Assessment of liver function in COVID-19

Introduction: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that commonly involved the respiratory system. However, the virus can affect any organ in the body including the liver. Hepatic involvement in COVID-19 could be related to the direct cytopathic effect of the virus, an uncontrolled immune reaction, sepsis, or drug-induced liver injury. Background: The current study aims to evaluate the relevance of liver enzyme derangement in COVID-19. Methods: The sample size of 165 patients, tested positive for covid 19 and underwent liver enzyme testing. These patients were categorized into mild, severe, and critical diseases based on clinical evaluation, radiological findings, and biochemical parameters. Results: Of 165 patients selected 103 (62.4%) have mild disease, 40(24.2%) have severe and 12(7.2%) suffered from the critical disease. 48(29.1%) patients show deranged liver function. 83.3% of critical patients and 45% of severe patients show deranged liver function.9.09%of patients died due to severe COVID-19 infections showing moderately to severe liver function derangement. Conclusions: This study concludes that the severity of COVID-19 disease may increase due to chronic liver disease, particularly fatty liver. Atypical ALT and AST levels during hospitalization were indicative of liver injury and correlated with the severity of patients.

Gastrointestinal features of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in selected referral hospitals in Iran

Background and purpose: Multisystem Inflammatory Syndrome in Children (MIS-C) occurs after having COVID-19. The severity and outcomes of COVID-19 with gastrointestinal symptoms are higher. The aim of this study was to investigate gastrointestinal manifestations in MIS-C patients in selected referral hospitals in Iran to obtain comprehensive information about the treatment and prevention of MIS-C. Materials and methods: In this cross-sectional study, all MIS-C patients <21 years in Dec 2019 to Oct 2021 were included. The patients were identified by the Centers for Disease Control and Prevention (CDC) checklist and data were analyzed applying t-test and Chi-square in STATA11. Results: There were 225 patients with a median age of 55 months (26-96 months), including 59.56% boys and all had fever on admission. At least one gastrointestinal symptom was seen in 200 patients and the most common symptoms were vomiting (60.9%) and abdominal pain (45.77%). Almost 60% of the patients had positive RT-PCR results. Among the patients with and without gastrointestinal symptoms 85.5% and 48% were admitted to intensive care unit (ICU), respectively. There were significant differences between the two groups in respiratory symptoms, ALT, AST, NT-pro BNP, ESR, and PLT (P < 0.05). All patients without gastrointestinal symptoms were discharged but nine patients in the group with gastrointestinal symptoms deceased. Conclusion: According to the current study, gastrointestinal symptoms are common in MIS-C patients and are associated with higher rates of death and intensive care unit admission. Therefore, in providing services to COVID-19 patients, all typical and atypical signs and symptoms should be considered to prevent unnecessary interventions.

Comparison of laboratory parameters during herpes zoster infection: a case-control study

Objective: We aimed to find the parameters that can change during herpes zoster infection and observe the relationship of these parameters throughout the disease. Material and Methods: We compared 40 herpes zoster patients and 2 separate control groups, who were healthy and had comorbidities similar in age and gender. Patient files were retrospectively analyzed, and laboratory parameters were compared between groups. The laboratory values of the patient group with herpes zoster were evaluated among themselves according to the duration of the symptoms. Results: Fasting glucose, creatinine, aspartate aminotransferase values, the percentage and the absolute number of monocytes, red blood cell distribution width-coefficient of variation, and C-reactive protein levels of the patients with herpes zoster were significantly higher, and the absolute number of lymphocytes, mean corpuscular volume and platelet distribution width levels were lower than the control groups. The percentage of monocytes in the first 5 days was significantly higher than in the following days, and hematocrit values were lower in the last days. Conclusion: Examining routine laboratory values during diseases may help diagnose the disease, especially in patients with faint clinical signs and zoster sine zoster. In addition, it may be useful to question patients with herpes zoster for renal dysfunction, rheumatological diseases, and malignancy.

