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MeSH Disease

HGNC Genes

SARS-CoV-2 proteins

ORF1ab (1)

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    Effect of COVID-19 MESHD on Lipid Profile and its Correlation with Acute Phase Reactants

    Authors: Jahanzeb Malik; Uzma Ishaq; Talha Laique; Amna Ashraf; Asmara Malik; Mommana Ali Rathore; Syed Muhammad Jawad Zaidi; Muhammad Javaid; Asad Mehmood

    doi:10.1101/2021.04.13.21255142 Date: 2021-04-14 Source: medRxiv

    Background and Objective Coronavirus disease 2019 MESHD ( COVID-19 MESHD) manifests as multiple clinical and pathological organ dysfunctions. It also disrupts metabolic profile due to the release of pro-inflammatory cytokines causing a systemic inflammation reaction MESHD. However, the development and correlation of dyslipidemia MESHD with acute phase reactants is unknown. This investigation was performed to assess the pathological alterations of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL), triglycerides, and total cholesterol levels in COVID-19 MESHD patients. Methods This was a prospective study performed on real-world patients to assess serum levels of LDL-C, HDL, TG, TC on COVID-19 MESHD patients (mild: 319; moderate: 391; critical: 357) hospitalized at our center between April 2020 through January 2021. Age- and gender-matched controls who had their lipid profiles in the same period were included as the control group. Results LDL-C, HDL, TG, and TC levels were significantly lower in COVID-19 MESHD patients when compared with the control group (P < 0.001, 0.047, 0.045, < 0.001, respectively). All parameters decreased gradually with COVID-19 MESHD disease severity (LDL-C: median (IQR), mild: 98 (91,134); moderate: 97 (81,113); critical: 68 (68,83); HDL: mild: 45 (37,50); moderate: 46 (41,50); critical: 40 (37,46); TG: mild: 186 (150,245); moderate: 156 (109,198); critical: 111 (98,154); TC: mild: 224 (212,238); moderate: 212 (203,213); critical: 154 (125,187)). LDL-C, TC, and TG were inversely correlated with acute phase reactants ( interleukin-6 HGNC ( IL-6 HGNC), Procalcitonin, C-reactive protein HGNC ( CRP HGNC), and D-dimers). Logistic regression demonstrated lipid profile, thyroid profile, and acute phase reactants as predictors of severity of COVID-19 MESHD disease. Conclusion Hypolipidemia MESHD develops in increasing frequency with severe COVID-19 MESHD disease. It inversely correlates with levels of acute-phase reactants, indicating SARS-COV-2 as the causative agent for alteration in lipid and thyroid levels.

    Clinical Characteristics and Outcomes of Critically ill Mechanically Ventilated MESHD COVID-19 MESHD Patients Receiving interleukin-6 HGNC Receptor Antagonists and/or Corticosteroid Therapy, the INTERACT study: A Multicenter International Observational Study

    Authors: Marwa R Amer; Mohammed Bawazeer; Khalid Maghrabi; Ahmed Mohamed Kamal; Abid Butt; Talal Dahhan; Eiad Kseibi; Mohammed Abujazar; Razan Alghunaim; Muath Rabee; Maal Abualkhair; Ali Al-Janoubi; Abeer AlFirm; Syed Moazzum Khurshid; Ognjen Gajic; Allan J. Walkey; Jarrod M Mosier; Igor Borisovich Zabolotskikh; Oscar Y Gavidia; Santiago Y. Teruel; Michael A. Bernstein; Karen Boman; Vishakha K. Kumar; Vikas Bansal; Rahul Kashyap

