Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 112.622
Filtrar
1.
Georgian Med News ; (306): 41-46, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33130644

RESUMO

The goal of the study is assessing the population structure of lymphocytes and the subpopulation composition of NK cells in the peripheral blood of humans in the case of drug-induced osteonecrosis of the jaw for improving the quality of diagnosis, treatment, and prevention of osteonecrosis of the jaw. Thirty patients were examined, including 15 patients with drug-induced osteonecrosis of the jaw (ONJ), 10 healthy individuals, and five patients with pyoinflammatory diseases of the maxillofacial region, aged 49 to 77. Every four weeks, the patients had been receiving 4 mg intravenous injections of bisphosphonates (the Zometa preparation (zoledronic acid)) for 1.5 - 3 years. The study was performed on a FACS Canto II flow cytometer manufactured by Becton Dickinson (BD), USA. In the patients with ONJ, an imbalance of the NK cell subtypes was observed. As to the common NK cells, the level of subtypes of cytolytic NK cells (CD3-CD16+(or hight)56dim) was elevated, and the level of cytokine-producing cells (СD3-CD16-(or low) 56bright) was reduced, compared to the healthy individuals (p<0.05). In the patients with ONJ, after the surgical treatment, the relative and absolute levels of lymphocytes and the total level of NK cells (CD3-CD16+/56+) normalized on the seventh day. The level of NK cells subtypes did not change after the treatment. This pathology is characterized by a low level of innate protection factors, as evidenced by the reduction of the total population of NK cells, and the imbalance of NK cells subtypes. The imbalance of NK cells (the natural killer cells) was an indicator of unfavorable prognosis for osteonecrosis treatment.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Doenças Maxilomandibulares , Células Matadoras Naturais , Linfócitos , Idoso , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/imunologia , Difosfonatos/efeitos adversos , Humanos , Pessoa de Meia-Idade
2.
Clin Nutr ESPEN ; 40: 101-102, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183520

RESUMO

Systemic inflammation has been reported as a new predictor for COVID-19 outcomes. Thus, we highlight in this viewpoint the importance of the neutrophil to lymphocyte ratio in COVID-19 pandemic-infected patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Linfócitos/citologia , Neutrófilos/citologia , Pneumonia Viral/mortalidade , Biomarcadores , Infecções por Coronavirus/sangue , Estado Terminal , Humanos , Pandemias , Pneumonia Viral/sangue , Prognóstico
3.
J Toxicol Sci ; 45(11): 701-711, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33132244

RESUMO

We aimed to investigate the role of programmed cell death protein 1 (PD-1) and T lymphocytes in the proliferation, apoptosis and secretion of cells from patients and mice with Graves' disease (GD). The levels of serum hormones, related antibodies and inflammatory cytokines in GD patients were determined by electrochemiluminescence immunoassay and ELISA. The percentages of CD4 and CD8 T-lymphocytes and PD-1 expression were examined by flow cytometry. A GD mouse model, a thyroid follicular epithelial cell, and a CD4+PD-1+, CD4+PD-1- and CD8+PD-1+, CD8+PD-1- T lymphocyte co-culture system were constructed. The viability, apoptosis-related markers, serum hormones, related antibodies and inflammatory cytokines in thyroid follicular epithelial cells were determined by CCK-8, Western blot, qTR-PCR, electrochemiluminescence immunoassay and ELISA. Elevated free thyroid hormones (FT3, FT4), thyroid hormone antibodies (TRAb, TPOAb and TGAb), inflammatory cytokines, and inhibited TSH were observed in GD patients. The percentage of CD4+ T cells was increased, while that of CD8+ T cells was reduced in GD patients. PD-1 expression level was lifted in both CD4+ and CD8+ cells from GD patients. In mouse thyroid follicular epithelial cells co-cultured with CD4+PD-1+ and CD8+PD-1+ T lymphocytes, the cell viability, TH and TRAb levels and inflammatory cytokines level were the highest, while the TSH level and apoptosis were the lowest. PD-1 positive T lymphocytes were able to promote viability and inhibit apoptosis of thyroid follicular epithelial cells, which further caused a more accelerated development of GD.