Correlation between laboratory findings and clinical severity among the COVID-19 patients in the tertiary care centre

Background: Coronavirus is a highly infectious novel virus we are in urge to know more about their clinical characteristics and laboratory findings for the characterization and selection of treatment protocol. Methods: Prospective, single centre study. Two months data was collected, clinical characteristics data from patient case sheet and the laboratoryvalues from the Hospital Information System (HIS) for the month of July and August 2020. Results: Of 462 patients, 55 (11.9%) are falls under asymptomatic category, 194 (42%) are in mild category, 167 (36.1%) are in moderate category and 46 (10%) in severe category. Fever 230 (49.8%) and cough 211 (45.7%) was most common clinical symptom with p value < 0.01. Non-severe vs severe, 340 (73.6%) and 201 (43.5%) showed decreased in eosinophil count and absolute eosinophil count, 125 (27.1%) and 80 (17.3%) patient showed decrease in lymphocyte count and absolute lymphocyte count, 200 (43.3%) showed increase in neutrophil count with a significance of p value >0.05.186 (40.3%) patients had one or more co-morbidities. Laboratory findings between Asymptomatic VS symptomatic, showed significance changes in neutrophil, lymphocyte, Aspartate aminotransferase, Alkaline phosphatase, globulin values (p value <0.05). Conclusion: Clinical severity categorization at the time of admission was very helpful for the treating doctors in proper understanding of disease progression and appropriate treatment of the patient. Presence of co-morbidity, abnormal laboratory values, old age group patients, higher Computed Tomography score, higher mortality rate are seen more in patients who were in clinical severity grade severe category than in non-severe category patients.

Restrospective study of hemogram profile in effusive feline infectious peritonitis

Feline Infectious Peritonitis (FIP) is highly mortality disease in cats. The reliable and fast diagnosis is crucial to the best prognosis. The aim of this study to evaluate the hemogram profile in cats infected with effusive FIP. Twenty cats had been diagnosed effusive FIP at Animal Clinic Department of Internal Medicine, Faculty Veterinary Medicine, Universitas Gadjah Mada were used in the study. The diagnosis were based on clinical examination, ultrasound, x-ray, rivalta test, and rapid test. The hemogram profile were analyzed include routine hematology and serum biochemistry. Hemogram profile in effusive FIP showed the decreased hematocrit, hyperproteinemia, and leukocytosis with an average 22.9+or-7.4%;9.0+or-2.2 g/dL;22425+or-4116 cells/mm3 respectively. Erythrocyte, hemoglobin and fibrinogen levels were still in the normal range. The results of differential leukocytes revealed that 90% cats had neutrophilia and 75% lymphopenia with an average 20066+or-3337 cells/mm3 and 1861+or-1818 cells/mm3 respectively. The blood chemistry profile showed 60% of cats experienced increase in SGPT and SGOT with an average 138.4+or-72.3 IU/L and 101+or-60.5 IU/L respectively. Hyperglobulinemia was found in 90% samples with an average 6.7+or-0.8 g/dL. All cats have a low albumin:globulin ratio with an average 0.3+or-0.1. The hemogram profile of effusive FIP were: leukocytosis, neutrophilia, lymphopenia, hyperglobulinemia, and decreased albumin-globulin ratio..

Characteristics of albumin levels and liver function in patients with COVID-19 at H. Adam Malik Hospital, Medan

Background: COVID-19 (Corona Virus Disease-2019) pandemic has a high mortality rate especially in Medan, Indonesia. Serum albumin and liver function tests are believed to be predictive biomarkers for prognosis in patients with infectious diseases, including COVID-19. This study aimed to investigate the association between the mortality events and severely ill COVID-19 patients' serum albumin and liver enzymes. Method: This is a cross-sectional study using secondary data from the medical records of H. Adam Malik Hospital patients with COVID-19 who were confirmed by RT-PCR from August to December 2020. All patients were analyzed for age, sex, hypoalbuminemia, increased liver enzymes and outcome using Chi-square tests (P <0.05). Results: The average age of severe COVID-19 patients at H. Adam Malik Hospital ranged from 41 to 60 years, with more women prevalence than men. Most of the patients had hypoalbuminemia (84.2%), an increase in AST (59.4)% and ALT (45.5%). There was no significant association between hypoalbuminemia and the disease outcome (P =0.12). There was a significant association between elevated liver enzymes and mortality in severely ill COVID-19 patients (P <0.001). Conclusion: We found that hypoalbuminemia is common in patients with severe COVID-19. However, we found that albumin levels had no association with the patients' mortality rate. Liver enzymes levels appear to be a predictive biomarker for outcomes in COVID-19 patients of H. Adam Malik Hospital. We found that higher ALT and AST levels were associated with significantly higher mortality.

