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1.
Int Immunopharmacol ; 93: 107390, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33529907

RESUMEN

BACKGROUND: Exposure to viral or bacterial pathogens increases the number of neutrophils with a relative decrease in lymphocytes, leading to elevated neutrophil to lymphocyte ratio (NLR). This study aimed to investigate whether differences in NLR among real-time polymerase chain reaction (PCR)-positive and -negative patients presenting with a prediagnosis of COVID-19 pneumonia could be useful in the differential diagnosis. METHODS: The study included 174 patients admitted because of suspected COVID-19 infection between March and April 2020. Patients were divided into two groups: PCR-negative and PCR-positive. Hemogram, NLR, urea, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, ferritin, D-dimer, C-reactive protein, procalcitonin, troponin, and coagulation parameters were analyzed. RESULTS: On comparison of laboratory parameters between both groups at presentation, PCR-positive patients were significantly more likely to have leukopenia (p < 0.001), thrombocytopenia (p = 0.006), neutropenia (p < 0.001), lymphopenia (p = 0.001), and increased NLR (p = 0.003). Furthermore, PCR-positive patients showed significant elevations of ferritin (p = 0.012) and procalcitonin (p = 0.038) and significant lower potassium levels (p = 0.05). CONCLUSION: COVID-19 pneumonia has become a major global health problem. Early diagnosis and treatment of these patients are crucial, as COVID-19 pneumonia shows a rapid progression in most cases. Thus, leukopenia, thrombocytopenia, elevated NLR, and elevated ferritin may be useful as supplementary diagnostic tests in these patients, which may allow early initiation of treatment and may contribute to preventing progression in patients with abnormal results.


Asunto(s)
/sangre , Infecciones por Coronavirus/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/sangre , Femenino , Ferritinas/metabolismo , Humanos , Recuento de Leucocitos , Leucocitos/patología , Leucopenia/sangre , Leucopenia/virología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Neutrófilos/patología , Recuento de Plaquetas , Reacción en Cadena de la Polimerasa , Estudios Retrospectivos , Trombocitopenia/sangre , Trombocitopenia/virología
2.
Vet Res ; 52(1): 2, 2021 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-33397461

RESUMEN

Porcine epidemic diarrhea (PED) is a coronavirus disease characterized by the rapid spread of severe diarrhea among pigs. PED virus (PEDV) infects and replicates mainly in the epithelial cells of the duodenum, jejunum, ileum and colon. Serum or mucosal IgA antibody levels have been used to predict both vaccine efficacy and the level of protective immunity to enteric infectious diseases in individuals or herds. Details of the B-cell immune response upon PEDV infection, such as the systemic and mucosal PEDV IgA antibody response, the distribution of IgA antibody-secreting cells (ASCs), and their role in virus clearance are not yet clear. In this experimental infection study, we observed similar fluctuations in PEDV IgA antibody levels in serum and intestinal contents of the upper and lower jejunum and ileum, but not fecal samples, over the 4-week experimental course. ASCs that actively secrete PEDV IgA antibody without in vitro stimulation were distributed mainly in the upper jejunum, whereas memory B cells that showed enhanced PEDV IgA antibody production upon in vitro stimulation were observed in mesenteric lymph nodes and the ileum. Our findings will contribute to the development of effective vaccines and diagnostic methods for PEDV.


Asunto(s)
Anticuerpos Antivirales/sangre , Infecciones por Coronavirus/veterinaria , Virus de la Diarrea Epidémica Porcina , Enfermedades de los Porcinos/virología , Animales , Chlorocebus aethiops , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Heces/química , Heces/virología , Inmunoglobulina A/sangre , Inmunoglobulina A/química , Inmunoglobulina A/metabolismo , Inmunoglobulina G/sangre , Mucosa Intestinal/metabolismo , ARN Viral , Porcinos , Enfermedades de los Porcinos/sangre , Enfermedades de los Porcinos/inmunología , Células Vero
3.
JCI Insight ; 6(4)2021 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-33497357