Assuntos
Antígeno B7-H1/imunologia , Antígeno B7-H1/fisiologia , Proliferação de Células , Citocinas/metabolismo , Células Epiteliais/imunologia , Células Epiteliais/fisiologia , Doença de Graves/genética , Doença de Graves/imunologia , Mediadores da Inflamação/metabolismo , Linfócitos/imunologia , Receptor de Morte Celular Programada 1/imunologia , Receptor de Morte Celular Programada 1/fisiologia , Glândula Tireoide/citologia , Adulto , Animais , Apoptose , Células Cultivadas , Técnicas de Cocultura , Modelos Animais de Doenças , Progressão da Doença , Feminino , Doença de Graves/patologia , Humanos , Masculino , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade
4.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 36(10): 865-870, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33148379

RESUMO

Objective To investigate dynamic changes of type 3 innate lymphoid cells (ILC3) in lungs of mice with bronchopulmonary dysplasia (BPD). Methods Forty newborn C57BL/6 mice were randomized into air group and the hyperoxia group, 20 mice in each group. C57BL/6 newborn mice were delivered by caesarean section on the 19th day of pregnancy and exposed to 850 mL/L O2 for replication of the BPD model. Five mice in each group were sacrificed 1 day, 3, 7, 14 days after they were born for procurement of fresh lung tissues. HE staining was used to observe the pathological changes of lung tissues. ELISA was used to detect the protein content of downstream cytokines interleukin-17 (IL-17), IL-22 and granulocyte-macrophage colony stimulating factor (GM-CSF) in lung homogenate. Flow cytometry was used for measuring the proportion of ILC3 in lymphocytes as well as the proportions of IL-17+ ILC3 and IL-22+ ILC3 in the lung. Results The proportion of ILC3 in lung tissues reached the peak on the 7th day after birth. In contrast with the air group, the proportion of ILC3 in the hyperoxia group was significantly elevated at the same time points. The protein content of IL-17 and IL-22 in the hyperoxia group went up significantly in comparison with those in the air group at the same time points, while the GM-CSF content in the hyperoxia group showed no significant changes. The proportions of IL-17+ILC3 and IL-22+ILC3 in the hyperoxia group significantly increased as compared with those in the air group at the same time points. Conclusion The secretion of IL-17 and IL-22 derived from ILC3 is associated with BPD.


Assuntos
Displasia Broncopulmonar/imunologia , Interleucina-17/imunologia , Interleucinas/imunologia , Linfócitos/citologia , Animais , Animais Recém-Nascidos , Modelos Animais de Doenças , Feminino , Hiperóxia , Imunidade Inata , Pulmão/citologia , Pulmão/imunologia , Pulmão/fisiopatologia , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , Distribuição Aleatória
5.
PLoS One ; 15(11): e0241262, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33137167

RESUMO

The coronavirus disease 2019 (COVID-19) has become a pandemic. Rapidly distinguishing COVID-19 from other respiratory infections is a challenge for first-line health care providers. This retrospective study was conducted at the Taipei Medical University Hospital, Taiwan. Patients who visited the outdoor epidemic prevention screening station for respiratory infection from February 19 to April 30, 2020, were evaluated for blood biomarkers to distinguish COVID-19 from other respiratory infections. Monocyte distribution width (MDW) ≥ 20 (odds ratio [OR]: 8.39, p = 0.0110, area under curve [AUC]: 0.703) and neutrophil-to-lymphocyte ratio (NLR) < 3.2 (OR: 4.23, p = 0.0494, AUC: 0.673) could independently distinguish COVID-19 from common upper respiratory tract infections (URIs). Combining MDW ≥ 20 and NLR < 3.2 was more efficient in identifying COVID-19 (AUC: 0.840). Moreover, MDW ≥ 20 and NLR > 5 effectively identified influenza infection (AUC: 0.7055). Thus, MDW and NLR can distinguish COVID-19 from influenza and URIs.


Assuntos
Infecções por Coronavirus/patologia , Influenza Humana/patologia , Linfócitos/citologia , Monócitos/citologia , Neutrófilos/citologia , Pneumonia Viral/patologia , Área Sob a Curva , Biomarcadores/metabolismo , Infecções por Coronavirus/imunologia , Feminino , Humanos , Influenza Humana/imunologia , Linfócitos/metabolismo , Masculino , Monócitos/metabolismo , Neutrófilos/metabolismo , Razão de Chances , Pandemias , Projetos Piloto , Pneumonia Viral/imunologia , Curva ROC , Infecções Respiratórias/imunologia , Infecções Respiratórias/patologia
6.
BMC Pulm Med ; 20(1): 301, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33198751