    doi:10.1101/2021.04.12.21255323 Date: 2021-04-13 Source: medRxiv

    Objectives: To compare the clinical characteristics and outcomes of critically ill coronavirus disease MESHD ( COVID-19 MESHD) patients requiring mechanical ventilation (MV), receiving interleukin 6 receptor ( IL6R HGNC) antagonists, steroids, or a combination of both. Design: An international, multicenter, observational study derived from the COVID-2019 Viral Infection and Respiratory Illness University Study (VIRUS) registry and conducted through the Discovery Network, the Society of Critical Care Medicine. Marginal structural modeling was used to adjust for time-dependent confounders, and observations were weighted using the inverse probability of treatment weight. Sensitivity analysis was conducted to emulate a target trial design. Setting: 168 hospitals in 16 countries. Patients: adult ICU patients ( > 18 years) requiring MV for COVID-19 MESHD between March 01, 2020, and January 10, 2021. Intervention: None. Measurements and Main Results: A total of 860 patients met eligibility criteria: 589 received steroids, 170 IL-6R HGNC antagonists, and 101 combination therapy, and the groups were balanced after adjustment. The median daily steroid dose was 7.5 mg dexamethasone or equivalent (IQR: 6 to 14 mg); 80.8% received low-dose and 19.2% high-dose steroids (> 15 mg/day of dexamethasone or equivalent). The median C-reactive protein HGNC level was > 75 mg/L in majority of our cohort. The use of IL6R HGNC antagonists alone or in combination was not associated with a significant difference in ventilator free days ( VFD MESHD) compared to steroids alone (adjusted incidence rate ratio [95% CI]): IL6R HGNC antagonists (1.12 [0.88,1.4]), combination (0.83 [0.6,1.14]). Patients treated with low or high-dose steroids had non-significant differences in VFD MESHD compared to IL6R HGNC antagonists (beta= 0.62, 95% CI -1.54, 2.78 for low-dose steroid; beta= -1.19, 95% CI -3.85, 1.47 for high-dose steroid). The use of IL6R HGNC antagonists alone or in combination was not associated with a significant difference in 28 day mortality compared to steroids alone (adjusted odds ratio [95% CI]): IL6R HGNC antagonists alone (0.68 [0.44,1.07]), combination (1.07 [0.67,1.7]). There was no difference in hospital mortality compared to steroids alone (aOR 0.68, 95% CI 0.43,1.09 for IL6R HGNC antagonist, aOR 1.23, 95 % CI 0.72,2.11 for combination). The findings of sensitivity analysis were consistent with the primary analysis. The rate of liver dysfunction MESHD was higher in the IL6R HGNC antagonist (p=0.038), while the rate of bacteremia MESHD did not differ among the three groups. Conclusions: We observed no difference in outcomes between mechanically ventilated adult ICU patients who received IL6R HGNC antagonists, steroids, or combination therapy and those who received IL6R HGNC antagonists or low or high dose steroids. Further trials are needed to evaluate high-dose steroids as substitutes for IL6R HGNC antagonists in resource-limited settings.

    Making sense of non-randomized comparative treatment studies in times of Covid-19 MESHD: A case study of tocilizumab

    Authors: Ruth R C Owen; Nawab Qizilbash; Sara Velazquez Diaz; Jose Maria Castellano Vazquez; Stuart J Pocock

    doi:10.1101/2021.04.06.21254612 Date: 2021-04-07 Source: medRxiv

    BACKGROUND Tocilizumab (TCZ) is an interleukin-6 HGNC inhibitor and the second established effective drug for the treatment of hospitalized patients with Covid-19 MESHD. In this study, we sought to validate the recent positive findings from the randomised clinical trial RECOVERY and to evaluate the challenges in the analysis and interpretation of non-randomized comparative effectiveness studies in Covid-19 MESHD. METHODS We performed a retrospective cohort study using an openly available database of hospitalised Covid-19 MESHD patients in Spain. The primary outcome was all-cause in-hospital mortality at 28 days. We used multivariable Fine and Gray competing risk models which adjusted for both fixed and time-variant confounders to investigate the effect of TCZ on the primary outcome. RESULTS We analysed 2547 patients hospitalised with Covid-19 MESHD between 1st January and 28th June 2020. Patients in the TCZ group tended to have more severe Covid-19 MESHD at admission, as measured by biomarkers of disease severity including CRP HGNC, D-dimer and LDH. At 28 days, 91 out of 440 TCZ patients had died compared to 267 out of 2107 patients in the control group. In multivariable analysis, there was no evidence of an association between TCZ and the primary outcome (adjusted hazard ratio 1.20, 95% CI 0.86 to 1.64, P=0.26). CONCLUSIONS Our observational study failed to find a benefit of TCZ on all-cause in-hospital mortality in Covid-19 MESHD patients compared with randomized trials, highlighting the impact that unmeasured confounding and other sources of bias can have in a retrospective observational setting. For future observational studies, we recommend prospective data collection to ensure all variables have the necessary quality, completeness and timing for reliable treatment evaluation.

