Predictors of severity in COVID-19

Background: In the context of home monitoring of severe acute respiratory syndrome coronavirus-2 disease (COVID-19) patients, it is imperative to evaluate the accuracy of finger pulse oximetry oxygen saturation (SpO2) in the assessment of hypoxia. Methods: Retrospective data analysis was performed on (n = 132) hospitalised COVID-19 patients with various levels of severity, in whom SpO2, haematological, biochemical and arterial blood gas (ABG) parameters were measured within 48 h after admission. Discrepancy between SpO2 and arterial blood oxygen saturation SaO2 was compared between mild, moderate and severe COVID-19 to assess the accuracy of finger pulse oximetry. Results: We found that total white blood cell count, neutrophil %, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, ferritin, C-reactive protein and lactate dehydrogenase (LDH) were significantly increased in severe COVID-19, while lymphocyte % was significantly less when compared to mild and moderate cases. Multivariable analysis suggested that red cell distribution width (RDW) and LDH together account for significant variance in the severity of disease. The SpO2 and SaO2 were significantly less in the severe group. The difference between SpO2 and SaO2 has a clinically meaningful albeit statistically nonsignificant trend with the discrepancy greater in severe COVID-19 cases when compared to mild and moderate cases. Conclusions: Finger pulse oximetry has the potential to underestimate the severity of hypoxia in severe COVID-19 and this has implications in the decision to start oxygen therapy. RDW and LDH constitute the best parsimonious set of variables to predict severity.

Effect of synbiotics on inflammatory markers and white blood cell count in COVID-19 patients: a randomized, double-blind, placebo-controlled clinical trial. (Special Issue: The relationship between nutrition and COVID-19.)

Purpose: Today, coronavirus disease-19 (COVID-19) treatment is an evolving process, and synbiotic administration has been suggested as a new therapeutic strategy. This study aims to investigate the effect of synbiotic supplementation in COVID-19 patients. Design/methodology/approach: In this placebo-controlled trial, 80 patients were randomized to receive oral synbiotic capsule (containing fructooligosaccharide and seven bacterial strains;Lactobacillus (L) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium longum, L. bulgaricus, each one 109 colony-forming units) or placebo for two months. Inflammatory markers (Interleukin-6 [IL-6], C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) and white blood cell (WBC) count were evaluated at two timepoints (baseline, two months later). The measured variables were adjusted for confounders and analyzed by SPSS v21.0. Findings: All 80 enrolled patients completed the study. The study adherence was good (approximately 70%). The mean changes for IL-6 were not significant ( = -0.6 +or- 10.4 pg/mL vs = +11.2 +or- 50.3 pg/mL, p > 0.05). There were no significant improvements for CRP, ESR and WBC. Originality/value: Administration of synbiotics for two months did not improve inflammatory markers in COVID-19 patients.

Special issue: The role of laboratory medicine in predicting the survival, progression and mortality of patients with corona virus disease 2019 (Covid-19). (Special issue: The role of laboratory medicine in predicting the survival, progression and mortality of patients with corona virus disease 2019 (Covid-19).)

This special issue contains 8 articles that explore various latest research on COVID-19, including the clinical presentation of the disease, the role of inflammation, the development of new treatments, and the long-term effects of the infection. The topics covered include the evaluation of white blood cell parameters and their significance in COVID-19 patients in Western Maharashtra, India;the association between acute phase reactants and COVID-19 severity and mortality in a tertiary care hospital in India;the clinico-hematological profile of COVID-19 patients from an Indian perspective;the correlation between C-reactive protein test results and clinical characteristics in COVID-19 patients;the effective binding affinity of an inhibitor against the SARS-CoV-2 NSP13 helicase;the assessment of absolute neutrophil count in COVID-19 patients in a tertiary care hospital;the analysis of the anti-SARS-CoV-2 IgG response following the first and second dose of a COVID-19 vaccine;and a case report discussing the diagnostic dilemma of hypoplastic acute myeloid leukemia in a COVID-19 patient.