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. Given that the main target of SARS-CoV-2 are lungs leading to severe pneumonia with hyperactivation of the inflammatory cascade, we conducted a prospective study to assess alveolar inflammatory status in patients with moderate to severe COVID-19. METHODS: Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin (IL)6, 8 and 10 levels. RESULTS: ICU patients showed a marked increase in neutrophils (1.24 × 105 ml- 1, 0.85-2.07), lower lymphocyte (0.97 × 105 ml- 1, 0.024-0.34) and macrophages fractions (0.43 × 105 ml- 1, 0.34-1.62) compared to IMW patients (0.095 × 105 ml- 1, 0.05-0.73; 0.47 × 105 ml- 1, 0.28-1.01 and 2.14 × 105 ml- 1, 1.17-3.01, respectively) (p < 0.01). Study of ICU patients BAL by electron transmission microscopy showed viral particles inside mononuclear cells confirmed by immunostaining with anti-viral capsid and spike antibodies. IL6 and IL8 were significantly higher in ICU patients than in IMW (IL6 p < 0.01, IL8 p < 0.0001), and also in patients who did not survive (IL6 p < 0.05, IL8 p = 0.05 vs. survivors). IL10 did not show a significant variation between groups. Dividing patients by treatment received, lower BAL concentrations of IL6 were found in patients treated with steroids as compared to those treated with tocilizumab (p < 0.1) or antivirals (p < 0.05). CONCLUSIONS: Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.


Assuntos
Líquido da Lavagem Broncoalveolar/imunologia , Infecções por Coronavirus/imunologia , Inflamação/imunologia , Interleucina-6/imunologia , Interleucina-8/imunologia , Leucócitos/imunologia , Pulmão/imunologia , Macrófagos Alveolares/imunologia , Pneumonia Viral/imunologia , Monofosfato de Adenosina/análogos & derivados , Monofosfato de Adenosina/uso terapêutico , Corticosteroides/uso terapêutico , Idoso , Alanina/análogos & derivados , Alanina/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Lavagem Broncoalveolar , Líquido da Lavagem Broncoalveolar/citologia , Líquido da Lavagem Broncoalveolar/virologia , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Combinação de Medicamentos , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Unidades de Terapia Intensiva , Interleucina-10/imunologia , Itália , Leucócitos Mononucleares/virologia , Lopinavir/uso terapêutico , Pulmão/citologia , Pulmão/virologia , Linfócitos/imunologia , Masculino , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Neutrófilos/imunologia , Pandemias , Pneumonia Viral/terapia , Prognóstico , Estudos Prospectivos , Respiração Artificial/métodos , Ritonavir/uso terapêutico , Glicoproteína da Espícula de Coronavírus/metabolismo , Taxa de Sobrevida , Vírion/metabolismo , Vírion/ultraestrutura
7.
Sci Rep ; 10(1): 18277, 2020 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-33106497

RESUMO

Severe COVID-19 associated respiratory failure, poses the one challenge of our days. Assessment and treatment of COVID-19 associated hyperinflammation may be key to improve outcomes. It was speculated that in subgroups of patients secondary hemophagocytic lymphohistiocytosis (sHLH) or cytokine release syndrome (CRS) with features of macrophage activation syndrome might drive severe disease trajectories. If confirmed, profound immunosuppressive therapy would be a rationale treatment approach. Over a median observation period of 11 (IQR: 8; 16) days, 19 consecutive confirmed severe COVID-19-patients admitted to our intensive-care-unit were tested for presence of sHLH by two independent experts. HScores and 2004-HLH diagnostic criteria were assessed. Patients were grouped according to short-term clinical courses: discharge from ICU versus ongoing ARDS or death at time of analysis. The median HScore at admission was 157 (IQR: 98;180), without the key clinical triad of HLH, i.e. progressive cytopenia, persistent fever and organomegaly. Independent expert chart review revealed the absence of sHLH in all cases. No patient reached more than 3/6 of modified HLH 2004 criteria. Nevertheless, patients presented hyperinflammation with peripheral neutrophilic signatures (neutrophil/lymphocyte-ratio > 3.5). The latter best paralleled their short-term clinical courses, with declining relative neutrophil numbers prior to extubation (4.4, [IQR: 2.5;6.3]; n = 8) versus those with unfavourable courses (7.6, [IQR: 5.2;31], n = 9). Our study rules out virus induced sHLH as the leading cause of most severe-COVID-19 trajectories. Instead, an associated innate neutrophilic hyperinflammatory response or virus-associated-CRS appears dominant in patients with an unfavourable clinical course. Therapeutic implications are discussed.