    IL-6 HGNC and D-Dimer at Admission Predicts Cardiac Injury MESHD and Early Mortality during SARS-CoV-2 Infection MESHD

    Authors: Daoyuan Si; Beibei Du; Bo Yang; Lina Jin; Lujia Ni; Qian Zhang; Zhongfan Zhang; Mohammed Ali Azam; Patrick F.H Lai; Stephane Masse; Huan Sun; Xingtong Wang; Slava Epelman; Patrick R Lawler; Ping Yang; Kumaraswamy Nanthakumar

    doi:10.1101/2021.03.22.21254077 Date: 2021-03-29 Source: medRxiv

    BACKGROUND: We recently described mortality of cardiac injury MESHD in COVID-19 MESHD patients. Admission activation of immune, thrombotic MESHD biomarkers and their ability to predict cardiac injury MESHD and mortality patterns in COVID-19 MESHD is unknown. METHODS: This retrospective cohort study included 170 COVID-19 MESHD patients with cardiac injury MESHD at admission to Tongji Hospital in Wuhan from January 29-March 8, 2020. Temporal evolution of inflammatory cytokines, coagulation markers, clinical, treatment and mortality were analyzed. RESULTS: Of 170 patients, 60 (35.3%) died early (<21d) and 61 (35.9%) died after prolonged stay. Admission lab work that correlated with early death MESHD were elevate levels of interleukin 6 HGNC ( IL-6 HGNC) (p<0.0001), Tumor Necrosis Factor-a HGNC Tumor Necrosis Factor-a MESHD ( TNF-a HGNC) (p=0.0025), and C-reactive protein HGNC ( CRP HGNC) (p<0.0001). We observed the trajectory of biomarker changes after admission, and determined that early mortality had a rapidly increasing D-dimer, gradually decreasing platelet and lymphocyte counts. Multivariate and simple linear regression models showed that death risk was determined by immune and thrombotic MESHD pathway activation. Increasing cTnI HGNC levels were associated with those of increasing IL-6 HGNC (p=0.03) and D-dimer (p=0.0021). Exploratory analyses suggested that patients that received heparin has lower early mortality compared to those who did not (p =0.07), despite similar risk profile. CONCLUSIONS: In COVID-19 MESHD patients with cardiac injury MESHD, admission IL-6 HGNC and D-dimer predicted subsequent elevation of cTnI HGNC and early death MESHD, highlighting the need for early inflammatory cytokine-based risk stratification in patients with cardiac injury MESHD.

    Increased angiotensin-converting enzyme 2 HGNC, sRAGE and immune activation, but lowered calcium and magnesium in COVID-19 MESHD: association with chest CT abnormalities MESHD and lowered peripheral oxygen saturation.

    Authors: Hussein Al-Hakeim; Hawraa Al-Jassas; Gerwyn Morris; Michael Maes

    doi:10.1101/2021.03.26.21254383 Date: 2021-03-26 Source: medRxiv

    Background. The characterization of new biomarkers of COVID-19 MESHD is extremely important. Few studies measured the soluble receptor for advanced glycation end product (sRAGE), angiotensin-converting enzyme 2 HGNC ( ACE2 HGNC), calcium and magnesium in COVID-19 MESHD. Aims: To measure sRAGE, ACE2 HGNC, interleukin (IL)-6 HGNC, IL-10 HGNC, CRP HGNC, calcium, magnesium, and albumin in COVID-19 MESHD patients in association with peripheral oxygen saturation (SpO2) and chest CT scan abnormalities (CCTA) including ground glass opacities. Methods. This study measured sRAGE, ACE2 HGNC, IL-6 HGNC, IL-10 HGNC, CRP HGNC using ELISA techniques, and calcium, magnesium, and albumin using a spectrophotometric method in 60 COVID-19 MESHD patients and 30 healthy controls. Results. COVID-19 MESHD is characterized by significantly increased IL-6 HGNC, CRP HGNC, IL-10 HGNC, sRAGE, ACE2 HGNC, and lowered levels of SpO2, albumin, magnesium and calcium. Neural networks showed that a combination of calcium, IL-6 HGNC, CRP HGNC, and sRAGE yielded an accuracy of 100% in detecting COVID-19 MESHD patients with calcium being the most important predictor followed by IL-6 HGNC, and CRP HGNC. COVID-19 MESHD patients with CCTAs showed lower SpO2 and albumin levels than those without CCTAs. SpO2 was significantly and inversely correlated with IL-6 HGNC, IL-10 HGNC, CRP HGNC, sRAGE, and ACE2 HGNC, and positively with albumin, magnesium and calcium. Patients with positive IgG results showed a significant elevation in the serum level of IL-6 HGNC, sRAGE, and ACE2 HGNC compared to the negatively IgG patient subgroup. Conclusion. The results show that immune-inflammatory and RAGE HGNC pathway biomarkers may be used as external validating criterion for the diagnosis COVID-19 MESHD. Those pathways coupled with lowered SpO2, calcium and magnesium are drug targets that may help to reduce the consequences of COVID-19 MESHD.