RESUMEN

Four endemic human coronaviruses (HCoVs) are commonly associated with acute respiratory infection in humans. B cell responses to these "common cold" viruses remain incompletely understood. Here we report a comprehensive analysis of CoV-specific antibody repertoires in 231 children and 1168 adults using phage immunoprecipitation sequencing. Seroprevalence of antibodies against endemic HCoVs ranged between approximately 4% and 27% depending on the species and cohort. We identified at least 136 novel linear B cell epitopes. Antibody repertoires against endemic HCoVs were qualitatively different between children and adults in that anti-HCoV IgG specificities more frequently found among children targeted functionally important and structurally conserved regions of the spike, nucleocapsid, and matrix proteins. Moreover, antibody specificities targeting the highly conserved fusion peptide region and S2' cleavage site of the spike protein were broadly cross-reactive with peptides of epidemic human and nonhuman coronaviruses. In contrast, an acidic tandem repeat in the N-terminal region of the Nsp3 subdomain of the HCoV-HKU1 polyprotein was the predominant target of antibody responses in adult donors. Our findings shed light on the dominant species-specific and pan-CoV target sites of human antibody responses to coronavirus infection, thereby providing important insights for the development of prophylactic or therapeutic monoclonal antibodies and vaccine design.


Asunto(s)
Anticuerpos Antivirales/aislamiento & purificación , Resfriado Común/virología , Infecciones por Coronavirus/inmunología , Coronavirus/inmunología , Enfermedades Endémicas , Adulto , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , Especificidad de Anticuerpos , Antígenos Virales/sangre , Antígenos Virales/inmunología , Niño , Preescolar , Resfriado Común/sangre , Resfriado Común/epidemiología , Resfriado Común/inmunología , Coronavirus/aislamiento & purificación , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Reacciones Cruzadas , Epítopos de Linfocito B/sangre , Epítopos de Linfocito B/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dominios Proteicos/inmunología , Estudios Retrospectivos , Estudios Seroepidemiológicos , Proteínas Virales/inmunología
6.
Expert Rev Hematol ; 14(2): 155-173, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33480807

RESUMEN

INTRODUCTION: COVID-19 has similarities to the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks, as severe patients and non-survivors have frequently shown abnormal coagulation profiles. Immune-mediated pathology is a key player in this disease; hence, the role of the complement system needs assessment. The complement system and the coagulation cascade share an intricate network, where multiple mediators maintain a balance between both pathways. Coagulopathy in COVID-19, showing mixed features of complement-mediated and consumption coagulopathy, creates a dilemma in diagnosis and management. AREAS COVERED: Pathophysiology of coagulopathy in COVID-19 patients, with a particular focus on D-dimer and its role in predicting the severity of COVID-19 has been discussed. A comprehensive search of the medical literature on PubMed was done till May 30th, 2020 with the keywords 'COVID-19', 'SARS-CoV-2', 'Coronavirus', 'Coagulopathy', and 'D-dimer'. Twenty-two studies were taken for weighted pooled analysis of D-dimer. EXPERT OPINION: A tailored anticoagulant regimen, including intensification of standard prophylactic regimens with low-molecular-weight heparin is advisable for COVID-19 patients. Atypical manifestations and varying D-dimer levels seen in different populations bring forth the futility of uniform recommendations for anticoagulant therapy. Further, direct thrombin inhibitors and platelet inhibitors in a patient-specific manner should also be considered.


Asunto(s)
Trastornos de la Coagulación Sanguínea/etiología , Activación de Complemento , Animales , Anticoagulantes/uso terapéutico , Biomarcadores , Trastornos de la Coagulación Sanguínea/sangre , Trastornos de la Coagulación Sanguínea/inmunología , Trastornos de la Coagulación Sanguínea/fisiopatología , Pruebas de Coagulación Sanguínea , /inmunología , China/epidemiología , Comorbilidad , Infecciones por Coronavirus/sangre , Coagulación Intravascular Diseminada/sangre , Coagulación Intravascular Diseminada/epidemiología , Coagulación Intravascular Diseminada/etiología , Coagulación Intravascular Diseminada/fisiopatología , Ferritinas/sangre , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Predicción , Humanos , Inmunización Pasiva , Inflamación/etiología , Inflamación/fisiopatología , Quelantes del Hierro/uso terapéutico , Isquemia/sangre , Isquemia/etiología , Isquemia/fisiopatología , Ratones , Prevalencia , Síndrome Respiratorio Agudo Grave/sangre , Índice de Severidad de la Enfermedad , Trombofilia/tratamiento farmacológico , Trombofilia/etiología , Trombofilia/fisiopatología , Tromboembolia Venosa/sangre , Tromboembolia Venosa/etiología , Tromboembolia Venosa/fisiopatología
7.
Ann Med ; 53(1): 103-116, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33063540

