Corpus overview


Overview

MeSH Disease

Sepsis (53)

Disease (30)

Infections (20)

Death (20)

Syndrome (14)


Human Phenotype

Transmission

Seroprevalence
    displaying 1 - 10 records in total 55
    records per page




    Deciphering the state of immune silence in fatal COVID-19 patients

    Authors: Ido Amit; Pierre Bost; Francesco De Sanctis; Stefania Canè; Ugel Stefano; Katia Donadello; Monica Castellucci; Eyal David; Alessandra Fiore; Cristina Anselmi; Roza Barouni; Rosalinda Trovato; Simone Caligola; Alessia Lamolinara; Manuela Iezzi; Federica Facciotti; Anna Mazzariol; Davide Gibellini; Pasquale De Nardo; Evelina Tacconelli; Leonardo Gottin; Enrico Polati; Benno Schwikowski; Vincenzo Bronte

    doi:10.21203/rs.3.rs-56689/v1 Date: 2020-08-10 Source: ResearchSquare

    Since the beginning of the SARS-CoV-2 pandemic, COVID-19 has appeared as a unique disease MESHD with unconventional tissue and systemic immune features. While COVID-19 severe forms share clinical and laboratory aspects with various pathologies such as hemophagocytic lymphohistiocyto-sis, sepsis MESHD sepsis HP or cytokine release syndrome MESHD, their exact nature remains unknown. This is severely imped-ing the ability to treat patients facing severe stages of the disease MESHD. To this aim, we performed an in-depth, single-cell RNA-seq analysis of more than 150.000 immune cells isolated from matched blood SERO samples and broncho-alveolar lavage fluids of COVID-19 patients and healthy controls, and integrated it with clinical, immunological and functional ex vivo data. We unveiled an immune sig-nature of disease MESHD severity that correlated with the accumulation of naïve lymphoid cells in the lung and an expansion and activation of myeloid cells in the periphery. Moreover, we demonstrated that myeloid-driven immune suppression is a hallmark of COVID-19 evolution and arginase 1 expression is significantly associated with monocyte immune regulatory features. Noteworthy, we found mon-ocyte and neutrophil immune suppression loss associated with fatal clinical outcome in severe pa-tients. Additionally, our analysis discovered that the strongest association of the patients clinical outcome and immune phenotype is the lung T cell response. We found that patients with a robust CXCR6+ effector memory T cell response have better outcomes. This result is line with the rs11385942 COVID-19 risk allel, which is in proximity to the CXCR6 gene and suggest effector memory T cell are a primary feature in COVID-19 patients. By systemically quantifying the viral landscape in the lung of severe patients, we indeed identified Herpes-Simplex MESHD-Virus 1 (HSV-1) as a potential opportunistic virus in COVID-19 patients. Lastly, we observed an unexpectedly high SARS-CoV-2 viral load in an immuno-compromised patient, allowing us to study the SARS-CoV-2 in-vivo life cycle. The development of myeloid dysfunctions and the impairment of lymphoid arm establish a condition of immune paralysis MESHD paralysis HP that supports secondary bacteria and virus infection MESHD and can progress to “immune silence” in patients facing death MESHD.

    Integration of heparin-binding protein and interleukin-6 in the early prediction of respiratory failure HP and mortality in pneumonia MESHD pneumonia HP by SARS-CoV-2 (COVID-19)

    Authors: Maria Saridaki; Simeon Metallidis; Sotiria Grigiropoulou; Emmanouil Vrentzos; Malvina Lada; Katerina Argyraki; Olga Tsachouridou; Anna Georgiadou; Anil Vasishta; Evangelos J. Giamarellos-Bourboulis