    PREDICTIVE IMMUNOLOGICAL, VIROLOGICAL, AND ROUTINE LABORATORY MARKERS FOR CRITICAL COVID-19 MESHD ON ADMISSION.Immunocovid study

    Authors: Mercedes Garcia Gasalla; Juana M Ferrer; Pablo A Fraile-Ribot; Adrian Ferre-Beltran; Adrian Rodriguez; Natalia Martinez-Pomar; Luisa Ramon-Clar; Amanda Iglesias; Francisco Fanjul; Joan A Pou; Isabel LLompart; Ines Losada; Nuria Toledo; Jaime Pons; Antonio Oliver; Melchor Riera; Javier Murillas

    doi:10.1101/2021.03.17.21253816 Date: 2021-03-20 Source: medRxiv

    Introduction: Early identification of COVID-19 MESHD patients at risk of critical illness is challenging for clinicians. Immunological, virological, and routine laboratory markers to be used in addition to clinical data are needed. Aim and methods: Blood tests to measure neutrophil/lymphocyte ratio (NLR), levels of ferritin, CRP HGNC, D-dimer, complement components (C3, C4), lymphocyte subsets, and cytokines, and SARS-Cov2 RT-PCR tests were performed in COVID-19 MESHD confirmed cases within 48 hours of admission. Cycle threshold (Ct) values were determined by RT-PCR from oral or nasopharyngeal swabs on the day of admission. Severity of symptoms was categorized as mild (grade 1), severe (grade 2), and critical (grade 3). Results: 120 patients were included. COVID-19 MESHD was mild in 49, severe in 32, and critical in 39. Ferritin >370 ng/mL (OR 16.4, 95% CI 5.3-50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36-12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3-30.8), NLR >3.77 (OR 13.4, 95% CI 4.3-41.1), IL-6 HGNC >142.5 pg/mL (OR 8.76, 95% CI 3.56-21.54), IL-10 HGNC >10.8 pg/mL (OR 16.45, 95% CI 5.32-50.81), sIL-2r (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56-43.28), IL-1Ra HGNC >88.4 pg/mL (OR 4.54, 95% CI 2.03-10.17), and IL-18 HGNC >144 pg/mL (OR 17.85, 95% CI 6.54-48.78) were associated with critical COVID-19 MESHD in the univariate age-adjusted analysis. In the multivariate age-adjusted analysis, this association was confirmed only for ferritin, CRP HGNC,NLR, IL-10 HGNC, sIL-2r, and IL-18 HGNC. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was undetected in blood except in 3 patients with indeterminate results. Ct values determined by RT-PCR from oral/nasopharyngeal swabs on admission were not related to symptom severity. Conclusion: levels of ferritin, D-dimer, CRP HGNC, NLR, and cytokines and cytokine receptors IL-6 HGNC, IL1-Ra HGNC, sCD25, IL-18 HGNC, and IL-10 HGNC, taken together with clinical data, can contribute to the early identification of critical COVID-19 MESHD patients.