Assuntos
Infecções por Coronavirus/patologia , Síndrome da Liberação de Citocina/etiologia , Linfo-Histiocitose Hemofagocítica/patologia , Pneumonia Viral/patologia , Idoso , Betacoronavirus/isolamento & purificação , Estudos de Coortes , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Estado Terminal , Síndrome da Liberação de Citocina/diagnóstico , Feminino , Ferritinas/análise , Humanos , Unidades de Terapia Intensiva , Interleucina-6/metabolismo , Linfócitos/citologia , Linfo-Histiocitose Hemofagocítica/complicações , Linfo-Histiocitose Hemofagocítica/diagnóstico , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Pandemias , Projetos Piloto , Pneumonia Viral/complicações , Pneumonia Viral/virologia
8.
Sarcoidosis Vasc Diffuse Lung Dis ; 37(2): 225-230, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33093787

RESUMO

Objective: Immunoglobulin G4-related disease (IgG4-RD) is a recently described systemic disorder. Pleural effusion is considered an uncommon manifestation of the disease. We describe a case series of patients with IgG4-RD and clinically significant pleural effusions. Methods: A retrospective analysis of patients with histologically proven IgG4-RD treated for pleural effusion in our clinic. Results: We identified 4 male patients with pleural effusion caused by IgG4-RD. The effusions were lymphocytic exudates, with especially high protein concentrations. All patients had hyperglobulinemia, elevated serum immunoglobulin G (IgG) levels and elevated levels subclasses IgG1 and IgG4. In two patients, levels of adenosine deaminase (ADA) were measured in the effusion and were elevated (309 and 108 IU/L). Tuberculosis was excluded in both cases by pleural biopsy. Involvement of other organs by IgG4-RD was the rule, especially thoracic lymphadenopathy which was prominent in all patients. In all cases, effusion responded to corticosteroids therapy. One patient developed radiological findings compatible with rounded atelectasis during remission. Conclusions: IgG4-RD may cause an ADA-positive, lymphocytic exudate with a high protein concentration, characteristics resembling tuberculous effusion. Thoracic lymphadenopathy, hyperglobulinemia, and an increased total IgG, IgG1, IgG4 may suggest the diagnosis. Not previously described, IgG4-RD pleural inflammation may result in rounded atelectasis. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 225-230).


Assuntos
Adenosina Desaminase/metabolismo , Doença Relacionada a Imunoglobulina G4/enzimologia , Linfócitos/enzimologia , Derrame Pleural/enzimologia , Corticosteroides/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Biópsia , Diagnóstico Diferencial , Humanos , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/tratamento farmacológico , Doença Relacionada a Imunoglobulina G4/imunologia , Contagem de Linfócitos , Linfócitos/efeitos dos fármacos , Linfócitos/imunologia , Masculino , Derrame Pleural/diagnóstico , Derrame Pleural/tratamento farmacológico , Derrame Pleural/imunologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
9.
PLoS One ; 15(10): e0240959, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33085709

RESUMO

As a novel concept of responding to disease epidemics, Fangcang shelter hospitals were deployed to expand the health system's capacity and provide medical services for non-severe COVID-19 patients during the outbreak in Wuhan. To give insights on patient management within Fangcang hospitals, we conducted a retrospective analysis to: 1) describe the characteristics of the patients admitted to Fangcang hospitals and 2) explore risk factors for longer length of stay (LOS). We enrolled 136 confirmed COVID-19 patients, including asymptomatic patients and those with mild symptoms, who were hospitalized in the Wuti Fangcang Hospital. 58 patients completed the treatment and discharged before 1 March 2020. After describing patients' demographic and clinical characteristics, exposure history, treatment received and time course of the disease, we conducted linear regression analysis to identify factors influencing LOS. We found that patients having fever before admission were hospitalized 3.5 days (95%CI 1.39 to 5.63, p = 0.002) longer than those without fever and that patients having bilateral pneumonia were hospitalized 3.4 days (95%CI 0.49 to 6.25, p = 0.023) longer than those with normal CT scan results. We also found weak evidence suggesting that patients with diabetes were hospitalized 3.2 days longer than those without diabetes (95%CI -0.2 to 6.56, p = 0.065). However, we observed no significant differences in LOS between symptomatic and asymptomatic patients and between patients who received treatment and those without treatment. Longer duration of hospitalization among non-severe COVID-19 patients is associated with having fever, bilateral pneumonia on CT scan and diabetes. However, being asymptomatic and using supportive medications at the early stage of infection do not have significant influences on LOS. Our study is a single-centered study with relatively small sample size. The findings provide evidence for predicting hospital bed demand in a novel response scenario and may help decision-makers in preparing for ramping up the health system capacity.


