Development and validation of a laboratory-based risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19.

BACKGROUND: Early identification of patients with COVID-19 who may develop critical illness is of great importance. METHODS: In this study a retrospective cohort of 264 COVID-19 cases admitted at Macarena University was used for development and internal validation of a risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. Backward stepwise logistic regression was used to derive the model, including clinical and laboratory variables predictive of critical illness. Internal validation of the final model used bootstrapped samples and the model scoring derived from the coefficients. External validation was performed in a cohort of 154 cases admitted at Valme and Virgen del Rocio University Hospital. RESULTS: A total of 62 (23.5%) patients developed a critical illness during their hospitalization stay, 21 (8.0%) patients needed invasive ventilation, 34 (12.9%) were admitted at the ICU and the overall mortality was of 14.8% (39 cases). 5 variables were included in the final model: age >59.5 years (OR: 3.11;95%CI 1.39-6.97), abnormal CRP results (OR: 5.76;95%CI 2.32-14.30), abnormal lymphocytes count (OR: 3.252;95%CI 1.56-6.77), abnormal CK results (OR: 3.38;95%CI 1.59-7.20) and abnormal creatinine (OR: 3.30;95%CI 1.42-7.68). The AUC of this model was 0.850 with sensitivity of 65% and specificity of 87% and the IDI and NRI were 0.1744 and 0.2785, respectively. The validation indicated a good discrimination for the external population. CONCLUSIONS: Biomarkers add prognostic information in COVID-19 patients. Our risk-score provides an easy to use tool to identify patients who are likely to develop critical illness during their hospital stay.

Recomendaciones para el mantenimiento de equipos en el Laboratorio de Andrología y Embriología. Segunda parte. Equipos auxiliares / Recommendations for the maintenance of equipment in the Andrology and Embryology Laboratory. Second part. Auxiliary equipment

Segundo de la serie de la Comisión de Andrología y Técnicas de Reproducción Asistida elaborada para facilitar el correcto mantenimiento, control y ajuste de los equipos que se utilizan en el Laboratorio de Andrología y Embriología. Se centra en los equipos auxiliares que dan soporte a los diferentes procesos de reproducción asistida. Incluye un programa de control para equipos de seguimiento y medición con frecuencias de revisión y criterios de aceptación

The second in the series of the Committee of Andrology and Techniques of Assisted Reproduction Committee, is prepared in order to carry out the correct maintenance, control and adjustment of the equipment used in the Andrology and Embryology laboratory. It focuses on the auxiliary equipment that supports the different processes of assisted reproduction. It includes a control program for monitoring and measuring equipment with revision frequencies and acceptance criteria

Recomendaciones en el proceso preanalítico del análisis de semen II. Recomendación 2016 / Recommendations on the pre-analytical process of semen analysis II. Recommendation 2016

Las condiciones de obtención y transporte de las muestras tienen influencia en los resultados del análisis de semen en el laboratorio. El diseño y la implementación de un protocolo adecuado para la fase preanalítica es necesario para generar resultados fiables. Este documento trata de proporcionar una serie de recomendaciones en la información que debe ser incluida en las instrucciones a los pacientes. También caracteriza variables y factores de confusión, como el periodo de abstinencia, el lugar de obtención de la muestra, etc. en un listado de verificación

Collection and transport of semen samples can have an influence on the laboratory analysis results. The design and implementation of a protocol suitable for the pre-analytical phase is required in order to offer accurate results. This document is intended to provide a series of recommendations on the information that should be included in the instructions to the patients. Furthermore, it mentions pre-analytical confounders, such as the period of sexual abstinence, the location where the semen sample was obtain, as well as explanatory variables, included in a sample reception checklist

Técnicas avanzadas para selección de espermatozoides / Advanced techniques for sperm selection

El tracto genital femenino ejecuta un análisis de semen particular, identificando y seleccionando el mejor espermatozoide para la fecundación. Este análisis in vivo trata de asegurar que la descendencia reciba el material genético de mejor calidad. La selección artificial de espermatozoides implica eliminar las barreras naturales con las que se encuentra el gameto masculino en su largo recorrido. Las técnicas convencionales de selección de espermatozoides que se emplean en reproducción asistida (swim-up y gradientes de densidad específicos), se fundamentan en la recuperación o selección de los espermatozoides con mejor movilidad y morfología, pero no distinguen espermatozoides funcionalmente capaces de fecundar ni genéticamente normales. El objetivo de las técnicas avanzadas es seleccionar el espermatozoide con las mejores características funcionales para ICSI o FIV y conseguir una progenie sana. La introducción de nuevas técnicas en el Laboratorio de Andrología podría suponer un salto cualitativo en los resultados en reproducción (AU)

The female genital tract performs a particular sperm analysis, identifying and selecting the best sperm for fertilization. This in vivo analysis seeks to ensure that the offspring receives the best genetic material. Through artificial sperm selection, natural barriers along the female tract are skipped. Conventional selection techniques used in assisted reproduction are based on sperm motility and morphology, not distinguishing between fecundating ability or genetic normality. The object of advanced sperm selection techniques is to retrieve the spermatozoa with better functional characteristics for intracytoplasmic sperm injection or in vitro fertilization. The introduction of these techniques in the andrology laboratory might represent a qualitative leap in assisted reproduction results (AU)