    Single-Arm, Open-Label Phase 2 Trial of Preemptive Methylprednisolone to Avert Progression to Respiratory Failure MESHD in High-Risk Patients with COVID-19 MESHD

    Authors: Fernando Cabanillas; Javier Morales; Jose G. Conde; Jorge Bertran-Pasarell; Ricardo Fernandez; Yaimara Hernandez-Silva; Idalia Liboy; James Bryan-Diaz; Juan Arraut-Gonzalez

    doi:10.1101/2021.03.08.21253117 Date: 2021-03-09 Source: medRxiv

    Introduction: Covid-19 MESHD is a triphasic disorder first typified by a viral phase that lasts from the first onset of symptoms until seven days later. This is followed by a second and third phase, initially characterized by the appearance of lung infiltrates, followed in 20% by respiratory failure MESHD. The second phase is usually heralded by an elevation of serologic inflammatory markers including CRP HGNC, ferritin, IL-6 HGNC, LDH as well as D-dimers. Approximately 20% proceed to the second phase and are usually then treated with dexamethasone, provided they are oxygen-dependent since these are the only cases that benefit from dexamethasone. If we had objective criteria to predict this 20% that develop severe illness, they could preemptively be treated with steroids. In this exploratory study we investigated the early use of preemptive steroids in the setting of early disease, in high-risk non-oxygen dependent cases. Methods: Eligible patients were those 21 years or older with a diagnosis of Covid-19 MESHD and oxygen saturation >91%. For patients to be classified as high-risk, they had to exhibit two or more of the following abnormalities 7-10 days after first symptom: IL-6 HGNC > 10 pg/ml, ferritin > 500 ng/ml, D-dimer > 1 mg/L (1,000 ng/ml), CRP HGNC > 10 mg/dL (100 mg/L), LDH above normal range lymphopenia MESHD (absolute lymphocyte count <1,000 /microliter), oxygen saturation between 91-94%, or CT chest with evidence of ground glass infiltrates. Primary endpoint was progression to respiratory failure MESHD. CALL score method was used to predict the expected number of cases of respiratory failure MESHD. High risk patients received methylprednisolone (MPS) 80 mg IV daily x 5 days starting no earlier than seven days from first onset of symptoms. The primary endpoint was progression to hypoxemic respiratory failure MESHD defined as PaO2 <60 mm Hg or oxygen saturation <90%. Secondary endpoints included survival at 28 days from registration, admission to intensive care and live discharge from the hospital. Change in levels of inflammatory markers and length of hospitalization were also assessed. Results In 76 patients, the expected number with respiratory failure MESHD was 30 (39.5%), yet only 4 (5.3%) developed that complication (p=.00001). Survival at 28 days was 98.6%. Improvement in inflammatory markers correlated with favorable outcome. Conclusions Our results are encouraging and suggest that this approach is both effective and safe.

    Clinical course and risk factors for in-hospital mortality of 205 patients with SARS-CoV-2 pneumonia MESHD in Como, Lombardy Region, Italy

    Authors: Mauro Turrini; Angelo Gardellini; Livia Beretta; Lucia Buzzi; Stefano Ferrario; Sabrina Vasile; Raffaella Clerici; Andrea Colzani; Luigi Liparulo; Giovanni Scognamiglio; Gianni Imperiali; Giovanni Corrado; Antonella Strada; Marco Galletti; Nunzio Castiglione; Claudio Zanon