RESUMEN

BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Hiperglucemia/complicaciones , Neumonía Viral/mortalidad , Sistema de Registros , Anciano , Anciano de 80 o más Años , Glucemia , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Cuidados Críticos/estadística & datos numéricos , Femenino , Humanos , Hiperglucemia/mortalidad , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Respiración Artificial/estadística & datos numéricos , España/epidemiología
8.
Biosens Bioelectron ; 171: 112679, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33069957

RESUMEN

The 2019 SARS CoV-2 (COVID-19) pandemic has illustrated the need for rapid and accurate diagnostic tests. In this work, a multiplexed grating-coupled fluorescent plasmonics (GC-FP) biosensor platform was used to rapidly and accurately measure antibodies against COVID-19 in human blood serum and dried blood spot samples. The GC-FP platform measures antibody-antigen binding interactions for multiple targets in a single sample, and has 100% selectivity and sensitivity (n = 23) when measuring serum IgG levels against three COVID-19 antigens (spike S1, spike S1S2, and the nucleocapsid protein). The GC-FP platform yielded a quantitative, linear response for serum samples diluted to as low as 1:1600 dilution. Test results were highly correlated with two commercial COVID-19 antibody tests, including an enzyme linked immunosorbent assay (ELISA) and a Luminex-based microsphere immunoassay. To demonstrate test efficacy with other sample matrices, dried blood spot samples (n = 63) were obtained and evaluated with GC-FP, yielding 100% selectivity and 86.7% sensitivity for diagnosing prior COVID-19 infection. The test was also evaluated for detection of multiple immunoglobulin isotypes, with successful detection of IgM, IgG and IgA antibody-antigen interactions. Last, a machine learning approach was developed to accurately score patient samples for prior COVID-19 infection, using antibody binding data for all three COVID-19 antigens used in the test.


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Técnicas Biosensibles/instrumentación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/sangre , Neumonía Viral/sangre , Anticuerpos Antivirales/inmunología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/inmunología , Pruebas con Sangre Seca , Diseño de Equipo , Fluorescencia , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Dispositivos Laboratorio en un Chip , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Sensibilidad y Especificidad
9.
Biosens Bioelectron ; 171: 112709, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33075724

RESUMEN

Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was classified as a pandemic by the World Health Organization and has caused over 550,000 deaths worldwide as of July 2020. Accurate and scalable point-of-care devices would increase screening, diagnosis, and monitoring of COVID-19 patients. Here, we demonstrate rapid label-free electrochemical detection of SARS-CoV-2 antibodies using a commercially available impedance sensing platform. A 16-well plate containing sensing electrodes was pre-coated with receptor binding domain (RBD) of SARS-CoV-2 spike protein, and subsequently tested with samples of anti-SARS-CoV-2 monoclonal antibody CR3022 (0.1 µg/ml, 1.0 µg/ml, 10 µg/ml). Subsequent blinded testing was performed on six serum specimens taken from COVID-19 and non-COVID-19 patients (1:100 dilution factor). The platform was able to differentiate spikes in impedance measurements from a negative control (1% milk solution) for all CR3022 samples. Further, successful differentiation and detection of all positive clinical samples from negative control was achieved. Measured impedance values were consistent when compared to standard ELISA test results showing a strong correlation between them (R2=0.9). Detection occurs in less than five minutes and the well-based platform provides a simplified and familiar testing interface that can be readily adaptable for use in clinical settings.