Tipping Toward a New Academic Consciousness

The COVID-19 pandemic and racial reckoning of 2020-2021 have led many faculty in higher education to see the profession and their place in it in a new light (Walton 2022). While people are broadly engaged in a large-scale cultural re-evaluation of work, labor conditions, and equity, this awakening has posed an existential threat to many academics' senses of identity, purpose, and community. Through autoethnographic narratives, the authors make meaning of this tipping point through the feminist intersections of space, power, and consciousness. The authors explore coaching and mutual mentoring as strategies for creating and holding space for disrupting these norms and expectations and for reimagining mentoring, collaboration, and collective action in ways that respond to our current realities and to changing academic work, moving us toward professional work that supports faculty flourishing.

Serum total bilirubin and aminotransferases in patients with COVID-19 in Nellore district of South Andhra Pradesh

BACKGROUND: Corona virus disease-19 (COVID -19) infection is an acute infectious disease caused by a newly discovered beta corona virus, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). While the primary target organ is the lungs, involvement of many other organs is often evident in patients with COVID-19. There is emerging evidence to suggest association of SARS-CoV-2 infection with development of many liver abnormalities. The purpose of this study was to evaluate the prevalence of abnormal liver parameters in COVID-19 patients and their variation in moderate and severe cases. METHODS: This is a retrospective study. All patients with COVID -19, between the ages 20-75 years, encountered between April and May 2021, were included for the study and compared with age-matched controls. Severity of infection was defined based on the presence of symptoms, oxygen saturation, need for respiratory and intensive care support. Liver parameters such as serum total bilirubin (TBIL), serum aminotransferases, alanine aminotransaminase (ALT) and aspartate aminotransaminase (AST) were analysed. Inflammatory markers such as C-reactive protein (CRP) and D-dimer were also included for assay. RESULTS: A total of 52 patients were encountered during the study period. Of these, 29% (15/52) required intensive care. Abnormal liver parameters were observed in 14 (27%) patients, and were significantly elevated compared to healthy controls. Liver dysfunction was markedly profound in severe infection than those with moderate disease. Higher levels of CRP and D-dimer were noted in severe patients of COVID-19. CONCLUSIONS: Mild liver abnormalities in the form of elevated ALT and AST are seen in COVID-19 patients suggesting mild or no liver injury. These abnormal parameters do not generally lead to significant liver function impairment/failure and no specific treatment is required.

Study of liver function test in COVID-19 patients and its correlation with inflammatory markers from Hubballi, Karnataka

BACKGROUND: Since its reporting in December 2019, SARC-COV-2 (COVID -19) has infected more than 230 million people over the world by colonising the respiratory tract, however very little is known about its effect on liver and how the liver injury affects disease prognosis. This study was done to assess the hepatic profile in SARC-COV-2 infection along with inflammatory markers. METHODS: This is a single centred prospective observational study. 400 patients with real time polymerase chain reaction (PCR) confirmed COVID 19 infection admitted in KIMS, Hubballi were taken for study. Patients with decompensated liver disease were excluded from the study. Clinical examination and laboratory investigations including liver function test (LFT), renal function test (RFT), complete blood count (CBC), chest X-ray, D-dimer, ferritin, lactate dehydrogenase (LDH), C reactive protein (CRP) was done for all the patients. RESULTS: Out of the 400 covid-19 positive patients admitted, 286 (71.5%) had abnormal liver enzymes. Significantly raised liver enzymes were seen in males. Raised liver enzymes and inflammatory markers were associated with poor outcome of the disease. Significant reduced albumin was associated with poor outcome of the disease. Significantly raised aspartate transaminase (AST), alanine transaminase (ALT) levels were associated with increased severity of the disease. (P = 0.009 and 0.029 respectively). Significant positive relation was found between liver profile and inflammatory markers. CONCLUSIONS: Majority of patients admitted with SARS-CoV-2 had deranged liver profile. Higher proportion of abnormal liver enzymes were seen in males. Degree of liver injury increases with increasing severity of the disease. Even though abnormal liver enzymes were positively associated with elevated inflammatory markers and severity of the disease, more studies are needed to study implications of liver injury in prognosis of SARS-CoV-2 infection.