    doi:10.1101/2021.02.25.20134866 Date: 2021-03-05 Source: medRxiv

    Importance: With randomized clinical trials ongoing and vaccine still a long distance away, efforts to repurpose old medications used for other diseases provide hope for treatment of COVID-19 MESHD. Objectives: To examine the risk factors for in-hospital mortality and describe the effectiveness of different treatment strategies in a real-life setting of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia MESHD. Design: Real-life single-center study during the Lombardy COVID-19 MESHD outbreak. Setting: Valduce Hospital in Como, Lombardy Region, Italy. Participants: 205 laboratory-confirmed patients presenting with SARS-Cov-2 pneumonia MESHD requiring hospitalization. Interventions: All patients received best supportive care and, based on their clinical needs and comorbidities, specific interventions that included the main drugs being tested for repurposing to treat COVID-19 MESHD, such as hydroxychloroquine, anticoagulation, antiviral drugs, steroids or interleukin-6 HGNC pathway inhibitors. Main outcomes and measures: Clinical, laboratory and treatment characteristics were analyzed with univariate and multivariate logistic regression methods to explore their impact on in-hospital mortality and compared with current literature data. Results: Univariate analyses for clinical variables showed prognostic significance for age equal or greater than 70 years (estimated 28-days survival: 21.4 vs 67.4%; p<0.0001), presence of 2 or more relevant comorbidities (35.3 vs 61.8%; p=0.0008), ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F) less than 200 at presentation (21-days survival: 14.7 vs 52.4%;p<0.0001), high levels of lactate dehydrogenase (LDH) (26.4 vs 65.3%; p=0.0001), and elevated C-reactive protein HGNC (CRP) values (25.4 vs 74.9%; p=0.0001), while no statistical significance was found for all the other clinical variables tested. At univariate analysis for the different treatment scheduled, prognostic significance for survival was showed for intermediate or therapeutic-dose anticoagulation (estimated 28-days survival: 37.1 vs 23.4%; p=0.0001), hydroxychloroquine (35.7 vs 27.3%; p=0.0029), early antiviral therapy with lopinavir/ritonavir (60.1 vs 22.4%; p<0.0001), late short-course of steroids (47.9 vs 18.2%; p<0.0001) or tocilizumab therapy (69.4 vs 29.4%; p=0.0059). Multivariable regression confirmed increasing odds of in-hospital death associated with age older than 70 years (odds ratio 3.26, 95% CI 1.81 - 5.86; p<0.0001) and showed a reduction in mortality for patients treated with anticoagulant (-0.37, 0.49 - 0.95; p=0.0273), antiviral (-1.22, 0.16 - 0.54; p<0.0001), or steroids (-0.59, 0.35 - 0.87; p=0.0117) therapy.

    Compassionate use of rectal Ozone (O3) in severe COVID-19 MESHD pneumonia MESHD: a case-control study.

    Authors: Marcos Edgar Fernández-Cuadros; María Jesús Albaladejo-Florín; Sandra Alava-Rabasa; Juan Gallego-Galiana; Gerardo Fabiel Pérez-Cruz; Isabel Usandizaga-Elio; Enrique Pacios; David Torres-Garcia; Daiana Peña-Lora; Luz Casique-Bocanegra; María Jesús López-Muñoz; Javier Rodríguez-de-Cía; Olga Susana Pérez-Moro

    doi:10.21203/rs.3.rs-231696/v1 Date: 2021-02-11 Source: ResearchSquare

    Objectives: To evaluate effect of rectal Ozone in severe COVID-19 MESHD pneumonia MESHD and to compare to Standard-of-care (SOC). Material and Methods: In a case-control study, 14 patients with severe bilateral COVID-19 MESHD pneumonia MESHD (positive RT-PCR), treated with SOC and rectal Ozone, were evaluated before-and-after treatment and compared with SOC (14 patients) in a 10 day follow-up period. Ozone-protocol consisted of 8 sessions (1 session/day) of intra-rectal Ozone, (150mL volume, 35mg/ml concentration [5.25mg total dose]). The SOC-protocol included O 2- supply, antivirals (Remdesivir), corticosteroids (Dexamethasone/Metilprednisolone), monoclonal antibodies (Anakinra/Tocilizumab), antibiotics (Azytromicine), anticoagulants (Enoxaparine) and hyperimmune serum (if necessary). Primary outcome variables: a) clinical (O 2- saturation and O 2- supply); b) biochemical (Lymphocyte count, Fibrinogen HGNC, D-Dimer, Urea, Ferritin, LDH, IL-6 HGNC and CRP HGNC); c) radiological Taylor Scale. Secondary outcome variables: a) hospitalization length-of-stay, b) mortality-rate. Results: At baseline, Ozone/SOC-groups were not different on age, comorbidities, O 2 -saturation and O 2 -supply. Patients in Ozone-Group improved O 2- saturation and decrease O 2- supply. SOC maintained O 2- saturation and required more O 2- supply. Lymphocyte-count improved only in Ozone-group and with statistical difference (p<0.05). Biomarkers of inflammation MESHD ( Fibrinogen HGNC, D-Dimer, Urea, LDH, CRP HGNC and IL-6 HGNC) decreased in both groups, but only significantly in favor of Ozone-group (p<0.05). Ferritin showed a significant decrease in the Ozone-group but an increase on the SOC-Group. Radiological pneumonitis MESHD decreased on both groups but the decrease was only significant in the Ozone-Group (p<0.0001). Mortality and length-of-stay, although not significant, were inferior in Ozone-Group. Conclusion: Compassionate use of Rectal Ozone improved O 2 -saturation, reduced O 2 -supply, decreased inflammation MESHD biomarkers and improved Taylor’s radiological scale significantly when compared to SOC-Group. Mortality and length-of-stay was inferior in the Ozone-group, but this difference was not significant.

