections.

Comparison of C-reactive protein, D-dimer, vitamin D and magnesium serum levels between migraineurs and tension-type headache sufferers

Headaches, especially migraines and tension-type headaches (TTH), are among the most prevalent problems encountered in neurology and medicine. Ongoing debate surrounds the pathophysiological mechanisms behind this condition. One of the potential ideas involves inflammation and diet. The purpose of the study was to compare the serum levels of C-reactive protein (CRP), D-dimer, vitamin D and magnesium in 23 migraineurs and 23 TTH-diagnosed sufferers. The CRP level (4.8±3.7 mg/L) was found to be significantly different between migraineurs and TTH sufferers, with a significant difference (p=0.03) between the two groups of headache sufferers. Vitamin D serum levels (19.5±7.9 ng/L) and TTH serum levels (26.7±8.4) were observed to differ significantly. Magnesium serum levels (p=0.692) did not differ significantly between the two headache patient groups.

Flow Cytometric Analysis of Lymphocyte Subsets of Covid-19 Patients from A Single Centre in Turkey

Background:&#x0D; Lymphocyte counts have been shown to negatively correlate with the severity and different outcomes in Covid-19. The aim of this single centre study is to analyse the distribution of lymphocyte subsets in response to SARS-CoV-2 infection and its relation to the severity, course and prognosis of the disease.&#x0D; Methods:&#x0D; Blood samples were obtained from 67 consecutive patients between April 2020 and July 2020. Data on other laboratory parameters, and clinical course were collected retrospectively from patient files and patints were defined to have as severe or non-severe (mild/moderate) disease. Leukocyte subsets to be studied were identified by using flow cytometric analysis. Patients were allocated into 3 groups based on the day of blood sample collection for the flow cytometric analysis: Days 0-7, Days 8-14 and Days &gt;14 as Group I, Group II and Group III, respectively. In 10 available of 67 patients an additional flow cytometric analysis was done 7-10 days after the initial sampling.&#x0D; Results:&#x0D; Lower total lymphocyte, CD3 positive, CD4 positive and B-cell counts were identified in severe infection compared to non-severe infection group which were also correlated with high serum CRP, D-dimer and ferritin levels. NK and monocyte counts were not different between the two groups. Activation markers CD38 and HLA-DR on CD4 and CD8 positive lymphocytes also were not different in either group. &#x0D; Conclusion:&#x0D; CD3 and CD4 lymphopenia were lower in accordance with previous studies and were associated with severe disease. The expectancy of high activation markers was not met. Future studies with detailed subgroup analyses at different time-points, and immune profiling after vaccination as well as during new infection in vaccinated patients will shed more light on our general knowledge of the immune response to COVID-19 and viruses in general.

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.

Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan.

This study aimed to determine the incidence of extra pulmonary complications among critically ill COVID-19 patients requiring invasive mechanical ventilation and association of these complications with various inflammatory markers and degree of hypoxia. A retrospective cohort study was conducted among 173 adults in Karachi having COVID-19 and were admitted to ICU in a tertiary care private hospital between August 2020 to July 2021. The median age of patients included in the analysis was 61 years (IQR; 16). Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most frequent extra pulmonary complications with proportion of 65.3% (n=113), 63.6% (n=110), 61.8% (n=107) and 33.5% (n=58). Statistically significant differences in the median serum levels of ferritin were observed among male versus female, critically ill covid patients with and without ICU mortality as well as patients with and without hospital mortality (p-value <0.05). Significantly higher serum levels of d-dimer were noted among patients who developed acute liver injury or NSTEMI, or had ICU stay of > 3 days or received mechanical ventilation for >2 days. Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most common extra pulmonary complications among mechanically ventilated COVID-19 patients with ARDS. Higher serum d-dimer levels were associated with acute liver injury, NSTEMI, ICU stay longer >3 days and invasive mechanical ventilation >2 days. Higher serum ferritin levels are associated with male sex and serve as an important predictor of ICU as well as hospital mortality.