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Técnicas Biosensibles/instrumentación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/sangre , Espectroscopía Dieléctrica/instrumentación , Neumonía Viral/sangre , Anticuerpos Antivirales/inmunología , Técnicas Biosensibles/economía , Técnicas de Laboratorio Clínico/economía , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/inmunología , Espectroscopía Dieléctrica/economía , Impedancia Eléctrica , Diseño de Equipo , Humanos , Proteínas Inmovilizadas/inmunología , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Sensibilidad y Especificidad , Glicoproteína de la Espiga del Coronavirus/inmunología , Factores de Tiempo
10.
Gene ; 766: 145145, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32941953

RESUMEN

COVID-19, a novel coronavirus-related illness, has spread worldwide. Patients with apparently mild/moderate symptoms can suddenly develop severe pneumonia. Therefore, almost all COVID-19 patients require hospitalization, which can reduce limited medical resources in addition to overwhelming medical facilities. To identify predictive markers for the development of severe pneumonia, a comprehensive analysis of serum chemokines and cytokines was conducted using serial serum samples from COVID-19 patients. The expression profiles were analyzed along the time axis. Serum samples of common diseases were enrolled from a BioBank to confirm the usefulness of predictive markers. Five factors, IFN-λ3, IL-6, IP-10, CXCL9, and CCL17, were identified as predicting the onset of severe/critical symptoms. The factors were classified into two categories. Category A included IFN-λ3, IL-6, IP-10, and CXCL9, and their values surged and decreased rapidly before the onset of severe pneumonia. Category B included CCL17, which provided complete separation between the mild/moderate and the severe/critical groups at an early phase of SARS-CoV-2 infection. The five markers provided a high predictive value (area under the receiver operating characteristic curve (AUROC): 0.9-1.0, p < 0.001). Low expression of CCL17 was specifically observed in pre-severe COVID-19 patients compared with other common diseases, and the predictive ability of CCL17 was confirmed in validation samples of COVID-19. The factors identified could be promising prognostic markers to distinguish between mild/moderate and severe/critical patients, enabling triage at an early phase of infection, thus avoiding overwhelming medical facilities.


Asunto(s)
Biomarcadores/sangre , Quimiocina CCL17/sangre , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/sangre , Neumonía Viral/fisiopatología , Betacoronavirus/fisiología , Citocinas/sangre , Hospitalización , Humanos , Pandemias , Índice de Severidad de la Enfermedad
11.
Med Sci Monit ; 26: e927674, 2020 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-33342993

RESUMEN

BACKGROUND The aim of this study was to analyze the clinical features and laboratory indices of patients with coronavirus disease (COVID-19) and explore their association with the severity of the disease. MATERIAL AND METHODS A total of 61 patients with COVID-19 were divided into groups with common symptoms and with severe diseases, and clinical data were collected to analyze and compare the differences between them. RESULTS In patients with severe COVID-19, compared with the common group, lymphocyte count and albumin levels were lower, and aspartate aminotransferase (AST), blood urea, blood creatinine, lactate dehydrogenase (LDH), and C-reactive protein (CRP) levels, and prothrombin time (PT) were elevated (all P<0.05). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and C-reactive protein-to-albumin ratio (CAR) were significantly elevated in the severe group compared with the group with common symptoms; however, the lymphocyte-to-monocyte ratio (LMR) was significantly reduced (P<0.05). Univariate logistic regression showed that lower lymphocyte count, prolonged PT, elevated CRP and LDH levels, and elevated NLR, PLR, MPVLR, and CAR were risk factors for COVID-19 severity (P<0.05). Multivariate logistic regression showed that elevated CRP levels (odds ratio [OR], 0.028; 95% confidence interval [CI]: 0.002-0.526; P=0.017), prolonged PT (OR, 0.014; 95% CI: 0.001-0.341; P=0.09), and an MPVLR >8.9 (OR, 0.026; 95% CI: 0.002-0.349; P=0.006) were independent risk factors for COVID-19 severity. CONCLUSIONS Elevated CRP and prolonged PT, and an MPVLR >8.9 were independent risk factors for COVID-19 severity.