Assuntos
Betacoronavirus/genética , Doenças Cardiovasculares/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Diabetes Mellitus/epidemiologia , Tempo de Internação , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Índice de Gravidade de Doença , Adulto , Idoso , Comorbidade , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/virologia , Feminino , Febre , Humanos , Contagem de Linfócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Tomografia Computadorizada por Raios X
10.
Sci Rep ; 10(1): 16826, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33033405

RESUMO

Excessive interleukin-6 signaling is a key factor contributing to the cytokine release syndrome implicated in clinical manifestations of COVID-19. Preliminary results suggest that tocilizumab, a humanized monoclonal anti-interleukin-6 receptor antibody, may be beneficial in severely ill patients, but no data are available on earlier stages of disease. An anticipated blockade of interleukin-6 might hypothetically prevent the catastrophic consequences of the overt cytokine storm. We evaluated early-given tocilizumab in patients hospitalized with COVID-19, and identified outcome predictors. Consecutive patients with initial Sequential-Organ-Failure-Assessment (SOFA) score < 3 fulfilling pre-defined criteria were treated with tocilizumab. Serial plasma biomarkers and nasopharyngeal swabs were collected. Of 193 patients admitted with COVID-19, 64 met the inclusion criteria. After tocilizumab, 49 (76.6%) had an early favorable response. Adjusted predictors of response were gender, SOFA score, neutrophil/lymphocyte ratio, Charlson comorbidity index and systolic blood pressure. At week-4, 56.1% of responders and 30% of non-responders had cleared the SARS-CoV-2 from nasopharynx. Temporal profiles of interleukin-6, C-reactive protein, neutrophil/lymphocyte ratio, NT-ProBNP, D-dimer, and cardiac-troponin-I differed according to tocilizumab response and discriminated final in-hospital outcome. No deaths or disease recurrences were observed. Preemptive therapy with tocilizumab was safe and associated with favorable outcomes in most patients. Biological and clinical markers predicted outcomes.


Assuntos
Anticorpos Monoclonais Humanizados/farmacologia , Anticorpos Monoclonais Humanizados/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Escores de Disfunção Orgânica , Pneumonia Viral/tratamento farmacológico , Receptores de Interleucina-6/antagonistas & inibidores , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Biomarcadores/sangue , Proteína C-Reativa/análise , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Feminino , Seguimentos , Humanos , Interleucina-6/sangue , Contagem de Linfócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Espanha/epidemiologia , Resultado do Tratamento
11.
Cell ; 183(2): 308-314, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33064987

RESUMO

The 2020 Lasker Awards, a celebration of one of the most prestigious international prizes given to individuals for extraordinary contributions to Basic and Clinical Medical Research, Pubic Health, and Special Achievement, was cancelled because of the COVID-19 pandemic. Typically, essays on the awardees and their scientific and medical contributions are solicited and published in Cell in collaboration with the Lasker Committee. This year, the Lasker Committee commissioned an essay to reflect on the historic contributions that scientists and physicians have made to our understanding of immunology and virology, and future directions in medical and basic research that have been highlighted by COVID-19 pandemic.


Assuntos
Alergia e Imunologia , Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Imunidade , Pneumonia Viral/imunologia , Alergia e Imunologia/história , Animais , Distinções e Prêmios , Citocinas/imunologia , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Sistema Imunitário/citologia , Imunoglobulinas/genética , Imunoglobulinas/imunologia , Linfócitos/citologia , Pandemias , Vacinação/história
12.
Tohoku J Exp Med ; 252(2): 109-119, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33028754

RESUMO

Coronavirus disease 2019 (COVID-19) is associated with various symptoms and changes in hematological and biochemical variables. However, clinical features, which can differentiate COVID-19 from non-COVID-19, are not clear. We therefore examined the key clinical features of COVID-19 and non-COVID-19 patients. This study included 60 COVID-19 patients and 100 non-COVID-19 patients, diagnosed by PCR, and no significant differences in the age and sex were seen between the two groups. The frequencies of fatigue, loose stool, diarrhea, nasal obstruction, olfactory dysfunction, taste dysfunction, underlying hyperlipidemia, and the prescription of angiotensin II receptor blocker (ARB) were significantly higher in COVID-19 patients than those in non-COVID-19 patients. The counts of leucocytes, neutrophils, lymphocytes, eosinophils, monocytes, and basophils and the levels of chloride and calcium in blood of COVID-19 patients were significantly lower than those of non-COVID-19 patients. The frequencies of atypical lymphocytes and the levels of lactate dehydrogenase (LDH) and potassium were significantly higher in COVID-19 than those in non-COVID-19. The C-reactive protein (CRP) level in COVID-19 patients was significantly lower than that in non-COVID-19 patients, when we compared CRP levels among patients with elevated CRP. This study is the first to indicate that electrolyte levels and the frequency of atypical lymphocytes in COVID-19 are significantly different from those in non-COVID-19. Fatigue, loose stool, diarrhea, nasal obstruction, olfactory dysfunction, and taste dysfunction were the key symptoms of COVID-19. Furthermore, hyperlipidemia and ARB may be risk factors of COVID-19. In conclusion, leucocytes, leucocyte fractions, CRP, LDH, and electrolytes are useful indicators for COVID-19 diagnosis.