Serum D-dimer Level in Patients with Acute Leukemia in a Tertiary Care Hospital

D-dimer is a molecule, formed by the breakdown of excessive fibrin from the activation of coagulation system. Ample evidence suggests that increased activation of coagulation system in patients with acute leukemia (AL) leads to higher D-dimer levels. Considering shortage of evidence in our perspective, the study was designed to observe the D-dimer level in acute leukemia in different morphological types and phases among the patients admitted in a tertiary care hospital. This hospital based cross-sectional study was conducted at the Department of Medicine and Department of Hematology in Dhaka Medical College Hospital, for a period of 6 months following approval of this protocol. Patients with New case (NC) of AL, at complete remission (CR) and in patient’s wither lapsed (R) AL were included in the study. Purposive sampling methods were followed for sample selection. Written informed consents were taken from the all study subjects and ethical issues were ensured. Data were collected by interview using a structured questionnaire. All study population were subjected to details history taking, physical examination and relevant investigations of D-dimer level. Collected data were analyzed by the SPSS version 20.0. Among 50 patients, 58% were males and 42% were females. Mean age was 34±5.6 SD years and the height number of patients (40%) belonged to age group 21-30 years. Three fourth of the patient (76%) had diagnosed as AML and rest of them 24% had ALL. The most common subtype of Acute Myeloblastic Leukemia M3 (AML) was 47, 37% and most common subtype of ALL L2 was 50%. Most of the respondents were found as new case (80%) followed by in decreasing order complete remission case 14% and relapse case 6%. Overall, D-dimer level was 3.69 mg/dl (0.1mg/dl-40 mg/dl), and D-dimer level is slightly higher in AML group than ALL patient (4.26 vs 2.18mg/dl). Moreover, new cases have higher level of D-dimer (4.2 mg/dl) in comparison with complete remission (1.2 mg/dl) or relapse case (2.7 mg/dl). It was also found that APL patients has higher D-dimer level than other form of leukemia. D-dimer level in acute leukaemia patients 3.69 mg/dl. Higher value of AML was found in patients than ALL and increased D-dimer level is also evident in newer case particularly APL. D-dimer level rises in acute leukemia patients. However, further study is recommended with appropriate study design. Bangladesh Med J. 2021 Sept; 51(1): 8-17

Correlation between the serum level of ferritin and D-dimer and the severity of COVID-19 infection

BackgroundMany laboratory biomarkers were used for diagnosis of COVID-19 infection; however, their accuracy to assess the severity and prognosis are still to be evaluated. This study aims to correlate between the serum ferritin and D-dimer levels and the severity of COVID-19 infection and its outcome.ResultsRetrospective data retrieval of 150 confirmed COVID-19 infection patients admitted in Ain Shams University Specialized Hospital El Obour during period between April and July 2020 were studied. Ninety-six were survivors and 54 were non-survivors. The number of co-morbidities, the level of D-dimer and serum ferritin were correlated with ICU admission, need for mechanical ventilation and mortality with P value < 0.0001. Serum ferritin and D-dimer levels were significantly correlated with degree of HRCT chest severity with P value < 0.0001. The cut-off value of D-dimer for mortality was 700 ng/ml (sensitivity 83.33%, specificity 59.38%), and that for serum ferritin was 300 ng/ml (sensitivity 88.89%, specificity 58.33%), cut-off value of D-dimer for ICU admission was 863 ng/ml and that for serum ferritin was 300 ng/ml, cut-off value of D-dimer for mechanical ventilation was 700 ng/ml, and that for serum ferritin was 600 ng/ml.ConclusionD-dimer and serum ferritin are important biomarkers in predicting the mortality, ICU admission and need for mechanical ventilation in COVID-19 subjects. Thus helps in early detection of risk of progression and improving outcome. The current study also provides probable cut-off values for both biomarkers above which mortality, ICU admission, and mechanical ventilation need can be expected.Trial registrationClinicalTrials.gov ID: NCT0567281. Retrospectively registered. 4th January 2023.https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000CT6C&selectaction=Edit&uid=U00056R5&ts=2&cx=-tlu9xu.