Correlation between C-reactive protein (Crp) level and clinicoradiological profile in COVID-19 patients admitted in a tertiary care hospital in eastern India

Background: Coronavirus disease 2019, first reported in December 2019 mainly presented with the symptoms of Cough, Fever, Shortness of breath, Myalgia, Weakness and anosmia. C-reactive Protein (CRP) is an acute-phase reactant protein which is synthesized by the liver in response to raised levels of interleukin-6 (IL-6) which is a biomarker of inflammation. Methods: This was a prospective observational study, done on 110 COVID-19 patients after applying inclusion and exclusion criteria. Detailed history, vaccination status, presence of comorbidities and thorough clinical examination was performed. Serum CRP levels was assessed and Computed Tomographic scan (CT scan) of Thorax was done. CORADS scoring and CT severity grading as per CT scan was done. All the above parameters were recorded in the preformed proforma and data was entered in excel spreadsheet and was analysed using SPSS v26 software. Results: Majority were males (56.3%) and majority were from 61-80 years of age. Majority (57.3%) patients were non-smokers. Hypertension was the most common associated comorbidity (86.4%) (r=0.743, p=0.000). There is a strong positive correlation between CRP levels and CTSS in COVID 19 patients and a strong negative correlation between the CRP levels and outcome of COVID-19 patients (r=-0.449, p=0.000). Conclusion: Elevated serum CRP value is associated with disease progression and poorer outcome.

C-reactive protein lymphocyte index in COVID-19: a little-explored tool

Background: COVID-19 develops severe inflammatory responses that can lead to death. It is essential in a pandemic to have accessible instruments to estimate the prognosis of the disease. The lymphocyte-to-C-reactive protein ratio (LCR) is a predictive biomarker studied in oncology, which could have some advantages in COVID-19 patients in the early stages of the disease. Our objective was to estimate the risk of LCR < 100 and mortality in hospitalized patients with COVID-19. Methods: hospitalized patients with COVID-19 seen between March to October 2020 were included. The patients were grouped according to LCR < 100 and LCR > 100. A Cox regression model was performed to estimate the association between LCR < 100 and mortality. Results: we included 730 patients with COVID-19. The mean age at diagnosis was 49.9 years (SD 16.8) and 401 (55%) were men. Cox regression model showed an association between LCR < 100 and mortality (HR 6.2;95% CI 1.6 to 23.5;p 0.008), adjusting by age. severe pneumonia, intensive care requirements, and comorbidities. Conclusion: LPCR < 100 in the initial assessment of hospitalized patients with COVID-19 suggests a higher risk of mortality.

Incidence and predisposing factors for de novo post-COVID-19 irritable bowel syndrome

Objective: Postinfectious irritable bowel syndrome (IBS) is a known entity. We evaluated the incidence of post-COVID-19 IBS in patients discharged from the hospital and analyzed its correlation with the clinical and laboratory parameters, and treatment during the hospital stay. Methods: Three hundred three COVID-19 hospitalized patients without prior history of IBS were prospectively followed after their discharge and were evaluated as per Rome-IV criteria for IBS. Results: One hundred seventy-eight patients were males (58.7%). The age range was 17-95 years (mean +or- SD, 55.9 +or- 15.8). A total of 194 (64%) had mild COVID-19, 74 (24.4%) had moderate COVID-19, whereas 35 (11.6%) had severe COVID-19 infection. Sixteen (5.3%) patients had concomitant GI symptoms during COVID-19 infection. IBS symptoms were found to be present in 32 (10.6%) patients, out of which 17 (53.13%) had diarrhea-predominant, 10 (31.25%) had constipation-predominant, and five (15.62%) had mixed-type IBS. Post-COVID-19 IBS was more common in the female sex (P < 0.001), concomitant GI symptoms with COVID-19 (P < 0.001), oxygen requirement (P = 0.015), deranged liver function tests at the time of admission (P = 0.002), high procalcitonin (P = 0.013), high C-reactive protein levels (P = 0.035);whereas negative correlation was found with remdesivir treatment (P = 0.047). After performing regression analysis, female sex (P < 0.001), oxygen requirement during hospital stay (P = 0.016), GI symptoms during COVID-19 infection (P < 0.001), and high procalcitonin levels (P = 0.017) were independently associated with post-COVID-19 IBS. Conclusion: GI symptoms during active COVID-19 infection increase the chances of developing post-COVID-19 IBS. The risk of developing post-COVID-19 IBS increases in female patients, those requiring oxygen and having high procalcitonin levels during COVID-19 infection.