    doi:10.21203/rs.3.rs-52975/v1 Date: 2020-08-03 Source: ResearchSquare

    Purpose Recent publications on the probable role of heparin-binding protein (HBP) as a biomarker in sepsis MESHD sepsis HP prompted us to investigate its diagnostic and prognostic performance SERO in severe COVID-19Methods HBP and IL-6 were measured by immunoassays SERO at admission and on day 7 in 178 patients with pneumonia MESHD pneumonia HP by SARS-CoV-2. Patients were classified into non- sepsis MESHD sepsis HP and sepsis MESHD sepsis HP as per the Sepsis MESHD Sepsis HP-3 definitions and were followed-up for the development of severe respiratory failure HP (SRF) and for outcome. Results were confirmed by multivariate analyses.Results HBP was significantly higher in patients classified as having sepsis MESHD sepsis HP and was negatively associated with the oxygenation ratio and positively associated with creatinine and lactate. Logistic regression analysis evidenced admission HBP more than 18 ng/ml and IL-6 more than 30 pg/ml as independent risk factors for the development of SRP. Their integration prognosticated SRF with respective sensitivity SERO, specificity, positive predictive value SERO and negative predictive 59.1%, 96.3%, 83.9% and 87.8%. Cox regression analysis evidenced admission HBP more than 35 ng/ml and IL-6 more than 30 pg/ml as independent risk factors for 28-day mortality. Their integration prognosticated 28-day mortality with respective sensitivity SERO, specificity, positive predictive value SERO and negative predictive 69.2%, 92.7%, 42.9% and 97.5%. HBP remained unchanged over-time course. Conclusion A prediction score of the disposition of patients with COVID-19 is proposed taking into consideration admission levels of IL-6 and HBP. Using different cut-offs the score may predict the likelihood for SRF and for 28-day outcome. 

    Treatment of sepsis MESHD sepsis HP-related Acute Respiratory Distress HP Syndrome MESHD with Vasoactive Intestinal Peptide

    Authors: Jihad G. Youssef; Sami Said; George Youssef; Matthew J. Javitt; Jonathan C Javitt

    doi:10.21203/rs.3.rs-52237/v1 Date: 2020-08-01 Source: ResearchSquare

    Purpose: To assess the clinical safety and possible effectiveness of Vasoactive Intestinal Peptide in the treatment of Acute Respiratory Distress HP Syndrome MESHD (ARDS) related to sepsisMethods: Under FDA Investigational New Drug clearance, 8 patients with ARDS related to sepsis MESHD sepsis HP were treated with 50 pmole/kg/hr – 100 pmole/kg/hr of Vasoactive Intestinal Peptide by intravenous infusion for 12 hours. All patients were on mechanical ventilation and full telemetery.Results: No drug-related serious adverse events were seen. Hypotension was seen in association with two infusions and diarrhea MESHD diarrhea HP in association with one, but did not necessitate cessation of therapy. Bigeminy was seen in association with one infusion without sequelae. Seven of eight patients demonstrated a successful course during intensive care and were successfully removed from mechanical ventilation and discharged from intensive care. The eighth patient succumbed to purulent secretions in the lungs. Of those who were discharged from the ICU, six demonstrated successful 30 day survival. The seventh died from a cerebral infract at day 30, deemed unrelated to treatment with VIP. Serum levels of Tumor Necrosis MESHD Factor α were obtained in 6 patients at baseline and 24 hours and were seen to decrease with treatment in five patients.Conclusions: Initial clinical results of treatment with VIP in patients with ARDS demonstrated a safety profile consistent with previous studies in normal volunteers. The successful clinical course seen in 7 of 8 patients in the setting of an expected 50% survival may suggest that VIP shows promise in the treatment of other infectious conditions that damage the pulmonary epithelium, particularly COVID-19.Registration: This clinical trial was registered with www.clinicaltrials.gov under NCT00004494. Trial was registered before the first patient was enrolled.

    Clinical Outcomes From COVID-19 Following Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers Among Patients with Hypertension MESHD Hypertension HP in South Korea: A nationwide study

    Authors: Ju Hwan Kim; Yeon-Hee Baek; Hyesung Lee; Young June Choe; Hyun Joon Shin; Ju-Young Shin