Assuntos
Infecções por Coronavirus/diagnóstico , Eletrólitos/sangue , Linfócitos/virologia , Pneumonia Viral/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Proteína C-Reativa/análise , Criança , Diagnóstico Diferencial , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/virologia , Pandemias , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Avaliação de Sintomas , Distúrbios do Paladar/virologia , Adulto Jovem
13.
Nat Commun ; 11(1): 4968, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009413

RESUMO

The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a worldwide emergency. Early identification of patients at risk of progression may facilitate more individually aligned treatment plans and optimized utilization of medical resource. Here we conducted a multicenter retrospective study involving patients with moderate COVID-19 pneumonia to investigate the utility of chest computed tomography (CT) and clinical characteristics to risk-stratify the patients. Our results show that CT severity score is associated with inflammatory levels and that older age, higher neutrophil-to-lymphocyte ratio (NLR), and CT severity score on admission are independent risk factors for short-term progression. The nomogram based on these risk factors shows good calibration and discrimination in the derivation and validation cohorts. These findings have implications for predicting the progression risk of COVID-19 pneumonia patients at the time of admission. CT examination may help risk-stratification and guide the timing of admission.


Assuntos
Infecções por Coronavirus/diagnóstico , Progressão da Doença , Pneumonia Viral/diagnóstico , Pneumonia , Tomografia Computadorizada por Raios X/métodos , Adulto , Betacoronavirus , China , Técnicas de Laboratório Clínico , Coinfecção , Infecções por Coronavirus/patologia , Infecções por Coronavirus/fisiopatologia , Feminino , Hospitalização , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/fisiopatologia , Análise de Regressão , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
14.
J Coll Physicians Surg Pak ; 30(9): 928-932, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33036676

RESUMO

OBJECTIVE: To investigate the association ​of white blood cell (WBC) counts, neutrophil, platelets, lymphocyte counts, C-reactive protein (CRP), neutrophil / lymphocyte ratio (NLR), derived NLR ratio (d-NLR), and platelet / lymphocyte ratio (PLR) at the time of first admission for mortality caused by COVID-19. STUDY DESIGN:  Descritive, analytical study. PLACE AND DURATION OF STUDY: Department of Emergency Medicine, Sakarya University Training and Research Hospital, Turkey from  March 2020 to  May 2020. METHODOLOGY: One hundred and sixty-nine patients with the diagnosis of Covid-19 were retrospectively reviewed. Patients were divided into two groups as survivors and non-survivors. Inclusion criteria were age ≥18 years, RT-PCR test positivity, hospitalisation. Patients with missing data were excluded. Data regarding age, gender, WBC counts, neutrophil, platelets, and lymphocyte, CRP, NLR, d-NLR, PLR and comorbid conditions were analysed for mortality. All tests were done with a two-sided significance of 5%. For each endpoint, the absolute and relative effects and their corresponding 95% confidence interval  were calculated. RESULTS: There was a statistically significant association between neutrophil, lymphocyte, CRP, NLR, d-NLR and PLR values (p=0.005, p<0.001, p<0.001, p<0.001, p<0.001, and p<0.001, respectively) with mortality status of the patients. The cutoff values calculated by this analysis were 67.50 years for age, 5.12 K / µl for neutrophil, 1.12 K / µl for lymphocyte, 67.78 mg / dl for CRP, 3.9 for NLR, 2.55 for d-NLR, and 148.85 for PLR. CONCLUSION: Altered neutrophil and lymphocyte counts, NLR, d-NLR, PLR, and CRP values can be used as early predictors of mortality in Covid-19 patients. Key Words: Covid-19, Mortality, Emergency, NLR, d-NLR, PLR.


