Sysmex-derived COVID-19 prognostic score as an early prognostic marker for severity of the COVID-19 disease.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a life-threatening disease with a heterogeneous course. Even some young patients are at increased risk of severe course or death, as they can face severe complications. It would be very useful to have a cheap and easily available marker to predict COVID-19 course in the early stages of the disease. The COVID-19 prognostic score could be a very useful clinical indicator available at the time of primary contact with the patient. METHODS: The COVID-19 prognostic score and the clinical condition together with selected laboratory parameters were evaluated in patients with respiratory tract infection and a positive PCR test for the SARS-CoV-2 during the first contact with the patient. Prognostic significance was evaluated using receiver operating characteristic curves (ROC) and area under the curve (AUC). Selected parameters of the blood count and hemostasis, as well as selected biochemical indicators, were examined too. RESULTS: Thirty-seven of 164 patients developed serious symptoms. The COVID-19 score had one of the highest AUC values (0.855) of all markers. The highest combination of sensitivity (91.9%) and specificity (71.7%) for identifying patients with a subsequent moderate and severe course of the disease was achieved at the threshold 1.5. The predictive value of a negative test is beneficial too (0.968). CONCLUSIONS: The COVID-19 prognostic score is a promising indicator stratifying patients with COVID-19 into prognostic groups at the time of the first contact, thus allowing the timely provision of increased care in patients at high risk of severe development.

Tailored first- and second-order coherence properties of quantum dot superluminescent diodes via optical feedback.

We demonstrate experimentally that the first- and second-order coherence properties of light emitted by a quantum dot superluminescent diode can be simultaneously tailored by well-controlled optical feedback. Depending on feedback intensity and feedback spectral range we achieve a spectral width Δλ between 120 and 0.26 nm, corresponding to a coherence length in first order in the range between 13 and 5820 µm, while the central second-order coherence degree g((2))(τ=0) is tuned gradually from a thermal value of g((2))(0)~1.8 down to the coherent laser limit of g((2))(0)=1.0. These results are complemented by comprehensive investigations of relative intensity noise, which are in excellent agreement with the observed intensity correlation behavior.

Intensive Care Infection Score (ICIS) is elevated in patients with moderate and severe COVID-19 in the early stages of disease.

BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus is still a very dangerous and life-threatening disease with an extremely heterogeneous course. Older patients and those with comorbidities are at increased risk of death from the disease but young patients can develop potentially lethal complications too. For those reasons, numerous recent studies focus on the analysis of markers associated with early assessment of COVID-19 prognosis. Previous publications provided evidence for the Intensive Care Infection Score (ICIS) as an easy to use tool to assess the risk for bacterial infection in ICU patients based on a combination of haematologic parameters. This study evaluated the performance of ICIS as a prognostic marker of stages of disease in COVID-19 patients. METHODS: A total of 205 COVID-19 patients admitted to the University Hospital Hradec Kralove, Czech Republic, with symptoms of respiratory tract infection and a positive RT-PCR test for SARS-CoV-2 virus were enrolled in this study. Forty-nine patients developed mild COVID-19 symptoms (no oxygen therapy needed), 156 patients developed moderate or severe symptoms (supplemental oxygen therapy or death). RESULTS: ICIS predicted the mild or moderate/severe course with the highest AUC (0.773). The cut-off value (ICIS = 3.5) was selected as the value with the highest Youden index (0.423). The cut-off value could predict a mild or moderate/severe course of the disease with the highest specificity (77.6%) and positive predictive value (90.2%) of all markers used in this study. Sensitivity was 64.7%. CONCLUSION: ICIS is a reliable, cheap, fast and simply interpretable score for the early identification of moderate/severe course of COVID-19 in an early stage of the disease. ICIS> 3 predicts a severe course of the disease with high specificity and positive predictive value.

Unifying intensity noise and second-order coherence properties of amplified spontaneous emission sources.

We present joint investigations of relative intensity noise (RIN) and second-order coherence properties of amplified spontaneous emission (ASE) generated by a superluminescent diode. We introduce a generalized intensity noise description for ASE sources that contains the shot noise contribution but also accounts for first- and second-order coherence properties reflecting the process of light generation. We find excellent agreement between pump-current-dependent RIN values and this new description, with the perspective of particular interesting consequences for the realization of low-noise broadband emitters.