Clinical significance of serum interleukin 6 in elderly patients infected with severe acute respiratory syndrome Coronavirus 2 Omicron variant and its correlation with underlying diseases

Objective: To investigate the clinical significance of serum interleukin 6 (IL-6) in elderly patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant and its correlation with underlying diseases. Methods: A total of 22 elderly patients (> 80 years old) infected with omicron variant, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. to Jun. 2022 and tested positive for SARS-CoV-2 RNA, were included. The level of serum IL-6 was measured by flow cytometry, and the level of serum C reactive protein (CRP) was measured by immunonephelometry. Patients were divided into pneumonia group (16 cases) and non-pneumonia group (6 cases) according to the imaging examination results, and were divided into severe group (severe and critical type, 5 cases) and non-severe group (mild and normal type, 17 cases) according to the condition. Binary logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the correlation between serum IL-6 and CRP levels and the severity of the disease and whether it would progress to pneumonia. Meanwhile, the relationships between underlying diseases and serum IL-6 level were explored. Results: Among the 22 patients, 6 were mild, 11 were normal, 3 were severe, and 2 were critical. The baseline serum IL-6 level in the pneumonia group was significantly higher than that in the non-pneumonia group ([20.16+or-12.36] pg/mL vs [5.42+or-1.57] pg/mL, P=0.009), and there was no significant difference in baseline serum CRP level between the 2 groups (P > 0.05). There were no significant differences in baseline serum IL-6 or CRP levels between the severe group and the non-severe group (both P > 0.05). Logistic regression analysis showed that the baseline serum IL-6 and CRP might be related to pneumonia after infection with omicron variant (odds ratio [OR]=2.407, 95% confidence interval [CI] 0.915-6.328;OR=1.030, 95% CI 0.952-1.114). ROC curve analysis showed that the area under curve values of serum IL-6 and CRP in predicting the progression to pneumonia were 0.969 (95% CI 0.900-1.000) and 0.656 (95% CI 0.380-0.932), respectively, with statistical significance (Z=2.154, P=0.030). There were no significant differences in the baseline serum IL-6 level or proportions of severe patients or pneumonia patients among patients with or without hypertension, diabetes mellitus, coronary heart disease, chronic kidney disease or chronic obstructive pulmonary disease (all P > 0.05). The baseline serum IL-6 levels of the omicron variant infected elderly patients with 1, 2, and 3 or more underlying diseases were 12.50 (9.15, 21.75), 23.55 (9.63, 50.10), and 10.90 (5.20, 18.88) pg/mL, respectively, with no statistical significance (P > 0.05). Conclusion: For omicron variant infected patients, serum IL-6 level is significantly increased in patients with pneumonia manifestations and is correlated with disease progression. Serum IL-6 level is of great guiding significance to judge disease progression and evaluate efficacy and prognosis of elderly coronavirus disease 2019 patients.

Clinical application of blood cell subtype ratio and inflammatory indicators in COVID-19

Objective: To explore the application value of blood cell subtype ratio [neutrophil/lymphocyte ratio (NLR) platelet/lymphocyte ratio (PLR)], platelet/neutrophil ratio (PNR) and inflammatory indicators in clinical treatment and prognosis of coronavirus disease 2019 (COVID - 19) patients. Methods The blood routine and inflammatory data were collected from 47 hospitalized COVID- 19 patients and 30 healthy subjects and analyzed retrospectively, and the ratios of NLR, PLR and PNR were calculated. The differences of each index were compared between the two groups, and the variation trend of NLR, PLR and PNR were dynamically monitored during the course of disease. ROC curve was used to evaluate the diagnostic value of blood cell subtype ratio and inflammatory indicators. Results Compared with the control group, white blood cell (WBC) and lymphocyte (LYMPH) were decreased (Z =-3.578, -5.558, all P <0.05), and NLR, PLR, C-reactive protein(CRP), serum amyloid A(SAA) and SAA/CRP were increased in COVID-19 patients group (Z =-4.210, -5.087, -2.434, -5.263, -3.091, all /1/40.05). Trend analysis of NLR, PLR and PNR showed that NLR and PLR increased first and reached the peak, and gradually decreased with the improvement of patients' condition (x2=27.441, 38.699, all PC 0.05). ROC curve analysis results showed that the area under curve (AUC) of SAA, PLR, NLR and CRP were 0.855, 0.845, 0.786 and 0.662, respectively. Conclusions The combination of NLR, PLR, SAA and CRP could reflect systemic inflammatory status of patients, and had good clinical diagnostic value for disease monitoring and prognosis.