    doi:10.1101/2020.07.29.20164822 Date: 2020-08-01 Source: medRxiv

    There is ongoing debate as to whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) use is associated with poor prognosis of coronavirus disease MESHD-2019 (COVID-19). We sought to investigate the association between ACEI/ARB use and risk of poor clinical outcomes from COVID-19. We identified 1,290 patients with hypertension MESHD hypertension HP, of which 682 had recorded ACEI/ARB use and 608 without the use during 30 days preceding the date of COVID-19 diagnosis in completely enumerated COVID-19 cohort in South Korea. Our primary endpoint was the clinical outcomes comprised of all-cause mortality, use of mechanical ventilation, intensive care unit (ICU) admission, and sepsis MESHD sepsis HP. We used inverse probability of treatment weighting (IPTW) to mitigate selection bias, and Poisson regression model to estimate the relative risks (RR) and 95% confidence intervals (CI) to compare outcomes in ACEI/ARB users with non-users. Compared to non-use, ACEI/ARB use was associated with lower clinical outcomes (IPTW adjusted RR, 0.60; 95% CI, 0.42-0.85; p=0.0046). When assessed by individual outcomes, ACEI/ARB use was not associated with all-cause mortality (IPTW adjusted RR, 0.62; 95% CI, 0.35-1.09; p=0.0973) and respiratory events (IPTW adjusted RR, 0.99; 95% CI, 0.84-1.17; p=0.9043). Subgroup analysis showed a trend toward protective role of ACEIs and ARBs against overall outcomes in men (IPTW adjusted RR, 0.84; 95% CI, 0.69-1.03; p-for-interaction=0.008) and with pre-existing respiratory disease MESHD (IPTW adjusted RR, 0.74; 95% CI, 0.60-0.92; p-for-interaction=0.0023). We present clinical evidence to support continuing ACE/ARB use in completely enumerated hypertensive COVID-19 cohort in South Korea.

    Mortality rate among critically ill patients with COVID-19 in a medical system with adequate hospital resources: a prospective observational study

    Authors: Christina Routsi; Eleni Magira; Stelios Kokkoris; Ilias Siembos; Charikleia Vrettou; Dimitris Zervakis; Eleni Ischaki; Sotiris Malahias; Ioanna Sigala; Andreas Asimakos; Theodora Daidou; Panagiotis Kaltsas; Evangelia Douka; Adamandia Sotiriou; Vassiliki Markaki; Prodromos Temberikidis; Apostolos Koroneos; Panagiotis Politis; Zafiria Mastora; Efrosini Dima; Theodoros Tsoutsouras; Ioannis Papahatzakis; Panagiota Gioni; Athina Strilakou; Aikaterini Maraguti; Eleftheria Mizi; Ageliki Kanavou; Aikaterini Sarri; Evdokia Gavrielatou; Spyros Mentzelopoulos; Ioannis Kalomenidis; Vassilios Papastamopoulos; Anastasia Kotanidou; Spyros G Zakynthinos

    doi:10.21203/rs.3.rs-52242/v1 Date: 2020-08-01 Source: ResearchSquare

    Background: For critically ill patients with coronavirus disease MESHD 2019 (COVID-19) who require intensive care unit (ICU) admission, mortality rates vary widely depending on many factors, among which hospital resources and clinical setting seem important. We sought to determine the outcome of critically ill patients admitted in the usual multidisciplinary ICUs of a big referral for COVID-19 tertiary-care hospital with adequate resources.Methods: We performed a prospective observational study of all adult TRANS patients with COVID-19 consecutively admitted to four COVID-designated ICUs at Evangelismos Hospital, Athens, Greece, from March 11 to April 27, 2020.Results: Among 50 critically ill patients, ICU and hospital mortality for the entire cohort was 32% (16/50), whereas 66% (33/50) of patients were discharged alive from the ICU and 2% (1/50) were still treated in the ICU until June 16, 2020. ICU and hospital mortality for those who received invasive mechanical ventilation was 39% (16/41). Patients who eventually died had already increased risk of death MESHD on ICU admission, as suggested by the high values of the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, the presence of current malignancy and occurrence of cardiac arrest HP in 44% (7/16) of patients, and the general need for circulatory support by noradrenaline. Median PaO2/FiO2 on ICU admission for the entire cohort was 121 mmHg [interquartile range (IQR), 86-171 mmHg] and most patients had moderate and severe acute respiratory distress HP syndrome MESHD (ARDS) according to the Berlin Definition. The primary cause of death MESHD of all patients was multi-organ failure, most commonly due to sepsis MESHD sepsis HP, whereas none died from refractory hypoxemia HP, neurologic dysfunction or withdrawal of life support. Hospital stay was long in patients who survived [median 24 days (IQR, 15-35 days)] and was frequently complicated by bacteremias MESHD bacteremias HP [36% (12/33)].Conclusion: Severely ill COVID-19 patients with moderate and severe ARDS may have equal or even lower mortality rates compared to ARDS due to other causes, when they are admitted in general ICUs with experienced and adequate staff without limitations in hospital resources, where established ARDS therapies are used. 