Asunto(s)
/epidemiología , Infecciones por Coronavirus/diagnóstico , Adulto , Aspartato Aminotransferasas/sangre , Plaquetas , Proteína C-Reactiva/análisis , China/epidemiología , Coronavirus/patogenicidad , Infecciones por Coronavirus/sangre , Creatinina/análisis , Femenino , Humanos , Pacientes Internos , L-Lactato Deshidrogenasa/sangre , Recuento de Linfocitos , Linfocitos/química , Masculino , Volúmen Plaquetario Medio , Persona de Mediana Edad , Monocitos , Neutrófilos/química , Estudios Retrospectivos , Albúmina Sérica/análisis , Índice de Severidad de la Enfermedad
13.
Rev. patol. respir ; 23(supl.3): S263-S267, dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-197102

RESUMEN

El diagnóstico microbiológico de la infección por SARS-CoV-2 es de gran importancia por su repercusión clínica a nivel individual y para la elaboración de estrategias de salud pública para intentar frenar su propagación. Actualmente la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) es la técnica de elección para el diagnóstico microbiológico del paciente sintomático por COVID-19, detectando material genético del virus en el organismo. Requiere un adecuado manejo de las muestras y un laboratorio bien equipado. Otros métodos diagnósticos utilizados son la detección de anticuerpos generados por el individuo en contacto con el virus, son útiles para el estudio de infección pasada, estudios de vacunas o estrategias epidemiológicas; y la detección de antígenos del SARS-CoV-2 en muestras biológicas, de mayor rentabilidad, menor coste y gran especificidad, pero con altas tasas de falsos negativos en pacientes con baja carga viral. Es fundamental una correcta indicación e interpretación de las pruebas diagnósticas para su mayor rentabilidad


Microbiological diagnosis of SARS-CoV-2 infection is crucial due to its clinical repercussion at the individual level and for the development of public health strategies to try to stop its spread. Currently, reverse transcriptase polymerase chain reaction (RT-PCR) is the gold standard for microbiological diagnosis of symptomatic COVID-19 patients, detecting genetic material of the virus in the body. It requires proper sample handling and a well-equipped laboratory. Other diagnostic methods used are the detection of antibodies generated by the individual in contact with the virus, useful for the study of past infection, vaccine studies or epidemiological strategies; and the detection of SARS-CoV-2 antigens in biological samples, with greater profitability, lower cost and high specificity, but with high rates of false negatives in patients with low viral load. Correct indication and interpretation of diagnostic tests is essential for greater profitability


Asunto(s)
Humanos , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Pandemias , Infecciones por Coronavirus/sangre , Neumonía Viral/sangre , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad , Pruebas Serológicas , Anticuerpos/sangre
14.
Int J Mol Sci ; 21(22)2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33233715

RESUMEN

The pulmonary endothelium is a metabolically active continuous monolayer of squamous endothelial cells that internally lines blood vessels and mediates key processes involved in lung homoeostasis. Many of these processes are disrupted in acute respiratory distress syndrome (ARDS), which is marked among others by diffuse endothelial injury, intense activation of the coagulation system and increased capillary permeability. Most commonly occurring in the setting of sepsis, ARDS is a devastating illness, associated with increased morbidity and mortality and no effective pharmacological treatment. Endothelial cell damage has an important role in the pathogenesis of ARDS and several biomarkers of endothelial damage have been tested in determining prognosis. By further understanding the endothelial pathobiology, development of endothelial-specific therapeutics might arise. In this review, we will discuss the underlying pathology of endothelial dysfunction leading to ARDS and emerging therapies. Furthermore, we will present a brief overview demonstrating that endotheliopathy is an important feature of hospitalised patients with coronavirus disease-19 (COVID-19).