Carcinoembryonic antigen (CEA) and other surrogate inflammatory biomarkers in COVID-19

It has been two years since the global outbreak of the highly contagious and deadly corona virus disease (COVID-19) caused by SARS-CoV-2 first emerged in China. Since then, various diagnostic, prognostic and treatment strategies undertaken to address the pandemic have been dynamically evolving. Predictive and prognostic role of various biomarkers in COVID-19 has been a subject of intense exploration. We aimed to determine the association of Carcinoembryonic antigen (CEA) and various surrogate inflammatory biomarkers with the severity of COVID-19 disease. This retrospective cohort study was carried out on 98 patients admitted in Jaypee Hospital, Noida with COVID-19 disease. Information regarding demographics, laboratory parameters and clinical history was collected from Hospital Information System. Serum levels of CEA and other biomarkers such as Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), Interleukin-6 (IL-6), Ferritin, and Procalcitonin (PCT) were assessed. Correlation analyses were performed between the parameters and acute respiratory distress syndrome (ARDS) stages. Logistic regression and ROC curve analysis were performed to assess the various parameters for distinguishing COVID-19 patients requiring ICU admission. Mean hospital stay, NLR, CEA, IL-6, CRP, Ferritin (P < 0.0001) and PCT (P = 0.01) were significantly higher in ICU patients when compared to general ward patients. NLR, median serum CEA, IL-6, and CRP levels were significantly higher in non-survivor compared to the survivors (P < 0.0001, 0.0341 and 0.0092). CEA correlated well with disease severity based upon ARDS classification and was a better marker to differentiate patient according to ARDS stages (ARDS 0 vs 2 P = 0.0006;0 vs 3 P < 0.0001;ARDS 1 vs 2 P = 0.0183;1 vs 3 P = 0.0006). The area under the Receiver operating characteristic (ROC) curve for CEA was 0.7467 (95% CI- 0.64885- 0.84459) which revealed the potential of CEA as a biomarker to distinguish COVID-19 patients requiring ICU admission. CEA can be used to predict the severity of COVID-19 associated ARDS as well as patients requiring ICU admission. Along with routine inflammatory biomarkers (NLR, CRP, IL-6, PCT, and ferritin), CEA should be used for early identification of critical COVID-19 positive patients and for assessing prognosis.

