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SARS-CoV-2 proteins

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    Hyperinflammatory conditions, gender differences and mortality in Indian COVID-19 MESHD patients

    Authors: Fouzia Shoeb; Imran Hussain; Gazala Afrin; Shagufta T Mufti; Syed T Raza; Farzana Mahdi

    doi:10.1101/2021.01.19.21250134 Date: 2021-01-20 Source: medRxiv

    PurposeEvidence suggests that COVID-19 MESHD induces hyperinflammatory conditions and causes relatively more deaths MESHD in males than females. The purpose of this study was to analyze gender differences associated with various hyperinflammatory conditions (HIC) and mortality in the Indian COVID-19 MESHD patients MethodsThis study was conducted at the Eras Lucknow Medical College and Hospital (ELMCH), ERA HGNC University, which is located in the northern part of India. Starting from July 4, 2020 till December 3, 2020 a total of 2997 patients were treated at ELMCH. We randomly collected blood samples from 150 severe COVID-19 MESHD patients (required oxygen) between August 10 and September 15, 2020 for analyzing the following HIC and associated laboratory markers: hyperferritinaemia (serum ferritin), hematological dysfunctions MESHD ( lymphocytopenia MESHD and neutrophil to lymphocyte ratio), cytokinaemia ( C-reactive protein HGNC), coagulopathy MESHD (D-dimer), liver inflammation MESHD (aspartate aminotransferase), renal inflammation MESHD (blood urea and creatinine), and hyperglycemia MESHD (random blood glucose). The threshold values/cut off limits of these laboratory markers used for analyzing the risk of mortality in male and female COVID-19 MESHD patients were set according to the scale validated recently by Webb et al, (2020). ResultsIn the above cohort of consecutively admitted COVID-19 MESHD patients, analysis of various HIC revealed hyperferritinaemia (odd ratio: 2.9, 95% CI 1.4-6.0), hematological dysfunctions MESHD (odd ratio: 2.10, 95% CI 1.0-4.2), hepatic inflammation MESHD (odd ratio: 2.0, 95% CI 0.52-7.40), and coagulopathy MESHD (odd ratio: 1.5, 95% CI 1.50, 95% CI 0.50-4.60) were more prevalent and sever in male COVID-19 MESHD patients. Approximately 86% male to 64% female COVID-19 MESHD patients developed lymphocytopenia MESHD. Regarding mortality, while hyperferritinaemia (odd ratio: 1.70, 95% CI 0.37-7.43) and cytokinaemia (odd ratio: 1.60, 95% CI 0.37 -7.30) were strongly associated with mortality in male COVID-19 MESHD patients, coagulopathy MESHD (odd ratio: 3.30, 95% CI 0.31-35), and hematological dysfunctions MESHD (odd ratio: 1.70, 95% CI 0.27-10) were more commonly associated with mortality in female COVID-19 MESHD patients. Nearly 80% male and female COVID-19 MESHD patients, who died had developed [≥]2 criteria of HIS criteria. Chronic renal disease MESHD was associated with more deaths in female than male COVID-19 MESHD patients (odd ratio: 2.0, 95% CI 0.54 - 7.4). While the mortality proportion was slightly higher in male (6.3%) than female (4.5%) COVID-19 MESHD patients, survival curves of the two genders were not different (hazard ratio: 1.02, 95% CI 0.71-1.40, P = 0. 953). ConclusionDistinct HIC were associated with the severity, and mortality in male and female COVID-19 MESHD patients. Coagulopathy and renal injury MESHD were detrimental, specifically, for female COVID-19 MESHD patients. The overall mortality proportion was around 5.3%. The above results suggest that gender differences associated with COVID-19 MESHD severity and mortality arise due to differences in various HIC. These results may help in developing personalized or gender based treatments for COVID-19 MESHD patients.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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