Asunto(s)
Infecciones por Coronavirus/patología , Células Endoteliales/patología , Neumonía Viral/patología , /patología , Animales , Betacoronavirus/aislamiento & purificación , Coagulación Sanguínea , Permeabilidad Capilar , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Humanos , Inflamación/sangre , Inflamación/etiología , Inflamación/patología , Pulmón/patología , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , /etiología
15.
Eur Rev Med Pharmacol Sci ; 24(21): 11386-11394, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33215460

RESUMEN

OBJECTIVE: To explore the expression and significance of SAA, CRP and FERR in patients diagnosed with COVID-19. PATIENTS AND METHODS: A total of 225 patients diagnosed with COVID-19 who were admitted to the North Hospital of First Hospital in Changsha, China, from 9th February 2020 to 7th March 2020 were enrolled. Their general data, laboratory test results and levels of SAA, CRP and FERR were extracted from electronic medical records. RESULTS: Age was an important risk factor for the severity of COVID-19 in the patients. Compared with the non-severe group, the severe group showed statistical significance in the levels of total protein, albumin, ALT and AST in liver function, UA in renal function, myocardial enzyme CK-MB and LDH, and immunoglobulin IgG and IgM. The levels of SAA, CRP, and FERR were significantly increased in patients with severe COVID-19. ROC curve analysis results showed that the AUC, from small to large, was as follows: SAA+CRP+FERR, CRP + FERR, SAA + CRP, SAA + FERR, SAA, FERR, and CRP, which indicated the benefit of the combination of the three indicators. The sensitivity and specificity of the combined detection of the three indicators were higher than those of the detection of any single indicator or two combined indicators. A Spearman correlation analysis of the data showed that the initial CRP/SAA, SAA/FERR, and CRP/FERR were positively correlated. The continuous results of SAA, CRP and FERR throughout the study period showed that the values of the severe group on a given day were higher than those of the non-severe group; the values of the two groups peaked on the 5th or 7th day and then decreased, and the decreasing trend of the severe group was more evident. CONCLUSIONS: SAA, CRP and FERR are sensitive serological indicators used to evaluate the severity of COVID-19. The combined detection of serum SAA, FERR, and CRP, which are positively related to COVID-19 infection, offers guiding significance for the occurrence of COVID-19 infection and the severity of the disease. Such detection provides effective detection indicators for the progress and prognosis of COVID-19; these indicators will enable effective intervention measures to be implemented in time and the rates of severe illness and mortality to be reduced.


Asunto(s)
Proteína C-Reactiva/análisis , Infecciones por Coronavirus/diagnóstico , Ferritinas/sangre , Neumonía Viral/diagnóstico , Proteína Amiloide A Sérica/análisis , Adulto , Factores de Edad , Anciano , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , Biomarcadores/sangre , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/mortalidad , Neumonía Viral/virología , Pronóstico , Estudios Retrospectivos , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
16.
PLoS One ; 15(11): e0242306, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33216772

RESUMEN

BACKGROUND: Since 1920, a decrease in serum cholesterol has been identified as a marker of severe pneumonia. We have assessed the performance of serum apolipoprotein-A1, the main transporter of HDL-cholesterol, to identify the early spread of coronavirus disease 2019 (Covid-19) in the general population and its diagnostic performance for the Covid-19. METHODS: We compared the daily mean serum apolipoprotein-A1 during the first 34 weeks of 2020 in a population that is routinely followed for a risk of liver fibrosis risk in the USA (212,297 serum) and in France (20,652 serum) in relation to a local increase in confirmed cases, and in comparison to the same period in 2019 (266,976 and 28,452 serum, respectively). We prospectively assessed the sensitivity of this marker in an observational study of 136 consecutive hospitalized cases and retrospectively evaluated its specificity in 7,481 controls representing the general population. RESULTS: The mean serum apolipoprotein-A1 levels in the survey populations began decreasing in January 2020, compared to the same period in 2019. This decrease was highly correlated with the daily increase in confirmed Covid-19 cases in the following 34 weeks, both in France and USA, including the June and mid-July recovery periods in France. Apolipoprotein-A1 at the 1.25 g/L cutoff had a sensitivity of 90.6% (95%CI84.2-95.1) and a specificity of 96.1% (95.7-96.6%) for the diagnosis of Covid-19. The area under the characteristics curve was 0.978 (0.957-0.988), and outperformed haptoglobin and liver function tests. The adjusted risk ratio of apolipoprotein-A1 for survival without transfer to intensive care unit was 5.61 (95%CI 1.02-31.0; P = 0.04). CONCLUSION: Apolipoprotein-A1 could be a sentinel of the pandemic in existing routine surveillance of the general population. NCT01927133, CER-2020-14.