Features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome Coronavirus 2

Objective: To summarize and analyze the features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: In this study, an analysis was performed for the liver function test results of the locally transmitted or imported pediatric patients with SARS-CoV-2 infection during isolation who were admitted to Guangzhou Eighth People's Hospital, Guangzhou Medical University, since May 21, 2021, and the clinical data and the constituent ratio of liver injury were compared between the pediatric patients infected with Delta variant and those infected with Omicron variant. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results: A total of 85 pediatric patients infected with SARS-CoV-2 were enrolled, among whom there were 32 (37.6%) pediatric patients infected with Delta variant and 53 (62.4%) pediatric patients infected with Omicron variant, and there were no significant differences between the two groups in age, sex, body height, body weight, and comorbidities (all P > 0.05). There were no significant differences between the two groups in elating aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase, total bilirubin, albumin, and cholinesterase (all P > 0.05), and the pediatric patients infected with Omicron variant had a significantly higher level of total bile acid (TBA) than those infected with Delta variant (Z=-2.336, P=0.020). However, the median values of TBA were within the normal range and the ratios of abnormal TBA were no significant difference between the two groups (P > 0.05). Among the 85 pediatric patients, 10 (11.8%) had a mild increase in liver function parameters, among whom 7 had an increase in TBA, 1 had an increase in ALT, 1 had increases in ALT and AST, and 1 had an increase in ALP. The analysis of liver injury in the pediatric patients infected with Delta variant or Omicron variant showed that there was no significant difference in the constituent ratio of liver injury caused by the two variants (6.3% vs 15.1%, X2=0.691, P=0.406). Conclusion: Mild liver injury is observed in pediatric patients infected with Delta and Omicron variants of SARS-CoV-2, but further studies are needed to evaluate the long-term influence of such infection on liver function.

Analysis laboratory results of three cases of COVID-19 complicated with falciparum malaria

Objective: To analyze the laboratory indexes of patients infected with malaria patients and COVID-19, so as to provide reliable evidence for the diagnosis of mixed infection of both. Methods The routine clinical laboratory items such as routine blood, biochemistry and lymphocyte subsets were tested in three cases of COVID-19 complicated with falciparum malaria who admitted to Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University from July to December 2020 were tested. Laboratory data were stage-wise analyzed in conjunction with changes in the course of disease. Results Three patients confirmed COVID-19 infection recruited all had malaria infection history. Fever, headache, and other symptoms emerged on the 4rd to 11th day after admission. Malaria parasite was detected by malaria parasite antigen testing and blood smear testing, and all three patients had re-ignition of malaria after being confirmed COVID-19 infection. In the early stage of malaria relapse, lymphocytes decreased, CRP and SAA increased, and gradually returned to normal level after antimalarial treatment. Interestingly, we only found one patient at the initial stage of malaria detection showed PLT decreased, no other unnormal changes in other routine blood results (WBC, ESO) and liver function results (ALT, AST, GGT, TBIL, DBIL, CG) were found from the beginning to end course of the disease. Conclusion COVID-19 infection may promote the resurgence of malaria, so the relapse of malaria should be monitored especially for the patient with malaria infection history who begin to develop fever and other symptoms a few days after the diagnosis of COVID-19. The inflammatory indicators would be worth able as an auxiliary judgment basis for the effective treatment of the two combined infection.

Clinical significance of liver function indexes of patients with COVID-19

Objective: To explore the value of liver function indexes on evaluation of the illness condition of coronavirus disease 2019 (COVID-19). Methods: 261 patients with confirmed COVID-19 which collected from Huangshi Hospital of Traditional Chinese Medicine from January to March 2020 were investigated and separated into:group of critical type, group of severe type and group of common type, and the data of the patients about age, gender, past medical history and the results of liver function test were collected. Chi-square test, analysis of variance, univariate and multivariate logistic regression analysis were adopted to explore the relationship between liver function indexes and illness condition of COVID-19. Results: 50.2% of COVID-19 patients had abnormal liver function. Compared with the group of severe type, the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), P-glutamyl transferase (GGT) and total bilirubin (TBIL)in the group of critical type was significantly higher, while the level of albumin(ALB)was significantly lower, and the differences were statistically significant (all P < 0.05);compared with the group of common type, the levels of ALT, +AST, and GGT in the group of severe type were significantly higher, while the level of ALB was significantly lower, and the differences were statistically significant (all P < 0.05). The proportions of patients with abnormal liver function or liver damage in the group of critical type were significantly higher than those in the group of severe type (P < 0.05), and the proportions of patients with abnormal liver function or liver damage in the group of severe type was significantly higher than those in the group of common type (P < 0.05). The incidence ratio of abnormal liver function in patients with underlying disease was higher than that of without underlying disease (P < 0.05). ALT, AST, ALP, TBIL, and ALB were all risk factors for severe progress of COVID-19 disease (all P < 0.05);multivariate logistic regression analysis inidicating that TBIL (OR=10.862, P < 0.05) and ALB (OR=11.733, P < 0.05)were the independent risk factors. TBIL level was positively correlated with the severity of COVID-19 (r=0.367, P < 0.05), and ALB level was negatively correlated with the severity of COVID-19 (r=-0.613, P < 0.05). Conclusions: The abnormal liver function, especially the obvious abnormality of TBIL and ALB, could be used as the reference index of COVID-19 severity. The COVID-19 patients with underlying disease were easily suffered liver injury.