Dynamics of Cytokine, SARS-CoV-2-Specific IgG, and Neutralizing Antibody Levels in COVID-19 Patients Treated with Convalescent Plasma.

Coronavirus disease 2019 (COVID-19) is a contagious illness worldwide. While guidelines for the treatment of COVID-19 have been established, the understanding of the relationship among neutralizing antibodies, cytokines, and the combined use of antiviral medications, steroid drugs, and convalescent plasma therapy remains limited. Here, we investigated the connection between the immunological response and the efficacy of convalescent plasma therapy in COVID-19 patients with moderate-to-severe pneumonia. The study included a retrospective analysis of 49 patients aged 35 to 57. We conducted clinical assessments to determine antibody levels, biochemical markers, and cytokine levels. Among the patients, 48 (98%) were discharged, while one died. We observed significantly higher levels of anti-nucleocapsid, anti-spike, and neutralizing antibodies on days 3, 7, and 14 after the transfusion compared to before treatment. Serum CRP and D-dimer levels varied significantly across these four time points. Moreover, convalescent plasma therapy demonstrated an immunoregulatory effect on cytokine parameters, with significant differences in IFN-β, IL-6, IL-10, and IFN-α levels observed at different sampling times. Evaluating the cytokine signature, along with standard clinical and laboratory parameters, may help to identify the onset of a cytokine storm in COVID-19 patients and determine the appropriate indication for anti-cytokine treatment.

The Study of Biomarkers inSmokers Infected with Covid-19 in Basra, Iraq

Background: The COVID-19 pandemic has heightened awareness of infectious illnesses and their links to host variables and underlying disorders. Objectives: In this review, we look at current research on a possible link between smoking and COVID-19 and study the biomarker changes in patients. Material and Methods: A case-control study included 45 smoker’s patients with COVID-19 and 50 healthy subjects as a control group who visited Al-Basra Teaching Hospital and Allmwanei Hospital in Al-Basra province between October 2021 and February 2022. The age average for the study population was (25-80) years. Serum and blood levels of human CBC, ESR, CRP, Ferritin, D-Dimer, IL 6, Albumin, FBS, HbA1c, Troponin, Cholesterol, Triglyceride, HDL, LDL, VLDL, Creatinine, Urea, Uric acid and GFR were measured. Results: The results show all biomarkers tend to have high sensitivity and specificity for smoker COVID patients based on the ROC curve analysis: Lymphocyte, CRP, Ferritin, D-Dimer, IL 6, Albumin, FBS, HDL, Creatinine, Urea, and GFR. These biomarkers might be helpful in determining the kind and severity of COVID-19 in smokers. Although the data is limited to a total number of patients. Conclusion: Studying patient alterations and vital signs led to the conclusion that smoking and COVID-19 are related. It was also verified that all vital indicators had strong sensitivity and specificity for smoking COVID patients.

AN INVESTIGATION INTO THE IMPACT OF CONTINUING OR TERMINATING PREGNANCY ON THE MATERNAL, FETAL AND DISEASE PROGRESSION OUTCOMES IN PREGNANT WOMEN WITH COVID-19