Principles of glucocorticosteroid administration in patients with COVID-19

Introduction. This article discusses the treatment of coronavirus infection (COVID-19) with glucocorticosteroid drugs (GCS), side effects of drugs and their prevention, transfer from intravenous to intramuscular and then to oral administration, and the development of withdrawal syndrome. The article describes the conditions under which antibiotic therapy is prescribed, as well as the conditions under which the combined use of corticosteroids and antibiotics is necessary. Aim. The aim to analyze the basic principles of corticosteroids prescribing in the treatment of COVID-19: indications for corticosteroids administration, administration regimens and required dosages, side effects of corticosteroids administration. Material and methods. The article uses data from the Interim Guidelines for the Prevention, Diagnosis and Treatment of New Coronavirus Infection (COVID-19), the Federal Clinical Guidelines for the Specialty "Rheumatology", as well as using the literature on basic and clinical endocrinology, cardiology and pharmacology. The work was written using a systems approach, methods of analysis, induction and observation. Results and discussion. Systemic corticosteroids are used in cases of severe and critical course of the disease COVID-19 (confirmation may be an increase in ferritin, procalcitonin, C-reactive protein (CRP), decreased cognitive functions, development of sopor). Their appointment is also justified when the initial course of the disease was not diagnosed as severe, but suddenly the patient's condition deteriorated. The use of antibiotic therapy is advisable when a bacterial infection is attached - (procalcitonin (PCT) > 0.5 ng / ml, purulent sputum, leukocytosis> 12 x 109 / L (in the absence of previous use of glucocorticoids), an increase in band neutrophils of more than 10%). In the presence of chronic infectious diseases in patients with COVID-19 (for example, chronic obstructive pulmonary disease-COPD, chronic pyelonephritis, etc.), antibiotics are prescribed to prevent exacerbations of these diseases. Conclusion. In the course of the study, the authors of the article formulated the following principles of glucocorticoid therapy: drugs should be prescribed according to strict indications;maximum doses are applied in a short course;when the patient's condition is stabilized, it is necessary to reduce the dose in a timely manner and gradually to complete withdrawal to prevent the development of "withdrawal" syndrome, adrenal insufficiency of central genesis, sympathoadrenal crises;during and after treatment, prevention of complications of glucocorticoid therapy (hyperglycemia, hypocalcemia, osteopenia, inflammatory diseases of the urinary system) is recommended;collegial management of patients by infectious diseases and endocrinologists is mandatory.

Impact of acute kidney injury in COVID 19 infected patients

Background: Corona virus disease 2019 (covid-19) is a novel disease caused by a newly identified virus, severe acute respiratory syndrome corona virus 2 (sars-cov-2). The novel disease which begun in Wuhan, China in Dec 2019 was declared pandemic by world health organization on 11 march 2020. The most common reported reasons for intensive care unit admission for patients with severe corona virus disease 2019 (covid-19) are either hypoxemic respiratory failure leading to mechanical ventilation or hypotension requiring vasopressor support. Data on AKI are either lacking in this perspective, we emphasize that AKI can be a severe complication of covid-19 and highlight the importance of assessing, defining, and reporting the course of AKI in patients admitted in intensive care unit. Methods: This is a single centre retrospective observational study. 542 patients with real time-PCR and rapid antigen test confirmed COVID 19 infection admitted in KIMS intensive care unit, Hubballi were taken for study. Patients with chronic kidney disease were excluded from the study. Clinical examination and laboratory investigations including renal function test, liver function test, complete blood count, chest x-ray, d-dimer, ferritin, LDH, CRP was done for all the patients. Duration: 1 year (2020 August -2021 July) Results: Out of 542 patients, 166 patients developed acute kidney injury accounting for 30.62%. 145 patients died (87.47) who had acute kidney injury. And 27 patients were discharged (12.6%) who recovered from acute kidney injury. Results: Among the patients who did not developed AKI(376) .300(79.81) died and 76(20.2) got discharged. The p value was 0.034 which was significant for increase in mortality among patients who developed AKI. The incidence of mortality among COVID patient admitted to KIMS ICU was 82.1%. Conclusion: The mortality was significantly higher in COVID patients developing AKI. So we can predict the outcome in COVID infected patients who develops acute kidney injury. AKI is one of manifestation in COVID patients due to tropism of corona virus to ace receptors present in kidney.