Tailoring wave chaos in vertical-cavity surface-emitting lasers via polarization control.

We demonstrate that polarization control in combination with the geometrical shape affects wave chaos phenomena in vertical-cavity surface-emitting lasers (VCSELs). In a grating-polarization-stabilized VCSEL, we demonstrate wave chaos in one polarization mode and a transition from wave chaos to regular behavior in the other orthogonal polarization mode. We quantify the amount of chaoticity via the Brody nearest-neighbor distribution. Comparing with a reference VCSEL without a surface-grating, we explain these results and their injection current dependence by the surface-grating-induced mode selection and a change in the effective resonator shape.

Coherence function control of Quantum Dot Superluminescent Light Emitting Diodes by frequency selective optical feedback.

Low coherent light interferometry requires broad bandwidth light sources to achieve high axial resolution. Here, Superluminescent Light Emitting Diodes (SLDs) utilizing Quantum Dot (QD) gain materials are promising devices as they unify large spectral bandwidths with sufficient power at desired emission wavelengths. However, frequently a dip occurs in the optical spectrum that translates into high side lobes in the coherence function thereby reducing axial resolution and image quality. We apply the experimental technique of frequency selective feedback to shape the optical spectrum of the QD-SLD, hence optimizing the coherence properties. For well-selected feedback parameters, a strong reduction of the parasitic side lobes by a factor of 3.5 was achieved accompanied by a power increase of 40% and an improvement of 10% in the coherence length. The experimental results are in excellent agreement with simulations that even indicate potential for further optimizations.

WAA apheresis registry in the Czech Republic: two centers experience.

INTRODUCTION: Hemaphereses are sophisticated procedures performed for many indications even in severely ill patients. Many authors consider quite necessary to register as many details as possible of treatments with therapeutic apheresis. WAA meets the requirement to compare data with centers not performing apheresis for the same diagnosis. In Czech Republic hemaphereses are used in a broad spectrum of indications. Since the year 2004 data on hemaphereses done in Czech Republic have been registered. In this paper we present a survey of our to date recordings. PATIENTS AND METHODS: Data of performed therapeutic hemaphereses (plasma exchange, erythrocytapheresis, leukapheresis, thrombocytapheresis, photopheresis, immunopheresis, and rheopheresis) have been entered in WAA registry with many details. We have been evaluated 1289 procedures in 216 patients done in our two centers (center I, center II). RESULTS: Center I registered 129 procedures in 41 patients, center II 1260 procedures in 175 patients. The patients are divided according to centers specialization (center II has registered 12 long-term treated patients with LDL-apheresis; mean time of therapy 7.1 years and a median of 34 procedures/patient. Side-effects registered in center I and center II were 3.1% and 5.6% of the procedures, respectively. Most frequent side-effects were citrate toxicity, neurovegetative lability, problems with venous access and hypotension. All were easy to treat, no serious events or death occurred. CONCLUSIONS: In Czech Republic hemaphereses are performed in a broad scale of indications and now it is nearly 5 years that data are registered in our two university centers. In 2004 we entered WAA registry because it meets the requirement to compare data with centers that do not perform aphereses for the same diagnosis. This comparison would certainly improve efficacy of the hemapheresis therapy even further. To enter WAA registry is easy, at no expense and without any problems.

Safety and tolerability of long lasting LDL-apheresis in familial hyperlipoproteinemia.

The aim of this work is to arbitrate the incidence of side effects and tolerability of long lasting LDL-apheresis in familial hyperlipoproteinemia. 1200 procedures were performed and the last 463 of them were evaluated. An immunoadsorption method of LDL-apheresis was used (continuous blood cell separator Cobe Spectra; secondary device: automated adsorption-desorption ADA, Medicap; absorption columns: Lipopak). As a whole, 6.26% adverse events were found and subsequently resolved by standard symptomatic therapy. Vaso-vagal reactions (symptoms of neurovegetative lability) were the most common adverse effects, presented as malaise, weakness, slight and short-term drop in blood pressure or other general signs. They were all well controlled by symptomatic therapy. We conclude that LDL-apheresis in the hands of experienced personnel is a safe procedure. An acceptable procedure duration limit, balancing the possibility to achieve a targeted cholesterol level while still maintaining an acceptable patient tolerance, was confirmed to be 4 hours.