Abstract Introduction: There is limited evidence regarding the potential impact of COVID-19 on pregnancy, fetuses, and its outcomes. Evaluating population-level data on these outcomes as soon as they become available will be crucial for identifying trends related to the COVID-19 pandemic and managing the disease in pregnant women and their offspring. Material and methods: This study employed a descriptive-analytical approach based on the recorded hospital files. All pregnant mothers who presented to the hospitals and tested positive for COVID-19 were included. Data included background and initial information such as age, gender, maternal PCR positivity, COVID-19 vaccination, number of vaccinations, pregnancy count, number of deliveries after 20 weeks of gestation, miscarriage, gestational age at sonography, COVID-19 symptoms, pulmonary involvement, preterm labor, premature rupture of membranes, high blood pressure, preeclampsia, intrauterine fetal demise, deep vein thrombosis/pulmonary embolism, maternal death, pregnancy termination, age at pregnancy termination, reasons for pregnancy termination, method of pregnancy termination, hospitalization duration, maternal recovery, neonatal PCR positivity, Apgar score, neonatal weight, neonatal intensive care unit admission, and neonatal death. Blood factors at admission and discharge were also recorded. Results: A total of 401 pregnant women were enrolled in the study, among whom 282 individuals underwent delivery due to labor pain, previous cesarean section, pain, and labor. Among the pregnant women with COVID-19, 385 (96%) tested positive for PCR. White blood cells, hemoglobin, platelet, alanine aminotransferase, serum ferritin levels, and D-dimer levels showed statistically significant differences before and after discharge. Maternal PCR positivity was significantly associated with first-trimester termination, and the number of COVID-19 vaccinations had a significant relationship with third-trimester termination. In cases of moderate to severe pulmonary involvement, white blood cells, hemoglobin, alanine aminotransferase, aspartate aminotransferase, serum ferritin levels, D-dimer levels, and thrombocytopenia showed a noticeable increase, statistically significant compared to mild cases. Conclusion: This study suggests that the most common time for COVID-19 infection in pregnancy is the first and third trimesters, with clinical symptoms of fever and cough. Pregnancy termination during the inflammatory phase of COVID19 in patients with severe involvement was associated with unfavorable outcomes for both the mother and fetus.

Increased inflammatory mediators levels are associated with clinical outcomes and prolonged illness in severe COVID-19 patients

ObjectiveThe purpose of this study was to identify potential predictors of clinical outcome in severe COVID-19 patients and to investigate the relationship between immunological parameters and duration of illness. MethodsThis single-center study retrospectively recruited 73 patients with severe or critical COVID-19. Immunological indicators include white blood cell count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, and circulating inflammatory mediators were observed for their association with disease severity, mortality and duration of illness of COVID-19. ResultsSerum inflammatory mediators levels of C-reactive protein (P = 0.015), interleukin 6 (IL-6) (P < 0.001), CX3CL1 (P < 0.001), D-dimer (P < 0.001) and procalcitonin (PCT) (P < 0.001) were increased in critical illness patients compared to those severe COVID-19 patients. CX3CL1 has the highest C-index (0.75) to predict in-hospital mortality in patients with COVID-19. Furthermore, this study shows for the first time that the duration of illness in severe COVID-19 patients is associated with serum levels of CX3CL1 (P = 0.037) and D-dimer (P = 0.014). ConclusionCX3CL1, D-dimer, PCT, and IL-6 could effectively predict mortality in severe COVID-19 patients. In addition, only the circulating levels of CX3CL1 and D-dimer were significantly associated with duration of illness.

An Observational Study on Levels of Serum Fibrin Degradation Product (FDP), D-Dimer and Procalcitonin in Burn Sepsis

Background: Despite improvements in burn management, infection is still the biggest challenge in major burn cases globally. Burn causes extensive tissue destruction, immune dysfunction, increases the risk of infection and septicemia with high morbidity and mortality. The aim of this study was to observe the levels of serum fibrin degradation product (FDP), D-dimer and procalcitonin in patients with burn sepsis treated in intensive care unit (ICU). Materials &amp; Methods: This observational study was carried out in Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka from February 2018 to January 2019. Forty (40) patients with major burns, from (15% to 50% total body surface area burn) with burn sepsis, were recruited for the study. In all cases, plasma level of fibrin degradation product (FDP), D-dimer and procalcitonin were measured and recorded. Result: Male predominance (57.5%) was observed in our study. Eighty five percent (85%) patients had total body surface area burn (TBSA) 20% to 50%. Sixteen patients (40%) suffered from flame burn, 13 (32.5%) patients from scalds and 11 (27.5%) patients had high voltage electric burn. The value of FDP was raised in 62.5% patients, D- dimer in 67.5% patients. Serum procalcitonin level was high (&gt; 2ng/ml), indicating burn sepsis in 47.5% cases but it was not significant (2 sample t – test reveals no significant relationship between rise of serum level of procalcitonin and presence of burn sepsis) Conclusion: Fibrin degradation product (FDP) and D- dimer were raised in two-thirds of burn cases while procalcitonin in two-fifths cases. Measurement of serum level of FDP, Ddimer and procalcitonin may give an idea regarding early onset of bacterial infection and burn sepsis and can serve as an indicator for burn sepsis. J Bangladesh Coll Phys Surg 2023; 41: 193-197