Clinical characteristics of 95 patients with severe coronavirus disease 2019

Objective: To retrospectively analyze the clinical characteristics of 95 patients with severe coronavirus disease 2019 (COVID-19) admitted to Hankou Hospital of Wuhan, and provide evidence for clinical diagnosis and treatment of severe cases. Methods: From January to March 2020, 95 patients with severe COVID-19 were admitted to a designated Hankou Hospital of Wuhan. The clinical manifestations, laboratory examinations, chest CT, respiratory support, drug treatment, and outcomes were collected and analyzed. Results: Among the 95 patients, there were 76(80.0%) severe cases (severe group) and 19 (20.0%) critically ill cases (critically ill group);the average ages of the two groups were (56.9 .. 14.0) and (66.2 .. 14.1) years old, respectively. The main symptoms included fever [85 (89.5%)], cough [73 (76.8%)] dyspnea [57 (60.0%)], sputum expectoration [32 (33.7%)], diarrhea [20 (21.1%)], etc. The initial symptom was fever [64 (67.4%)], followed by cough [17 (17.9%)]. The main comorbidities were hypertension [29 (30.5%)], diabetes [18 (18.9%), coronary heart disease [12 (12.6%)], etc. Liver injury was the most frequently seen complication which occurred in 35 patients (36.8%), while myocardial damage in 20 patients (21.1%), heart failure in 10 patients (10.5%), and renal damage in 8 patients (8.4%). The level of urea nitrogen [7.5 (3.1-36.6) mmol/L], creatinine [88.0 (46.0-681.0) mol/L], aspartate aminotransferase (AST) [49.0 (8.0-2 290.0) U/L], total bilirubin [12.4 (6.8-112.4) mol/L], white blood cells [8.7 (2.7-16.3) .. 109], neutrophil count [7.9 (1.0-14.6) .. 109/L], high-sensitivity C-reactive protein (hsCRP) [35.6 (0.1-37.9) mg/L] and procalcitonin (PCT) [0.3 (0.1-9.6) ng/mL] in the critically ill group were higher than the severe group [4.5 (1.5-14.6) mmol/L, 70.0 (34.0-149.0) mol/L, 30.5 (10.0-184.0) U/L, 7.8 (1.4-24.5) mol/L, 4.5 (1.7- 10.7) .. 109/L 3.1 (0.6-9.1) .. 109/L, 31.8 (0.1- 40.4) mg/L, 0.1 (0.0- 1.2) ng/mL], and the difference were statistically significant (P all < 0.05);the albumin level reflecting nutritional status [30.2 (24.6-36.4) g/L] was lower than the severe group [35.2(23.5-44.5)g/L], and the difference was statistically significant (P < 0.001). Chest computed tomographic scans showed bilateral ground glass opacity or patchy shadows in the lungs of all patients. A total of 77 patients (82.1%) were discharged, and 13 patients (13.7%) died;of which, the mortality of the critically ill group was 68.4% (13 out of 19). Conclusions: The majority of patients with severe COVID- 19 were elderly. The main clinical manifestations were fever, cough, and dyspnea. Most patients had underlying diseases such as hypertension, diabetes and coronary heart disease. The occurrence of organ dysfunctions such as liver injury, cardiac damage, heart failure and kidney injury might be an important cause of death. The mortality of severe patients with COVID-19 was high, and treatment was even tough.

The relationship of laboratory parameters and rates with prognosis and mortality in COVID-19 infection

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.

Relationship with domestic spread and progression of COVID-19 in children

Objective: SARS-CoV-2 infection in children is usually mild, so the real positivity rate and the effect on children's virus spread are not excatly known. The purpose of this study is investigate the effect of children on the spread of COVID-19. Material and Methods: Children who were followed up and treated with a pre-diagnosis of COVID-19 between April and June 2020 were included in this study. The protocol for this retrospective study was approved by the Ministry of Health, Turkey, and the ethics committee of a university medical school. Data were collected retrospectively from the hospital medical system. Data analysis was done with IBM SPSS v21.0 statistical program. Categorical variables were expressed as n and %, while numerical variables were expressed as mean +or- std and median (min-max). The conformity of the data to the normal distribution was analyzed with the Kolmogorov Smirnov test. Chi-square test and Fisher's exact test were used in the analysis of categorical variables. In comparisons between groups, Independent-t and Mann-Whitney U tests were used. For correlation between continuous variables, Pearson and Spearman correlation coefficients were used. p< 0.05 was accepted for statistical significance.

Evaluation of inflammatory markers in COVID-19 disease in children

Objective: This study aims to determine the prognostic values of biomarkers obtained from complete blood count in the diagnosis of the coronavirus disease of 2019 (COVID-19) patients who came to the pediatric emergency department of Diyarbakir Pediatric Hospital. Material and Methods: A total of 190 child patients with COVID-19 with definite diagnosis and 41 healthy children as a control group were included in this study. The lymphocyte count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), C-reactive protein (CRP), neutrophil- lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) obtained from the patients' complete blood count were evaluated.