Assuntos
Infecções por Coronavirus/mortalidade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pneumonia Viral/mortalidade , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Proteína C-Reativa/análise , Infecções por Coronavirus/sangue , Feminino , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pandemias , Contagem de Plaquetas , Pneumonia Viral/sangue
15.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1528-1533, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067949

RESUMO

OBJECTIVE: To report the clinical characteristics in a case of extramedullary T-lymphoblastic blast crisis of de novo chronic myelogenous leukemia (CML) so as to improve the understanding of this disease. METHODS: The clinical characteristics, diagnostic approach and treatment of the patient were retrospectively analyzed, and some related literatures were reviewed. RESULTS: According to resuts of blood routine, bone marrow, chromosome and fusion gene tests, this patient was considered to be CML patient. The cervical lymph node biopsy indicated a T-cell lymphoblastic lymphoma (TLBL), and fluorescence in situ hybridization (FISH) analysis showed the BCR-ABL fusion gene within tumor cells of the patient's lymphnodes, thus was confirmedly diagnosed as extramedullary T-lymphoblastic blast crisis of chronic myelogenous leukemia. Treatment with dasatinib 140 mg/d combined with chemotherapy was then initiated, while the patient never achieved a complete remission. CONCLUSION: De novo chronic myelogenous leukemia in blast crisis is infrequent presence, the cases of extramedullary T-lymphoblastic blast crisis of newly diagnosed CML with additional chromosome 11q23 are extremely rare. And prognosis of these patients are poor, allogeneic hematopoietic stem cell transplantation maybe the only curable treatment.


Assuntos
Crise Blástica , Leucemia Mielogênica Crônica BCR-ABL Positiva , Humanos , Hibridização in Situ Fluorescente , Linfócitos , Estudos Retrospectivos
16.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1563-1569, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067955

RESUMO

OBJECTIVE: To explore the influence of lymphocyte / monocyte ratio (LMR), LMR/lactate dehydrogenase (LDH) ratio on the prognosis of patients with diffuse large B-cell lymphoma. METHODS: Clinical data of 107 newly diagnosed patients with DLBCL, including age, sex, stage, B symptoms, IPI score, ECOG score, absolute lymphocyte count, absolute value of monocytes, the ratio of lymphocyte to monocyte(LMR), LDH, LMR/LDH, and SUVmax detected by FDG-PET/CT were analyzed. The best cut-off points of LMR and LMR/LDH were determined by receiver operating characteristics (ROC) curve; the chi-square test was used to analyze the correlation of clinical factors with LMR and LMR/LDH; Spearman correlation analysis was used to determine the correlation between serum LDH level and SUVmax; the Kaplan-Meier protocol was used to compare the overall survival (OS) rate and progression-free survival (PFS) rate between LMR and LMR/LDH groups; the Cox proportional risk model was used to carry out the multivariate analysis of prognostic factors. RESULTS: The optimal limit value for LMR and LMR/LDH (%) determined by ROC curve was 2.535 (P<0.05) and 0.35% (P<0.01) respectively. Patients with an LMR<2.535 had a higher incidence of advanced Ann Arbor stage, B symptoms, higher IPI score, higher ECOG score, and elevated LDH level, while patients with LMR/LDH 0.35% had the same trend as patients with LMR <2.535. A significant positive correlation between serum LDH and SUVmax was observed by Spearman correlation analysis (P<0.001). K-M survival analysis showed that the PFS rate and OS rate in high LMR group were significantly better than that in the low LMR group (P<0.05). K-M analysis showed that the PFS rate and OS rate in high LMR/LDH group were statistical significantly better than that in low LMR/LDH group (P<0.05). Multivariate COX analysis showed that the predictive value in LMR/LDH was much better than single LMR, which may be an independent prognostic factor for patients with DLBCL. CONCLUSION: At the initial diagnosis, high LMR/LDH suggests that DLBCL patient is a better prognosis.


Assuntos
L-Lactato Desidrogenase , Monócitos , Humanos , Contagem de Leucócitos , Linfócitos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Prognóstico , Estudos Retrospectivos
17.
Arkh Patol ; 82(5): 57-62, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33054033

RESUMO

The paper describes 4 autopsy cases of myocarditis in elderly patients with confirmed coronavirus infection. It gives the data of a morphological study of heart specimens and a detailed characterization of a myocardial infiltrate. An immunohistochemical study with cellular infiltrate typing was performed. The fact that lymphocytic viral myocarditis can develop in COVID-19 was morphologically and immunohistochemically confirmed. The features of myocarditis in COVID-19 are the development of the former in the presence of coronaritis and the possibility of its concurrence with lymphocytic endo- and pericarditis.