Retrospective analysis of clinical presentation and outcome of COVID-19 in hemodialysis patients in a tertiary care hospital from South India

COVID-19 (SARS-CoV-2) imposed a serious health challenge to patients on maintenance hemodialysis in developing countries like India. We are presenting our clinical experience, dialysis unit management and outcome of COVID-19 during this pandemic period (April 2020-May-2021). Thisretrospective study was conducted on 60 patients admitted in our hospital due to COVID-19 infection. Patients were treated based on our institutional management protocol. For all patients, Blood sugar, complete haemogram, Blood urea, Serum Creatinine, Serum Electrolytes, Liver function test, serum C-reactive protein (CRP), Serum ferritin, D-Dimer level were done and CT- chest was done to assess the severity of lung involvement.: Sixty patients on maintenance hemodialysis were admitted (n=60) in our hospital with COVID -19 and 32 (52.4%) were in mild, 14 patients each in moderate and severe categories. A spectrum of clinical presentations among the categories were asymptomatic in 23 (38.3%) patients, 20 (33.3%) had fever with cough and 17 (28.4%) had breathlessness. Males were 41 (68.3%), mean age was 53.81±12.77yrs. Median dialysis vintage was 27.7 (13.8-41.5) months and mortality rate 10%. Remdesivir was administered in 17 patients (28.3%). Neutrophil lymphocyte ratio (NLR), D-Dimer levels were significantly elevated with disease severity (&amp;#60;0.05) and Serum CRP and D-Dimer levels were significantly elevated among the mortality cases (&amp;#60;0.05). Mortality was low in this study group (10%), NLR; D-Dimer levels were significantly elevated with disease severity. Serum CRP and D-Dimer levels were significantly elevated in the mortality group.

The effects of functional foods mixture on inflammatory cytokines and biochemical findings in hospitalized patients with COVID-19: a randomized double-blind controlled trial

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has been shown to affect nutritional recommendations. Some functional foods have been demonstrated to be useful in the treatment of people with COVID-19. However, little is known about the impact of combining functional foods on disease control. This study aimed to investigate the effects of functional foods mixture on serum levels of inflammatory cytokines and biochemical findings in patients with COVID-19.MethodsA randomized double-blind controlled trial was conducted in Baqiyatallah Al-Azam hospital in Tehran, Iran. Sixty patients were randomly assigned to receive either a soup containing functional foods (n = 30) or a usual soup (control group) (n = 30). Participants’ sociodemographic information was gathered using a general questionnaire. Blood levels of inflammatory markers and biochemical findings were assessed using standard protocols.ResultsThe results showed that soup containing functional foods was more effective in controlling serum levels of D-dimer, blood urea nitrogen, and creatinine than the control group (P < 0.05). Also, more significant improvement was found in the intervention group vs control group in terms of interleukin (IL)-1β, IL-6, IL-17, IL-10, and tumor necrose factor-α (P < 0.05). In contrast, the control intervention more efficiently controlled potassium levels and reduced quantitative C-reactive protein than the intervention group (P < 0.05).ConclusionsThis study indicates a soup containing functional foods could alleviate biomarkers of inflammation in patients with COVID-19. However, its effectiveness on biochemical findings remained inconclusive which warranted further research.Trial registrationIRCT, IRCT20180201038585N11. Registered 23 August 2021, https://www.irct.ir/trial/57338

Analysis of different risk factors of hospitalized COVID-19 patients from North-Eastern Bangladesh