Activity of thrombocytes as a marker of sufficient intensity of LDL-apheresis in familial hypercholesterolaemia.

Extracorporal elimination is used for selective removal of LDL-cholesterol in severe hypercholesterolaemias. Tests are still going on to find more reliable markers which would sufficiently determine the intensity of the therapy immediately after completion of the procedure, in order to attenuate atherosclerosis activity. According to some literature data such a marker may be platelet aggregability. However, this marker carried out by standard methods has shown to be unreliable. The method was modified (by using various ADP dilutions for aggregation stimulation) and only then changes in aggregation could be observed immediately after completion of the procedure, namely, if there is a rapid drop in cholesterol concentration (of 6 mmol/l or more). Presently, this modification seems to be a suitable marker to determine the intensity of therapy.

Haemorheopheresis could block the progression of the dry form of age-related macular degeneration with soft drusen to the neovascular form.

PURPOSE: To evaluate the influence of haemorheopheresis on anatomical and functional findings in patients with soft-drusen maculopathy. METHODS: We investigated 29 eyes (16 patients) and randomized 25 eyes (16 controls) with soft-drusen maculopathy [soft, confluent and reticular drusen, drusenoid retinal pigment epithelium detachment (RPED)]. Each patient received a series of eight haemorheophereses (cascade filtration of 1.5 plasma volume) within 10 weeks. The patients were followed up using Early Treatment Diabetic Retinopathy Study (ETDRS) charts, optical coherence tomography, fluorescein angiography, electroretinography and measurements of pulsed ocular blood flow. RESULTS: After the procedures, there was a substantial reduction in rheologically active substances [lipoproteins, α2-macroglobulin, immunoglobulin M (IgM), fibrinogen], plasma and blood viscosity. At the 1.5-year follow-up, we noticed soft drusen absorption; reattachment of drusenoid RPED and stabilization or improvement of visual acuity occurred in 72% of patients in comparison to only 39% of patients in the control group. Full-field electroretinograms showed significantly higher scotopic activity of treated patients in comparison with the control group, and mainly insignificant differences in photopic activity between both groups. Despite the significant increase of activity in the paramacular retina in treated patients, the differences in amplitudes of multifocal electroretinography (mfERG) average responses were insignificant between groups. CONCLUSION: Haemorheopheresis seems to be capable of changing the activity of promoters of the natural course of soft-drusen maculopathy, its development and progression. Visual acuity and electrical activity of the retina can be stabilized or even improved. The therapy has been shown to be effective and safe.

Elevated serum soluble endoglin (sCD105) decreased during extracorporeal elimination therapy for familial hypercholesterolemia.

Extracorporeal elimination is a method of LDL-lowering therapy that is used in severe familial hypercholesterolemia (FH) after other therapeutic approaches have failed. There are currently no universally accepted biomarkers that would allow determining necessary intensity of therapy and frequency of future therapeutic interventions. An ideal tool for immediate evaluation would be a readily measurable serum marker. We hypothesized that soluble endoglin (sCD105), a recently described indicator of endothelial dysfunction, may represent such a tool. Eleven patients with FH (three homozygous, eight heterozygous; Fredrickson type IIa, IIb) that have been monitored for 4.5+/-2.8 years were treated; eight by LDL-apheresis and three by hemorheopheresis. 40 sCD105 measurements were done, before and after two consecutive elimination procedures. Baseline serum sCD105 levels were significantly higher in the patients (5.74+/-1.47 microg/l in series I, 6.85+/-1.85 microg/l in series II) than in the control group (3.85+/-1.25 microg/l). They decreased to normal after LDL-elimination (p=0.0003) in all except for one patient. This return to normal was not due to a non-specific capture of endoglin in adsorption or filtration columns as demonstrated by measurement of sCD105 before and after passage through the elimination media. We conclude that the soluble endoglin levels in patients with severe FH remain elevated despite long-term intensive therapy and that they decrease after extracorporeal elimination. Endoglin can therefore serve as a marker for evaluation of the treatment efficacy and of the decreased atherosclerotic activity in patients with FH treated by extracorporeal LDL-cholesterol elimination.