Asunto(s)
Apolipoproteína A-I/sangre , Infecciones por Coronavirus/sangre , Neumonía Viral/sangre , Adulto , Anciano , Betacoronavirus , Biomarcadores/sangre , Infecciones por Coronavirus/epidemiología , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Estudios Retrospectivos , Estados Unidos
17.
Medicine (Baltimore) ; 99(47): e23315, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33217868

RESUMEN

Our study aimed to assess the existing evidence on whether severe coronavirus disease 2019 (COVID-19) is associated with elevated inflammatory markers.The PubMed, Embase, Web of Science, Scopus, Chinese National Knowledge Infrastructure, WanFang, and China Science and Technology Journal databases were searched to identify studies published between January 1 and April 21, 2020 that assayed inflammatory markers in COVID-19 patients. Three reviewers independently examined the literature, extracted relevant data, and assessed the risk of publication bias before including the meta-analysis studies.Fifty-six studies involving 8719 COVID-19 patients were identified. Meta-analysis showed that patients with severe disease showed elevated levels of white blood cell count (WMD: 1.15, 95% CI: 0.78-1.52), C-reactive protein (WMD: 38.85, 95% CI: 31.19-46.52), procalcitonin (WMD: 0.08, 95% CI: 0.06-0.11), erythrocyte sedimentation rate (WMD: 10.15, 95% CI: 5.03-15.46), interleukin-6 (WMD: 23.87, 95% CI: 15.95-31.78), and interleukin-10 (WMD: 2.12, 95% CI: 1.97-2.28). Similarly, COVID-19 patients who died during follow-up showed significantly higher levels of white blood cell count (WMD: 4.11, 95% CI: 3.25-4.97), C-reactive protein (WMD: 74.18, 95% CI: 56.63-91.73), procalcitonin (WMD: 0.26, 95% CI: 0.11-0.42), erythrocyte sedimentation rate (WMD: 10.94, 95% CI: 4.79-17.09), and interleukin-6 (WMD: 59.88, 95% CI: 19.46-100.30) than survivors.Severe COVID-19 is associated with higher levels of inflammatory markers than a mild disease, so tracking these markers may allow early identification or even prediction of disease progression.


Asunto(s)
Betacoronavirus , Biomarcadores/sangre , Infecciones por Coronavirus/sangre , Mediadores de Inflamación/sangre , Neumonía Viral/sangre , Índice de Severidad de la Enfermedad , Adulto , Anciano , Sedimentación Sanguínea , Proteína C-Reactiva/análisis , Infecciones por Coronavirus/mortalidad , Progresión de la Enfermedad , Femenino , Humanos , Inflamación , Interleucina-10/sangre , Interleucina-6/sangre , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Polipéptido alfa Relacionado con Calcitonina/sangre
18.
Medicine (Baltimore) ; 99(47): e23365, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33217881

RESUMEN

Hypercoagulability and thrombosis remain a challenge in severe coronavirus disease 2019 (COVID-19) infections. Our aim is to investigate the hemostatic profile of critically ill COVID-19 patients on therapeutic anticoagulant treatment.Forty one patients were enrolled into the study. We recruited 11 consecutive, COVID-19, patients who received therapeutic anticoagulant treatment on intensive care unit (ICU) admission. Disease severity indexes, biochemical, hematological and haemostatic parameters, endogenous thrombin potential (ETP), plasminogen activator inhibitor-1 (PAI-1) activity and extrinsically activated rotational thromboelastometry assay (EXTEM) were recorded on days 1, 3, 7. We also enrolled 9 ICU non-COVID-19, 21 non-ICU COVID-19 patients and 20 healthy blood donors as control populations.Critically ill COVID-19 patients demonstrated a more hypercoagulable and hypofibrinolytic profile related to those with COVID-19 mild illness, based on EXTEM amplitude at 10 min (A10), maximum clot firmness (MCF) and lysis index at 60 min (LI60) variables (p = 0.020, 0.046 and 0.001, respectively). Similarly, a more hypercoagulable state was detected in COVID-19 ICU patients related to non-COVID-19 ICU patients based on A10 and MCF parameters (p = 0.03 and 0.04, respectively). On the contrary, ETP and EXTEM (clotting time) CT values were similar between patients with severe and mild form of the COVID-19 infection, probably due to anticoagulant treatment given.Critically ill COVID-19 patients showed a hypercoagulable profile despite the therapeutic anticoagulant doses given. Due to the small sample size and the study design, the prognostic role of the hypercoagulability in this clinical setting remains unknown and further research is required in order to be assessed.