    The Age Again in The Eye of The Covid-19 MESHD Storm: Evidence-Based Decision Making.

    Authors: M. Carmen Martín; Aurora Jurado; Cristina Abad-Molina; Antonio Orduña; Oscar Yarce; Ana M. Navas; Vanesa Cunill; Danilo Escobar; Francisco Boix; Sergio Burillo-Sanz; María C. Vegas-Sánchez; Yesenia Jiménez-de las Pozas; Josefa Melero; Marta Aguilar; Oana Irina Sobieschi; Marcos López-Hoyos; Gonzalo Ocejo-Vinyals; David San Segundo; Delia Almeida; Silvia Medina; Luis Fernández-Pereira; Esther Vergara; Bibiana Quirant; Eva Martínez-Cáceres; Marc Boigues; Marta Alonso; Laura Esparcia-Pinedo; Celia López-Sanz; Javier Muñoz-Vico; Serafín López-Palmero; Antonio Trujillo; Paula Álvarez; Álvaro Prada; David Monzón; Jesús Ontañón; Francisco M. Marco; Sergio Mora; Ricardo Rojo; Gema González-Martínez; María T. Martínez-Saavedra; Juana Gil-Herrera; Sergi Cantenys-Molina; Manuel Hernández; Janire Perurena-Prieto; Beatriz Rodríguez-Bayona; Alba Martínez; Esther Ocaña; Juan Molina

    doi:10.21203/rs.3.rs-228480/v1 Date: 2021-02-10 Source: ResearchSquare

    Background: One hundred million of contagions, more than 2 million deaths and less than one year of COVID-19 MESHD have changed our lives and our health management systems forever. Ageing is known to be one of the significant determinants for COVID-19 MESHD severity. Two main reasons underlie this: immunosenescence and age correlation with main COVID-19 MESHD comorbidities such as hypertension or dyslipidaemia MESHD. This study has two aims. The first is to obtain cut-off points for laboratory parameters that can help us in clinical decision-making. The second one is to analyse the effect of pandemic lockdown on epidemiological, clinical, and laboratory parameters concerning the severity of the COVID-19 MESHD. For these purposes, 257 of SARSCoV2 inpatients during pandemic confinement were included in this study. Moreover, 584 case records from a previously analysed series, were compared with the present study data. Results: Concerning the characteristics of lockdown series, mild cases accounted for 14.4%, 54.1% were moderate and 31.5%, severe. There were 32.5% of home contagions, 26.3% community transmissions, 22.5% nursing home contagions, and 8.8% corresponding to frontline worker contagions regarding epidemiological features. Age >60 and male sex are hereby confirmed as severity determinants. Equally, higher severity was significantly associated with higher IL6 HGNC, CRP HGNC, ferritin, LDH, and leukocyte counts, and a lower percentage of lymphocyte, CD4 HGNC and CD8 HGNC count. Comparing this cohort with a previous 584-cases series, mild cases were less than those analysed in the first moment of the pandemic and dyslipidaemia became more frequent than before. Age, lymphocyte count and LDH had similar distributions at both moments. IL-6 HGNC, CRP HGNC and LDH values above 69 pg/mL, 97 mg/L and 328 U/L respectively, as well as a CD4 HGNC T-cell count below 535 cells/μL, were the best cut-offs predicting severity since these parameters offered reliable areas under the curve. Conclusion: Age, sex and dyslipidaemia together with selected laboratory parameters on admission can help us predict COVID-19 MESHD severity and, therefore, make clinical and resource management decisions. Demographic features associated with lockdown could affect the homogeneity of the data and the robustness of the results.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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