Correlation of serum interleukin-6 levels and neutrophil-lymphocyte ratio in the severity of COVID-19.

Background: Interleukin-6 (IL-6) is a pro-inflammatory cytokine that is produced at varying levels in patients with coronavirus disease 2019 (COVID-19). The neutrophil-lymphocyte ratio (NLR) is one of the new inflammatory markers of COVID-19. This study aimed to evaluate the differences in IL-6 level and the NLR in mild and severe COVID-19 and assess their correlation with COVID-19 severity and the correlation of IL-6 and NLR in COVID-19. Methods: A total of 91 patients with COVID-19 were divided into mild (n = 57) and severe (n = 34) COVID-19 groups. IL-6 levels were measured using the electrochemiluminescence immunoassay method on Roche Cobas e411. The NLR was the ratio of the total neutrophil and lymphocyte counts from complete haematology on the Sysmex XS-800i. Data were analysed using the Kolmogorov-Smirnov, Mann-Whitney, receiver operating characteristic curve, chi-square and Spearman correlation tests. The statistical test was significant at p <0.05. Results: Serum IL-6 levels and NLR significantly differed in mild and severe COVID-19. The median (min-max) IL-6 levels for mild and severe COVID-19 were 3.59 (1.50-638.30) pg/mL and 28.82 (5.52-926.30) pg/mL, respectively (p <0.001). The median (min-max) NLR in mild and moderate COVID-19 was 2.18 (0.69-15.58) and 8.13 (2.24-30.90), respectively (p <0.001). The obtained cut-off values for IL-6 and NLR were >6.99 pg/mL and >4.18, with odds ratios of 29.29 and 26.19, respectively. A positive correlation was found between IL-6 and NLR and COVID-19 severity (r = 0.612; p <0.001). Conclusions: The results indicated that serum IL-6 levels and NLR are higher in severe COVID-19 than in mild COVID-19. Patients with IL-6 levels >6.99 pg/mL and NLR >4.18 are 29 and 26 times more likely to suffer from severe COVID-19, respectively. Serum IL-6 levels and NLR are strongly correlated with COVID-19 severity. Serum IL-6 levels correlate with NLR in COVID-19.

Insulin resistance and testosterone level in Indonesian young adult males.

INTRODUCTION: Central obesity is characterized by the accumulation of abdominal fat which may lead to several diseases including insulin resistance. The prevalence of central obesity is higher in male and the incidence in young adult males is increased. Central obesity is also related to low testosterone levels. The research aimed to assess the relationship between the testosterone levels and insulin resistance of young adult males with central obesity. METHODS: This was a cross-sectional study, the subjects were young adult males of 18 to 25 years old. The central obesity consisted of 50 samples and non-central obesity comprised 70 samples. The examination of testosterone and insulin was performed by the ECLIA method, glucose used the enzymatic method, the insulin resistance was calculated by using the HOMA-IR index. RESULTS: The mean of the testosterone level in central obesity was lower than non-central obesity (5.24 + 1.17 vs 7.18 + 1.54 ng/mL, p < 0.001). HOMA-IR index in central obesity was higher than non-central obesity (4.29 + 2.23 vs 2.46 + 1.72, p < 0.001). Testosterone levels had negative correlation with HOMA-IR (r = -0.470, p < 0.001). There was significant difference in HOMA-IR among the quartiles of testosterone levels. CONCLUSION: There is negative correlation between testosterone level with HOMA-IR, the lower the testosterone level the higher the insulin resistance in young adult males.

Mortality risk of bloodstream infection caused by either Escherichia coli or Klebsiella pneumoniae producing extended-spectrum ß-lactamase: a prospective cohort study.

OBJECTIVE: Several studies reported that infection of extended-spectrum ß lactamase (ESBL)-producing Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae) contributed to higher mortality rates but others found it was not associated with mortality. A prospective cohort study which involved 72 patients was conducted to assess the risk of mortality of bloodstream infection due to ESBL-producing K. pneumoniae or E. coli as compared to those infected by either K. pneumoniae or E. coli which not produce ESBL. RESULT: Mortality in the group of patients infected with ESBL-producing bacteria was 30.6%, whereas in another group which was infected with non ESBL-producing bacteria was 22.2% (p = 0.59). Kaplan-Meier's analysis showed that the survival rate during 14-days follow-up among these two group was not significantly different (p = 0.45) with hazard ratio 1.41 (95% CI 0.568-3.51). Stratification analysis found that adult and elderly patients, patients with sign of leukocytosis, and patients treated with carbapenem were modifier effect variables.

Hyperglycemia as a prognosis predictor of length of stay and functional outcomes in patients with acute ischemic stroke.

BACKGROUND: Hyperglycemia has been shown to influence prognosis outcome of stroke. The objective of this study was to determine the correlation between hyperglycemia with length of stay (LOS) and functional outcomes in ischemic stroke patients. This is the first study to correlate hyperglycemia in ischemic stroke patients with their functional outcome as assessed by using Barthel index. METHODS: This is a prospective cohort study of patients admitted to the Stroke Unit of Dr. Sardjito General Hospital for ischemic stroke from January 2012 to June 2014. Subjects were selected in a consecutive manner until the required number of subjects was obtained. Data collected from medical records included the baseline social demographic variables and clinical variables. Bivariate and multivariate analyses with multiple linear regression analysis were used to identify correlation between hyperglycemia with LOS and functional outcomes. RESULTS: In total, 208 patients were included, of which 126 (60.6%) were men. The mean age was 61.18 (SD = 10.45), and the mean LOS in our study was 4.52 (SD = 5.89) d. For the univariate analysis, factors associated with LOS were history of diabetes (p = 0.003), urinary tract infection (p = 0.025), hyperglycemia (p < 0.001) and moderate to severe Barthel index on admission (p < 0.001), and the independent factor was hyperglycemia (ß: 6.212, p < 0.001) based on multivariate analysis. Furthermore, hyperglycemia was an independent factor of functional outcomes as measured with Barthel index (ß: 9.185, p < 0.001). CONCLUSIONS: Hyperglycemia is a prognosis predictor of LOS and functional outcomes of patients with acute ischemic stroke measured by discharge Barthel index.