    Clinical features and disease MESHD severity in an Iranian population of COVID-19 patients

    Authors: Shima Nabavi; Zahra Javidarabshahi; Abolghasem Allahyari; Mohammad Ramezani; Mohsen Seddigh-Shamsi; Sahar Ravanshad; Mina AkbariRad; Farnoosh Ebrahimzadeh; Shohre Khatami; Maryam Emadzadeh; Neda Saeedian; Ahmadreza Zarifian; Maryam Miri; Fariba Rezaeetalab; Sepide Hejazi; Reza Basiri; Mahnaz Mozdourian

    doi:10.21203/rs.3.rs-51568/v1 Date: 2020-07-31 Source: ResearchSquare

    Objectives: Coronavirus disease MESHD 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease MESHD may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease MESHD severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age TRANS of 69.75±6.39 years, of whom 82 (41%) were female TRANS were studied. Disease MESHD was severe/critical in the majority of patients (167, 83.5%). Disease MESHD severity was significantly associated with age TRANS, malignant comorbidities, dyspnea MESHD dyspnea HP, nausea MESHD nausea/vomiting HP/ vomiting MESHD, confusion MESHD confusion HP, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum SERO C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock MESHD shock HP, coagulopathy, acidosis MESHD acidosis HP, sepsis MESHD sepsis HP, acute respiratory distress HP syndrome MESHD (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea MESHD nausea/vomiting HP/ vomiting MESHD, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea MESHD nausea/vomiting HP/ vomiting MESHD, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum SERO CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease MESHD in COVID-19 patients.

    Clinical Characteristics of Pediatric Inflammatory Multisystem Syndrome MESHD Associated With COVID-19

    Authors: Leila Shahbaznejad; Mohammad Reza Navaifar; Ali Abbaskhanian; Fatemeh Hosseinzadeh; Mohammad Sadegh Rezai

    doi:10.21203/rs.3.rs-51157/v1 Date: 2020-07-30 Source: ResearchSquare

    Background: Although symptoms and signs MESHD of COVID-19 ( Coronavirus disease MESHD 2019) in children TRANS are milder than adults TRANS, there are reports of more severe cases which was defined as pediatric inflammatory multisystem syndrome MESHD (PIMS). The purpose of this report is to describe possible association between COVID-19 and PIMS in children TRANS.  Methods: From 28 March to 24 June 2020, 10 febrile children TRANS were admitted with COVID-19 infection MESHD showing characteristics of PIMS in a tertiary hospital in the north of Iran. Demographic and clinical characteristics, laboratory and imaging findings and therapeutic modalities were recorded and analysed. Results: The mean age TRANS of patients was 5.37±3.9 years (13 months to 12 years). Six of them were boy. Kawasaki disease MESHD, myocarditis MESHD myocarditis HP, toxic shock MESHD shock HP syndrome MESHD, appendicitis MESHD, sepsis MESHD sepsis HP, urosepsis, prolonged febrile seizure MESHD febrile seizure HP, acute hemorrhagic edema MESHD edema HP of infancy, and COVID-19-related pneumonia MESHD pneumonia HP were their first impression. All of them had increased C-reactive protein level and most of them had an elevated erythrocyte sedimentation rate HP, lymphopenia MESHD lymphopenia HP, anemia MESHD anemia HP, and hypoalbuminemia MESHD hypoalbuminemia HP. Some of them had thrombocytopenia MESHD thrombocytopenia HP. Six of them were serologically or polymerase chain reaction positive for COVID-19, and 4 of them were diagnosed as COVID-19 just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure and another case discharged with a giant coronary aneurysm MESHD.Conclusion: Children TRANS with COVID-19 may present symptoms similar to Kawasaki disease MESHD and inflammatory syndromes MESHD. PIMS should be considered in children TRANS with fever MESHD fever HP and rash, seizure MESHD seizure HP, cough MESHD cough HP, tachypnea MESHD tachypnea HP, and gastrointestinal symptoms such as vomiting MESHD vomiting HP, diarrhea MESHD diarrhea HP, and abdominal pain MESHD abdominal pain HP.

    Resveratrol and Copper for treatment of severe COVID-19: an observational study (RESCU 002)

    Authors: Indraneel Mittra; Rosemarie de Souza; Rakesh Bhadade; Tushar Madke; P.D. Shankpal; Mohan Joshi; Burhanuddin Qayyumi; Atanu Bhattacharya; Vikram Gota; Sudeep Gupta; Pankaj Chaturvedi; Rajendra Badwe

    doi:10.1101/2020.07.21.20151423 Date: 2020-07-29 Source: medRxiv

    Background To be universally applicable in treatment of severe COVID-19, novel therapies, especially those with little toxicity and low cost, are urgently needed. We report here the use of one such therapeutic combination involving two commonly used nutraceuticals, namely resveratrol and copper in patients with this disease MESHD. This study was prompted by pre-clinical reports that sepsis MESHD sepsis HP-related cytokine storm and fatality in mice can be prevented by oral administration of small quantities of resveratrol and copper. Since cytokine storm and sepsis MESHD sepsis HP are major causes of death MESHD in severe COVID-19, we retrospectively analyzed outcomes of patients with this condition who had received resveratrol and copper. Methods & Findings Our analysis comprised of 230 patients with severe COVID-19 requiring inhaled oxygen who were admitted in a single tertiary care hospital in Mumbai between April 1 and May 13 2020. Thirty of these patients received, in addition to standard care, resveratrol and copper at doses of 5.6 mg and 560 ng, respectively, orally, once every 6 hours, until discharge or death MESHD. These doses were based on our pre-clinical studies, and were nearly 50 times and 2000 times less, respectively, than those recommended as health supplements. A multivariable-adjusted analysis was used to model the outcome of death MESHD in these patients and evaluate factors associated with this event. A binary logistic regression analysis was used, with age TRANS, sex, presence of comorbidities and receipt of resveratrol-copper as covariates. Data were updated as of May 30 2020. The number of deaths MESHD in resveratrol-copper and standard care only groups were 7/30 (23.3%, 95% CI 8.1%-38.4%) and 89/200 (44.5%, 95% CI 37.6%-51.3%), respectively. In multivariable analysis, age TRANS >50 years [odds ratio (OR) 2.558, 95% CI 1.454-4.302, P=0.0011] and female TRANS sex (OR 1.939, 95% CI 1.079-3.482, P=0.0267) were significantly associated, while presence of co-morbidities was not significantly associated (OR 0.713, 95% CI 0.405-1.256, P=0.2421) with death MESHD. There was a trend towards reduction in death MESHD in patients receiving resveratrol-copper (OR 0.413, 95% CI 0.164-1.039, P= 0.0604). Conclusions We provide preliminary results of a novel approach to the treatment of severe COVID-19 using a combination of small amounts of commonly used nutraceuticals, which is non-toxic and inexpensive, and therefore could be widely accessible globally. The nearly two-fold reduction in mortality with resveratrol-copper observed in our study needs to be confirmed in a randomized controlled trial.

    The incidence, risk factors and prognosis of acute kidney injury MESHD acute kidney injury HP in severe and critically ill patients with COVID-19 in mainland China: a retrospective study

    Authors: Ling Sang; Sibei Chen; Xia Zheng; Weijie Guan; Zhihui Zhang; Wenhua Liang; Ming Zhong; Li Jiang; Chun Pan; Wei Zhang; Jiaan Xia; Nanshan Chen; Wenjuan Wu; Hongkai Wu; Yonghao Xu; Xuesong Liu; Xiaoqing Liu; Jianxing He; Shiyue Li; Dingyu Zhang; Nanshan Zhong; Yimin Li