Assuntos
Infecções por Coronavirus/complicações , Linfócitos/patologia , Miocardite/complicações , Miocardite/virologia , Pneumonia Viral/complicações , Idoso , Autopsia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Humanos , Imuno-Histoquímica , Miocardite/patologia , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/virologia
18.
Medicine (Baltimore) ; 99(44): e22557, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126304

RESUMO

To evaluate the performance of different blood cells-derived indexes in the diagnosis of rheumatoid arthritis (RA).Neutrophil-to-lymphocyte ratio (NLR), lymphocyte to monocyte ratio, platelet to lymphocyte ratio (PLR), systemic inflammation response index (SIRI), and aggregate inflammation systemic index were calculated in 199 consecutive RA patients and 283 sex and age-matched controls (147 healthy donors and 136 patients with other rheumatic diseases). Area under the curve (AUCs), sensitivity and specificity were calculated to evaluate the accuracy of indexes in discriminating between RA and controls. Association between indexes and RA variables was explored by multiple linear regression analyses.Blood cells-derived indexes did not demonstrate good accuracy in differentiating RA from controls with lymphocyte to monocyte ratio, the index with the best diagnostic performance, having 63.6% of sensitivity and 65.3% specificity [AUC (95%CI) = 0.67 (0.62-0.72]. The accuracy of the indexes in differentiating RA from healthy donors was significantly higher than that (AUCs < 0.6 for all comparisons) differentiating RA from rheumatic diseases. In RA, SIRI and aggregate inflammation systemic index showed significant association with C-reactive protein and erythrocyte sedimentation rate.Our results do not support the use of blood cells-derived indexes for the diagnosis of RA, suggesting that they might reflect chronic inflammatory burden in rheumatic diseases rather than, specifically, in RA.


Assuntos
Artrite Reumatoide/diagnóstico , Contagem de Células Sanguíneas/estatística & dados numéricos , Índice de Gravidade de Doença , Área Sob a Curva , Células Sanguíneas/metabolismo , Plaquetas , Sedimentação Sanguínea , Proteína C-Reativa , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Contagem de Linfócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Monócitos , Neutrófilos , Contagem de Plaquetas , Sensibilidade e Especificidade
19.
Cell Transplant ; 29: 963689720965980, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33040594

RESUMO

Novel therapies are urgently needed to combat the severe cytokine storm syndromes induced by coronavirus disease 2019 (COVID-19). An increasing number of preclinical and clinical investigations of stem cell and derivatives therapy for COVID-19 were being carried out, among which several studies have preliminarily demonstrated the safety and possible efficacy of stem cell transplantation therapy, providing a hint to solve the tricky situation of anti-COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Citocinas/metabolismo , Transplante de Células-Tronco Mesenquimais , Pneumonia Viral/terapia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Humanos , Linfócitos/citologia , Linfócitos/metabolismo , Pandemias , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Cordão Umbilical/citologia
20.
Medicine (Baltimore) ; 99(41): e21562, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031255

RESUMO

The importance of monocyte/lymphocyte ratio (MLR) has been indicated in the initiation and progression of coronary artery disease. However, few previous researches demonstrated the relationship between MLR and plaque vulnerability. We aimed to investigate coronary non-culprit plaque vulnerability in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT).A total of 72 ACS patients who underwent coronary angiography and OCT test in Beijing Anzhen Hospital were included in this retrospective study. The plaque vulnerability and plaque morphology were assessed by OCT.The non-culprit plaque in high MLR group exhibited more vulnerable features, characterizing as thinner thickness of fibrous cap (P = .013), greater maximum lipid core angle (P = .010) and longer lipid plaque length (P = .041). A prominently negative liner relation was found between MLR and thickness of fibrous cap (R = -0.225, P = .005). Meanwhile, the proportion of OCT-detected thin cap fibro-atheroma (TCFA) (P = .014) and plaque rupture (P = .017) were higher in high MLR group. Most importantly, multivariable logistic regression analysis showed MLR level was identified as an independent contributor to the presence of TCFA (OR:3.316, 95%: 1.448-7.593, P = .005). MLR could differentiate TCFA with a sensitivity of 60.0% and a specificity of 85.1%.Circulating MLR level has potential value in identifying the presence of vulnerable plaque in patients with ACS. MLR, as a non- invasive biomarker of inflammation, may be valuable in revealing plaque vulnerability.


Assuntos
Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/diagnóstico por imagem , Placa Aterosclerótica/sangue , Placa Aterosclerótica/diagnóstico por imagem , Tomografia de Coerência Óptica , Angiografia Coronária , Feminino , Humanos , Linfócitos , Masculino , Pessoa de Meia-Idade , Monócitos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA