RESUMEN
Background: The second wave of COVID-19 was disastrous and claimed many lives in India and abroad. The most challenging task was to provide the required treatment as per the patient's condition, within a limited span of time. The lack of prognostic predictors at the time of admission led to failure in prioritizing the patient's need for intensive care. Aim: This study was conducted to find out the clinical and laboratory parameters at the time of admission to ICU as predictors of outcomes in COVID-19 patients, which can help in judicious utilization of the available resources for better patient care. Subjects and Methods: Study comprises of 161 ICU admitted patients. Study of clinical traits, comorbidities, test results, and demographic variables were carried out among survivors and non-survivor. Result: Maximum death were patients of age group 21-30 years and male gender. Mortality in hypertensives, diabetics, and patients with sepsis were found to be statistically significant. Patients who developed ARDS and pneumonia or needed ventilation died invariably. High levels of laboratory parameters like IL-6, LDH, PT, INR, aPTT, ferritin, WBC count, and D-dimer were significantly associated with poor outcomes and at a particular cutoff had optimum sensitivity and specificity to predict mortality in ICU admitted COVID-19 patients. At the same time, low lymphocyte count and PaO2/FiO2 ratio was significantly associated with bad prognosis (P < 0.05). Conclusion: This paper will help in prioritizing patients in ICU who need special attention especially at the time of meager supply of resources.
RESUMEN
BACKGROUND: Uncontrolled increase in Reactive Oxygen Species (ROS) leads to the release of free radicals. Additionally, when antioxidants go below a certain level, major molecules of our system such as DNA, proteins, and many other macromolecules get damaged, leading to cancer, heart diseases, and metabolic syndromes like diabetes. Therefore, we in our study focused on newly diagnosed Type 2 Diabetes Mellitus (T2DM) patients and tried to evaluate the expression of antioxidant enzyme encoding genes; Superoxide Dismutase 1(SOD1) and Superoxide Dismutase 2 (SOD2) and DNA repair genes; X-ray repair cross-complementing 1(XRCC1) and 8-oxoguanine DNA glycosylase 1 (OGG1) in them. METHODS: Expression analysis was performed by RT-PCR on 60 subjects (30 T2DM cases and 30 non-diabetic controls). The level of the SOD enzyme was also estimated in a serum sample by the colorimetric method. Biochemical parameters such as fasting plasma glucose (FBG), glycated haemoglobin (HbA1c), high sensitivity C-reactive protein (hsCRP), and lipid profile were estimated in an auto analyzer. Receiver operating characteristic (ROC) curve analysis was done, the area under the curve for mRNA expression and enzyme level was calculated to determine their potential as markers in newly diagnosed T2DM. RESULTS: Down-regulation of both SOD1 (0.43 fold, p=0.02) and SOD2(0.41 fold, p=0.13) and up-regulation of both XRCC1(1.15 fold, p>0.05) and OGG1(1.49 fold, p>0.05) was observed in patients with T2DM. We also observed a significant decrease (p=0.02) in SOD enzyme levels in diabetic cases than in controls (599.8 ± 178.9 and 691.3 ±127.3). CONCLUSIONS: We report that antioxidant repair genes are downregulated and DNA repair genes are upregulated in newly diagnosed T2DM patients. SOD levels and SOD1 gene expression can serve as informative biomarkers for identifying T2DM patients.