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HGNC Genes

SARS-CoV-2 proteins

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    Evaluation of the ROX HGNC index in SARS-CoV-2 Acute Respiratory failure MESHD treated with both High-Flow Nasal Oxygen (HFNO) and Continuous Positive Airway Pressure ( CPAP HGNC)

    Authors: Hakim Ghani; Michael Shaw; Phyoe Pyae; Rigers Cama; Meghna Prabhakar; Alessio Navarra; Janice Yu Ji Lee; Felix Chua; Rahul Mogal; Andrew Barlow; Nazril Nordin; Rama Vancheeswaran

    doi:10.1101/2021.03.23.21254203 Date: 2021-03-24 Source: medRxiv

    Background: Non-invasive respiratory support including high-flow nasal oxygen (HFNO), and continuous positive airway pressure ( CPAP HGNC) have been used to provide therapy in selected SARS-CoV-2 patients with acute respiratory failure MESHD ( ARF MESHD). The value of the ROX HGNC index, a validated benchmark for outcomes in HFNO is unknown in CPAP HGNC. Objective: Can the ROX HGNC, a validated benchmark in HFNO be used for measuring treatment outcomes of CPAP HGNC in SARS-COV-2 ARF MESHD? Study Design and Methods: A non-randomised prospective protocol driven observational non-intensive care unit study in 130 SARS-COV-2 patients with ARF MESHD treated with non-invasive therapy from March 2020 to January 2021. The primary end point was failure of therapy ( death MESHD or escalation). Secondary outcomes included time to failure including invasive mechanical ventilation (IMV) or death MESHD, the effect of escalation to CPAP HGNC from HFNO and the utility of ROX HGNC in ARF MESHD. Results: HFNO was better than CPAP HGNC in treating SARS-COV-2 ARF MESHD: 17/35 (48.5%) with successful HFNO therapy versus 24/95 (25.2%) with CPAP HGNC. The ROX HGNC index was more sensitive to outcomes with CPAP HGNC compared to HFNO and distinguished treatment failure early at 1, 4, 6, 12, and 24 hours with the highest sensitivity at 24 hours ( ROX HGNC-24h). The AUC for the ROX-24h was 0.77 for HFNO (P<0.0001), and 0.84 for CPAP HGNC (P<0.0001). The ROX HGNC-24h cut-points predicted failure with HFNO when < 3.9 (PPV 71%, NPV 75%) and CPAP HGNC < 4.3 (PPV 75%, NPV 91%). For success, ROX HGNC-24h cut-points of 7.6 for HFNO (PPV 85%, NPV 48%) and 6.1 for CPAP HGNC (PPV 88%, NPV 62%) were observed. Escalation from HFNO to CPAP HGNC was mostly not successful. Conclusion: ARF MESHD in SARS-COV-2 can be successfully managed by non-invasive support. The ROX HGNC index, validated for HFNO, provides a timely, low resource measure for both HFNO and CPAP HGNC avoiding delayed intubation. Trial registration: Study approved by NHS HRAREC (20/ HRA MESHD/2344;ethics 283888)

    Role of ROX HGNC Index in the first assessment of COVID-19 MESHD patients in the Emergency Department

    Authors: Alice Gianstefani; Gabriele Farina; Veronica Salvatore; Francesca Alvau; Maria Laura Artesiani; Sara Bonfatti; Francesca Campinoti; Ilaria Caramella; Michele Ciordinik; Andrea Lorusso; Sara Nanni; Daniela Nizza; Stefano Nava; Fabrizio Giostra

    doi:10.21203/rs.3.rs-108370/v1 Date: 2020-11-14 Source: ResearchSquare

    Background: In Italy, since the first symptomatic cases of Coronavirus disease 2019 MESHD ( COVID-19 MESHD) appeared in late February 2020, 205.463 cases of Severe Acute Respiratory Syndrome MESHD 2 (SARS-CoV-2) were reported as of April 30, causing an high rate of hospital admission through the Emergency Department (ED).Objectives: The aim of the study was to evaluate the accuracy of ROX HGNC index in predicting hospitalization and mortality in patients with suspected diagnosis of COVID-19 MESHD in the ED. Secondary outcomes were to assess the number of readmissions and the variations of ROX HGNC index between first and second admission.Methods: This is an observational prospective monocentric study, conducted in the ED of Policlinico Sant’Orsola-Malpighi in Bologna. We enrolled 1371 consecutive patients with suspected COVID-19 MESHD and ROX HGNC index was calculated in 554 patients. Patients were followed until hospital discharge or death MESHD. Results: ROX HGNC index value < 25.7 was associated with hospitalization (AUC=0.737, 95%CI 0.696–0.779, p<0.001). ROX HGNC index < 22.3 is statistically related with higher 30-days mortality (AUC= 0.764, 95%CI 0.708-0.820, p<0.001). 8 patients were discharged and returned in the ED within the following 7 days, their mean ROX HGNC index was 30.3 (6.2; range 21.9-39.4) at the first assessment and 24.6 (5.5; 14.5-29.5) at the second assessment, (p=0.012).Conclusion: ROX HGNC index, together with laboratory, imaging and clinical findings, can help discriminate patients suspected for COVID-19 MESHD requiring hospital admission, their clinical severity and their mortality risk. Furthermore, it can be useful to better manage these patients in territorial healthcare services, especially in the hypothesis of another pandemic.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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