Correlation between severe COVID-19 and type 2 diabetes mellitus

Objective: To investigate the changes and significance of various indicators in patients with severe coronavirus disease 2019(COVID-19)pneumonia combined with type 2 diabetes mellitus(T2DM), and provide a theoretical basis for early clinical disease prediction, diagnosis and treatment. Method: A retrospective analysis of 80 patients with severe COVID-19 pneumonia in Wuhan Ninth Hospital from January to April 2020, among them, 42 cases were combined with type 2diabetes mellitus(COVID-19 combined with T2DM group), and 38 cases were not combined with type 2 diabetes mellitus(COVID-19 without T2DM group), including age,gender, medical history, laboratory examinations, and disease outcome were analyzed.

COVID pneumonia in patients admitted to the Department of Pneumology, Second Faculty of Medicine, Charles University and University Hospital in Motol during the first and fourth pandemic waves

In the last two years, COVID pneumonia has frequently been dealt with by both outpatient and inpatient pulmonology centers. To describe the actual situation, we conducted a retrospective study including 200 patients admitted to the Department of Pneumology, Second Faculty of Medicine. Charles University and University Hospital in Motol during the first (autumn 2020) and fourth (autumn 2021) waves of the COVID-19 pandemic. Of those, 25% of patients died, significantly more in the first wave (33%) than in the fourth wave (17%). The mean age of the deceased was 76 years. as compared with 67 years in the entire sample. The risk factor for admissions was. besides older age, a higher number of comorbidities, with 38% of patients being obese. A negative prognostic factor was high C-reactive protein. There were fewer deaths among patients treated with remdesivir (18% vs. 30%) and those with a body mass index over 31 (17% vs. 30%). Two thirds of patients died of COVID-19;one third died with the disease. Vaccination was beneficial for patients in the fourth wave. with significantly fewer of them dying. staying in intensive care units and requiring mechanical ventilation or extracorporeal membrane oxygenation. COVID pneumonia is a severe, life-threatening disease whose course was positively influenced by vaccination. treatment and herd immunity through previous infection.

Clinical characteristics of persons infected with imported SARS-CoV-2 omicron variant in Tianjin

Objective: To investigate the epidemiological, clinical and imaging characteristics of SARS-CoV-2 infection caused by Omicron variant.

Relationship between fever and early clinical diagnosis and treatment in mild COVID-2019 patients

Objective: To investigate the relationship between clinical manifestations, blood testing, chest CT, treatment and fever of 457 mild cases of COVID-19.

Changes and application value of clinical laboratory routine testing indicators in patients with diabetes mellitus complicated with corona virus disease 2019

The study's objective was to examine the clinically significant changes in regular laboratory testing in individuals with diabetes mellitus complicated by corona virus illness in 2019. (COVID-19). Methods From January 21 to March 2, 2020, the Department of Infectious Diseases at Nanyang Central Hospital in the Henan Province received test results from COVID-19 patients. The patients were split into two groups: those with diabetes mellitus (DM) and those without diabetes mellitus (NDM). The Mann-Whitney U test and the Kruskal-Wallis H test were used to assess the differences between the two groups, and the risk variables for patients with severe conditions were examined using logistic regression analysis. In the non-DM group, there were 36 instances, while in the DM group, there were 17 cases. The age difference between the DM group and the non-DM group was statistically significant (t=3.31, P=0.001), with the DM group's age being 59.12 10.92 years as opposed to the non-DM group's age being 45.03 16.73 years. The neutrophil count, FIB, D-dimer, C-reactive protein, and interleukin-4 levels of the DM group were significantly higher than those of the non-DM group, while the lymphocyte count was significantly lower. The differences were statistically significant (t=2.45 3.40, all P 0.05), and the lymphocyte count was lower than the neutrophil count in both groups. The percentage of severe COVID-19 (58.80% vs. 16.67%) and hospital stay (15.18 vs. 10.39 vs. 5.82 days) were both statistically significantly greater in the DM group than in the non-DM group. After correcting for gender and age, it was shown that lymphocyte count and diabetes were separate risk factors for patients with severe COVID-19. COVID-19 patients with diabetes had a more prominent inflammatory response and were in a hypercoagulable condition. For them, individualized hypoglycemic treatment should be used.