Observation of changes of early laboratory indicators and COVID-19 vaccine protection in patients infected with SARS-CoV-2 Delta variant

Objective: To observe early laboratory indicators in peripheral blood of patients infected with SARSCoV- 2 Delta variant and the protective effects of COVID-19 vaccine on patients infected with SARS-CoV-2 Delta variant, in order to provide reference for epidemic prevention and control. Methods: Twenty-five Chengdu local confirmed nonsevere COVID-19 patients over 18 years old who were infected with COVID-19 caused by Delta variant in November 2021 were included as the research group, 22 cases of whom were vaccinated with COVID-19 vaccine before infection, and 3(2 cases over 80 years old)were unvaccinated. In addition, 71 non-severe COVID-19 patients at the age of over 18 years diagnosed in Chengdu from January 2020 to February 2020 were included as the control group. Peripheral blood was collected for laboratory examination in all cases on the first or second days after admission, and peripheral blood was collected for laboratory examination again in patients on day 4 to 8 after admission in the research group. Laboratory indicators included the blood routine, C-reactive protein, procalcitonin, liver function, myocardial enzyme profile, coagulation routine, T lymphocyte subsets, SARS-CoV-2 IgG antibody, and total antibody, etc. The first peripheral blood laboratory test results: of the two groups were compared to observe the protective effect of COVID-19 vaccine on patients infected with SARS-CoV- 2 Delta variant. Results Among the first time of laboratory indicators after admission, the lymphocyte count, lactate dehydrogenase, and D-dimer in the research group were all lower than those in the control group(all P < 0.05), and the procalcitonin and aspartate aminotransferase were higher than those in the control group(all P < 0.05). Among the 22 cases who had gotten vaccine before infection in the research group, there were 5 cases with positive result of SARS-CoV-2 IgG antibody in the first time of peripheral blood, 22 cases with positive result of SARS-CoV-2 IgG antibody in the second time of peripheral blood, and none of them became severe cases. During 3 unvaccinated cases, twice of the SARS-CoV-2 IgG antibody were both negative among the 2 cases over 80 years who had not vaccinated in the research group, then they became severe cases on day 6-8 during hospitalization, and the rest one had negative result of SARS-CoV-2 IgG antibody in the second time of peripheral blood. Among the 22 vaccinated cases in the research group, the lymphocyte count, CD4+T cell count, CD8+T cell count, SARS-CoV-2 specific antibodies in the second time peripheral blood were all higher than those in the first time of peripheral blood(all P < 0.05), and platelet count, hemoglobin, total protein, creatine kinase were all lower than those in the first time of peripheral blood(all P < 0.05). Conclusions: Lymphocyte count at early admission in COVID-19 patients infected with Delta variant may be lower than that infected with wild strain. COVID-19 vaccine can reduce the risk of infection of SARS-CoV-2 Delta variant by preventing the emergence of inflammatory storms and producing a large number of specific antibodies.