Asunto(s)
Anticoagulantes/farmacología , Infecciones por Coronavirus/sangre , Hemostasis/efectos de los fármacos , Neumonía Viral/sangre , Trombofilia/tratamiento farmacológico , Trombosis/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Betacoronavirus , Pruebas de Coagulación Sanguínea , Estudios de Casos y Controles , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Enfermedad Crítica , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Pronóstico , Índice de Severidad de la Enfermedad , Tromboelastografía , Trombofilia/sangre , Trombofilia/virología , Trombosis/sangre , Trombosis/virología , Resultado del Tratamiento
19.
Medicine (Baltimore) ; 99(47): e23392, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33217883

RESUMEN

BACKGROUND: The impact of glycosylated hemoglobin on mortality in patients with coronavirus disease 2019 (COVID-19) and type 2 diabetes (T2D) remains uncertain. In this study, we aim to assess the effect of pre-hospital blood glucose regulation on patients with COVID-19 and pre-existing T2D. METHODS: All randomized controlled trials (RCTs) and cohort studies of association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D will be included in this review. PubMed, Embase, and CNKI will be searched for relevant literature, up to August 20, 2020 in English and Chinese language. Two reviewers will select trials independently for inclusion and assess trial quality. Two pairs of authors will independently extract information for each included trials. Primary outcomes are death and composite adverse outcomes: the number of participants who died or remained severely disabled. Revman 5.3 will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysisa and generating funnel-plots. RESULTS: We will provide practical results about the association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D. CONCLUSION: The stronger evidence about the association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D will be provided for clinical practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020200574. ETHICS AND DISSEMINATION: There is no need for ethical approval, and the review will be reported in a peer-reviewed journal.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/sangre , Diabetes Mellitus Tipo 2/sangre , Hemoglobina A Glucada/análisis , Neumonía Viral/sangre , Índice de Severidad de la Enfermedad , Adulto , Anciano , Estudios de Cohortes , Infecciones por Coronavirus/mortalidad , Diabetes Mellitus Tipo 2/mortalidad , Diabetes Mellitus Tipo 2/virología , Femenino , Humanos , Masculino , Metaanálisis como Asunto , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
20.
Nat Commun ; 11(1): 5761, 2020 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-33188185

RESUMEN

The rapid global spread of the novel coronavirus SARS-CoV-2 has strained healthcare and testing resources, making the identification and prioritization of individuals most at-risk a critical challenge. Recent evidence suggests blood type may affect risk of severe COVID-19. Here, we use observational healthcare data on 14,112 individuals tested for SARS-CoV-2 with known blood type in the New York Presbyterian (NYP) hospital system to assess the association between ABO and Rh blood types and infection, intubation, and death. We find slightly increased infection prevalence among non-O types. Risk of intubation was decreased among A and increased among AB and B types, compared with type O, while risk of death was increased for type AB and decreased for types A and B. We estimate Rh-negative blood type to have a protective effect for all three outcomes. Our results add to the growing body of evidence suggesting blood type may play a role in COVID-19.


Asunto(s)
Sistema del Grupo Sanguíneo ABO , Betacoronavirus , Infecciones por Coronavirus/sangre , Neumonía Viral/sangre , Sistema del Grupo Sanguíneo Rh-Hr , Adulto , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Humanos , Intubación Intratraqueal , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Prevalencia , Factores de Riesgo , Análisis de Supervivencia
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