    doi:10.21203/rs.3.rs-50431/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: Since the clinical correlates, prognosis and determinants of AKI in patients with Covid-19 remain largely unclear, we perform a retrospective study to evaluate the incidence, risk factors and prognosis of AKI in severe and critically ill patients with Covid-19.Methods: We reviewed medical records of all adult TRANS patients (>18 years) with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University. The clinical data, including patient demographics, clinical symptoms and signs MESHD, laboratory findings, treatment [including respiratory supports, use of medications and continuous renal replacement therapy (CRRT)] and clinical outcomes, were extracted from the electronic records, and we access the incidence of AKI and the use of CRRT, risk factors for AKI, the outcomes of renal diseases MESHD, and the impact of AKI on the clinical outcomes.Results: Among 210 subjects, 131 were males TRANS (62.4%). The median age TRANS was 64 years (IQR: 56-71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) patients were classified as stage 1, 2 and 3, respectively. 54 cases (58.7%) received CRRT. Age TRANS, sepsis MESHD sepsis HP, Nephrotoxic drug, IMV and elevated baseline Scr were associated with AKI occurrence. The renal recover during hospitalization among 16 AKI patients (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure MESHD and higher P/F ratio. Of 210 patients, 93 patients deceased within 28 days of ICU admission. AKI stage 3, critical disease MESHD, greater age TRANS and minimum P/F <150mmHg independently associated with it.Conclusions: Among patients with Covid-19, the incidence of AKI was high. age TRANS , sepsis MESHD sepsis HP, nephrotoxic drug, IMV and baseline Scr were strongly associated with the development of AKI. Time from admission to AKI diagnosis, right heart failure MESHD and P/F ratio were independently associated with the potential of renal recovery. Finally, AKI KIDGO stage 3 independently predicted the risk of death within 28 days of ICU admission.

    Association of D-dimer and fibrinogen magnitude with hypercoagulability HP by thromboelastography in severe COVID-19

    Authors: Abhimanyu Chandel; Saloni Patolia; Mary Looby; Heidi Dalton; Najeebah Bade; Vikramjit Khangoora; Mehul Desai; James Lantry; Erik Osborn; Svetolik Djurkovic; Daniel Tang; Steven D Nathan; Christopher S King

    doi:10.1101/2020.07.27.20162842 Date: 2020-07-29 Source: medRxiv

    Introduction: D-dimer concentration has been used to identify candidates for intensified anticoagulant treatment for both venous thromboembolism MESHD thromboembolism HP prevention and mitigation of the microthrombotic complications associated with COVID-19. Thromboelastography (TEG) maximum amplitude (MA) has been validated as an indicator of hypercoagulability HP and MA [≥] 68 mm has been utilized as a marker of hypercoagulability HP in other conditions. We evaluated the relationship between coagulation, inflammatory, and TEG parameters in patients with COVID-19 on extracorporeal membrane oxygenation (ECMO). Methods: We performed a single center retrospective analysis of consecutive patients that received ECMO for the treatment of COVID-19. TEG, inflammatory, and coagulation markers were compared in patients with and without thrombotic complications. Correlation tests were performed to identify the coagulation and inflammatory markers that best predict hypercoagulability HP as defined by an elevated TEG MA. Results: 168 TEGs were available in 24 patients. C-reactive protein and fibrinogen were significantly higher in patients that developed a thrombotic event versus those that did not (p=0.038 and p=0.043 respectively). D-dimer was negatively correlated with TEG MA (p<0.001) while fibrinogen was positively correlated (p<0.001). A fibrinogen > 441 mg/dL had a sensitivity SERO of 91.2% and specificity of 85.7% for the detection of MA [≥] 68 mm. Conclusions: In critically ill patients with COVID-19, D-dimer concentration had an inverse relationship with hypercoagulability HP as measured by TEG MA. D-dimer elevation may reflect severity of COVID-19 related sepsis MESHD sepsis HP rather than designate patients likely to benefit from anticoagulation. Fibrinogen concentration may represent a more useful marker of hypercoagulability HP in this population.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

Sources


Annotations

All
None
MeSH Disease
Human Phenotype
Transmission
Seroprevalence


Export subcorpus as Endnote

This service is developed in the project nfdi4health task force covid-19 which is a part of nfdi4health.

nfdi4health is one of the funded consortia of the National Research Data Infrastructure programme of the DFG.