Comparison of clinical manifestations, liver function, and antibody levels between omicron variant infection patients vaccinated and not vaccinated with COVID-19 vaccine

Objective: To compare the clinical manifestations, liver function, and antibody levels between Omicron variant infection patients vaccinated and not vaccinated with COVID-19 vaccine. Methods: Totally 430 convalescent COVID-19 patients infected with Omicron variant in Tianjin were selected, including 150 patients vaccinated with Corona Vaccine(Sinovac group), 185 patients vaccinated with BBIBP-CorV(Beijing biological group), 41 patients vaccinated with Ad5-nCoV vaccine(CanSino group), 16 patients vaccinated with Anhui Zhifei, Changchun Bio, Lanzhou Bio, Shandong Bio, other adenovirus vector vaccines or mixed vaccination(other group), and 38 unvaccinated patients(unvaccinated group). The clinical manifestations, liver function indexes [alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TB), albumin(ALB), total protein(TP), lactate dehydrogenase(LDH)], and antibody levels(IgG, IgM)were compared retrospectively. Results: There was no statistical difference in the sex composition ratio among groups(P > 0.05). The age of the Beijing biological group was significantly lower than that of other groups, and the proportion of time less than 3 months from the last vaccination to admission in the Beijing biological group and CanSino group was significantly higher than that in the Sinovac group and other groups(all P < 0.01). A total of 110 children aged less than 16 years were enrolled, including 7, 88, 0, 1 and 14 cases in the Sinovac group, Beijing biological group, CanSino group, other group, and unvaccinated group, respectively. There were 6 asymptomatic cases, 13 moderate cases, 91 mild cases and 0 severe case. There was no significant difference in the abnormal rate of ALT between Beijing biological group and unvaccinated group(P > 0.05), but the abnormal rates of ALT were higher in the Sinovac group and CanSino group than in the unvaccinated group and Beijing biological group(all P < 0.05). The abnormal rate of AST in the unvaccinated group was higher than that in other groups(P < 0.05). There were no significant differences in AST, TP or TB among the groups(all P > 0.05). The levels of ALT were higher in the Sinovac group and CanSino group than in Beijing biological Group and unvaccinated group, the level of ALB in the unvaccinated group was lower than that in the other groups, and the level of LDH in the Beijing biological group was higher than those in the Sinovac group and CanSino group(both P < 0.05). The IgG and IgM antibody levels of the unvaccinated group were significantly lower than those of the Sinovac group, Beijing biological group and CanSino group(all P < 0.05). Conclusions: Omicron variant infection patients vaccinated with BBIBP-CorV are younger and have a higher proportion of mild conditions, which can protect the liver function of patients to a certain extent. Patients vaccinated with different COVID-19 vaccines can produce higher levels of IgG and IgM antibodies than the unvaccinated patients.

Surveillance of adverse effects of Tocilizumab for COVID-19

Background: Tocilizumab (TCZ) is a new therapeutic alternative for severe cases of COVID-19 pneumonia. Aim: To evaluate the cumulative incidence (CI) of suspected adverse drug reactions (ADR) from TCZ in adult patients with COVID-19. Material and methods: An active pharmacological surveillance protocol was carried out in patients older than 18 years old, who received at least one dose of TCZ between May and August 2020 at a clinical hospital. Non-infectious ADRs were categorized according to the Common Terminology Criteria for Adverse Events and the development of infection was classified as present or absent. Causality and preventability of ADRs were determined with the Naranjo Algorithm and the modified Schumock & Thornton criteria, respectively. Results: The CI of ADRs caused by TCZ was 69.6% (95% confidence intervals (CI): 63.5-76.6). A rise in alanine and aspartate aminotransferases and the development of infections were the most frequent adverse events. Seventy-four percent were considered mild in severity. Sixty two percent of suspected non-infectious ADRs were classified as probable and all the infectious events as Possible. Of the ADRs observed, 33% were preventable. Conclusions: The occurrence of ADRs after the use of TCZ is frequent, of mild severity, and in one third of the cases, preventable. We suggest monitoring blood count, liver function tests and ruling out infection prior to TCZ administration.

The association between chest CT severity scores, CO-RADS, vitamin D levels and other laboratory parameters of COVID-19 patients