&lt;b&gt;Background:&lt;/b&gt; In Bangladesh, fighting with the delta sub variety of SARS-CoV-2 was most difficult than its previous and following waves. The aim of this study is to shed light upon different risk factors of COVID-19 and their influences across age-groups inpatients in North-Eastern Districts.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; In this case control study, we included 75 positive and 24 negative patients admitted to Jalalabad Ragib Rabeya Medical College and Hospital, Sylhet, Bangladesh from 1&lt;sup&gt;st&lt;/sup&gt; August to 30&lt;sup&gt;th &lt;/sup&gt;September 2021. Different demographic, clinical and radiographic data were collected, analyzed, and compared between/among patients to assess diseases severity.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; On average patients with COVID-19 were more likely to display remarkably 4, 1.3, and 1.5 times higher serum D-dimer, C-reactive protein, and ferritin level compared to non-COVID-19 people. Higher number of elderly inpatients from the age of 40; specially 60 years and older accounted for the abnormal rise of the aforesaid biochemical risk factors. This age range was also concerning for intensive care unit admission and multiple biomarker elevation. Nevertheless, the percentage of hospitalized COVID-19 patients with hypertension and diabetes is calculated 45% and 30.3%. Alarmingly, 96% of our patients showed COVID-19 assisted lung abnormalities diagnosed by computerized tomography scan and hither the order for degree of damage was bilateral consolidation&amp;gt;ground-glass opacity&amp;gt;pulmonary lesion&amp;gt;chronic obstructive pulmonary disease&amp;gt;cardiomegaly.&lt;br /&gt; &lt;b&gt;Conclusions: &lt;/b&gt;Age is the principle demographic risk factor of COVID-19, and it has positive correlation with different hospital outcomes, biochemical risk factors, abnormal radiographic manifestations and comorbidities.

Risk factors for pulmonary embolism in lung cancer patients with lower limb deep venous thrombosis: a case-control study.

There is growing evidence that misdiagnosis contributes to the high mortality rate in lung cancer patients complicated with pulmonary embolism (PE). This current study analyzed predictors of PE in lung cancer patients with lower extremity deep venous thrombosis (DVT) with the aim of personalizing the treatment and management of patients with PE. This retrospective case-control study included lung cancer patients with DVT at the emergency department of Shanghai Chest Hospital from January 2018 to December 2019. Patients were classified as having DVT with or without PE. The following characteristics were examined, including age, gender, smoking, hypertension, surgical trauma, hyperlipidemia, long-term bedridden status, calf swelling, coronary heart disease, chronic pulmonary disease, DVT location, DVT type, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, and D-dimer, and univariate and multivariate analyses were performed. A total of 90 patients with lung cancer and DVT were analyzed, of whom 60% (54/90) had PE. Those variables independently associated to PE were hypertension [odds ratio (OR): 7.883, 95% confidence interval (CI): 2.038-30.495, P=0.003], long-term bedridden status (OR: 4.166, 95% CI: 1.236-14.044, P=0.021), and D-dimer levels (OR: 2.123, 95% CI: 1.476-3.053, P=0.000) were identified as independent risk factors for PE. The cut-off value of the receiver operating characteristic (ROC) curve for predicting PE by presented scoring system according to the risk factors was 1.5 and the area under the curve (AUC) was 0.84 (P<0.001). Hypertension, being bedridden for an extended period, and elevated serum D-dimer levels were independent risk factors of PE in lung cancer patients with lower extremity DVT. Novel strategies for patient management should be developed to decrease the risk of PE.

Role of the score for the targeting of atrial fibrillation (STAF) combined with D-dimer in screening ischemic stroke patients with atrial fibrillation.

We aim to explore the effect of the score for the targeting of atrial fibrillation (STAF) combined with the serum D-dimer (DD) level in screening acute ischemic stroke patients with atrial fibrillation (AF). This study is a retrospective case observation study. This study consecutively selected patients with acute ischemic stroke who were hospitalized in the Department of Neurology at Zhuhai Hospital Affiliated with Jinan University from February 2019 to February 2021. Venous blood was drawn from all patients within 24 hours of hospitalization for DD detection. In accordance with the medical records, the patients were classified into an AF group and a non-AF group and were scored according to the STAF standard. A combined test method was used to estimate the diagnostic screening value of the STAF combined with the DD value for acute ischemic stroke patients with AF.