Objective: This study determined the correlation between several laboratory variables, chest computed tomography severity score (CTSS), and coronavirus disease-2019 (COVID-19) Reporting and Data System (CO-RADS) in COVID-19 patients. Materials and Methods: Ninety-one patients with COVID-19 infection verified by polymerase chain reaction test, presented to the emergency department with COVID-19 symptoms, and had a thoracic computed tomography (CT) scan at the time of admission were included in this retrospective study. 25-hydroxyvitamin D [25(OH)D] levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), D-dimer, glucose, ferritin, creatinine, alanine aminotransferase, aspartate aminotransferase, phosphorous, and calcium levels recorded and CO-RADS and CTSS data. The correlation of laboratory parameters with radiological findings was analyzed. Results: A positive correlation was found between CTSS and age, ESR, CRP, D-dimer while a negative correlation was found between CTSS and lymphocyte count. Patients with high CTSS levels had higher ESR, CRP, D-dimer, ferritin values and lower lymphocyte count, and lower calcium levels. Patients with typical CO-RADS involvement had higher sedimentation, CRP, glucose, and ferritin levels and lower lymphocyte count. No significant correlation was determined between the 25(OH)D level, CO-RADS, and CTSS. Conclusion: The results of this study highlight that the reduced lymphocyte count, high D-dimer, sedimentation, ferritin, and CRP levels are predictors of severe lung involvement in COVID-19 patients. Hypocalcemia can also be considered a marker of severe lung involvement evaluated by CT in COVID-19 patients. the association between vitamin D deficiency and COVID-19 pneumonia should be investigated in future studies.

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.

Serum level estimation of some biomarkers in diabetic and non-diabetic COVID-19 infected patients.

Diabetes, hypertension, and cardiovascular disease all raise the risk of hospitalization and mortality in individuals infected with coronavirus disease 2019 (COVID-19). Higher levels of flogosis mediators such as TNF, C-reactive protein (CRP), IL-1, IL-6, leptin, and resistin, as well as increased levels of TNF, C-reactive protein (CRP), IL-1, IL-6, leptin, and resistin, define diabetes. The goal of this study is to evaluate the levels of D-dimer, total serum bilirubin (TSB), glutamic-oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), and CRP in diabetic patients with COVID-19 infection to COVID-19 patients without diabetes. Blood samples were collected from individuals with diabetes who had COVID-19 and non-diabetic COVID patients as control. Moreover, D-dimer and CRP were evaluated by using Min Vidus and Latx, respectively, whereas AccEnT 200 system was used to measure the serum level of TSB, GPT, and GOT in the hematology lab. Also demonstrated that the average serum concentration of D-dimer, GOT and CRP was high in diabetic COVID-19-infected patients (980.66 ng/mL, 67.71 U/L, and 27.06 mg/L, respectively) compared with non-diabetic COVID-19-infected patients (791.17 ng/mL, 54.023 U/L and 20.11 mg/L, respectively) (p < 0.05), while the situation was inverse for the average concentration of TSB and GTP when their average concentrations were low in diabetic COVID-19-infected patients (12.89 Mmol/L and 59.79 U/L, respectively) (p > 0.05). Moreover, the cut-off values for serum D-dimer, TSB, GPT, GOT, and CRP of COVID-19-infected diabetic patients were ≥ 6500 ng/mL, ≥ 350 Mmol/L, ≥ 133 U/L mg/L, ≥ 150 U/L, and ≥ 15.22 mg/L, respectively, represented a perfect test for predicting COVID-19-infected diabetic patients with 100% sensitivity and specificity. In conclusion, serum D-dimer, TSB, GPT, GOT and CRP increased in diabetic COVID-19-infected patients compared to non-diabetic COVID-19 patients and the D-dimer concentration also increases. TSB and CRP were more pronounced among diabetic patients with corona, while liver enzyme concentrations were decreased.

Role of biomedical markers in the monitoring of Pfizer-BioNTech vaccine efficacy among Iraq's people

Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century, Forcing scientists to continue Research to discover a vaccine for this disease in in request to control and boundary the range Of the disease. This study was designed to hit upon out whether here are side effects on vaccinated people who received covid-19 vaccine or not by measuring the body's vitality by some of biochemical tests.Subjects:75 individuals between women and men aged (17-68 years)were enrolled in this study .Several biochemical tests were performed on them before taking the vaccine,a week to10 days after the first dose, and a week to 10 days after the second dose of covid-19 vaccine. RESULT(S): All subjects in this Study received the Pfizer-Bio N Tech vaccine and no systemic side effects were Observed in subjects vaccinated during the study period. Conclusion(s): From the Results of the current study, there were no abnormal biochemical markers, increased, or changes in basic body functions after receiving the Pfizer vaccine. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Changes of serum LXA4, Card9 and PTX-3 in patients with severe acute pancreatitis and their predictive value for complicated MODS

Objective: To investigate the changes of serum lipoxin A4 (LXA4), caspase recruitment domain containing protein 9 (Card9), and pentraxin 3 (PTX-3) in patients with severe acute pancreatitis (SAP) and their predictive value of multiple organ dysfunction syndrome (MODS).