1,720,965 research outputs found
Dynamics of clinical and laboratory indicators of patients with COVID-19 against the backdrop of treatment
No full textThe article presents the results of the analysis of the dynamics of the main indicators of the blood coagulation system and cytokines (IL-6, D-dimers, C-reactive protein and procalcitonin) on the background of thromboprophylaxis in patients with COVID-19. The aim of our study was to determine the dynamics of the main indicators of the blood coagulation system and cytokines in the setting of thromboprophylaxis. The study was conducted at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University and at the Municipal Non-Profit Enterprise "Kharkiv Regional Infectious Diseases Hospital" of the Kharkiv Regional Council, in 2020–2024 with compliance of the existing recommendations of bioethical norms and rules. All patients singed informed consent. We examined 179 patients aged 20–88 years (average age of [58.75±13.82] years) with COVID-19. The diagnosis of COVID-19 was confirmed by enzyme-linked im-munosorbent assay and polymerase chain reaction. Medical and statistical calculations were performed using the SPSS 25.0 software package. The mean value and standard square devia-tion were calculated. The probability of differences was determined using the Mann-Whitney U-test with a threshold value of statistical significance of p=0.05. According to the results of the study, a significant (p<0.001) dynamic of restoration of
D-Dimers’ levels was noted against the background of the applied therapy (on days 9–10, a decrease of 166.3 Fibrinogen Equivalent Unit (FEU), ng/ml, and on days 12–15 – of 376.7 FEU, ng/ml) and procalcitonin (on days 6–7 the content was by 0.04 ng/ml, p=0.006; on days 10–11 – 0.01 ng/ml, p<0.001; on days 12–15 – also 0.01 ng/ml, p=0.027)
Correlations between clinical, laboratory and instrumental characteristics of patients with COVID-19 infection
No full textCOVID-19 is a leading disease in terms of prevalence (more than 100 million cases) and mortality (more than 10.0%). Most often, COVID-19 is accompanied by hemostatic disorders (manifestations of COVID-19-associated coagulopathy) and blood coagulation
Determination of the degree of inflammatory response in patients with COVID-19 infection by interleukin-6 levels
No full textAn inflammatory reaction and subsequent severe organ damage play an undeniable role in the pathogenesis of disorders in patients with COVID-19 infection. Clinically, this is manifested by severe acute respiratory syndrome, which is characterized by diffuse damage to the alveoli at the level of hyaline membranes. The immune response in this case can manifest itself in the form of a cytokine storm: in the vast majority of patients, there is a significant increase in the levels of interleukin (IL)-6, IL-17A and tumor necrosis factor-α
Damage to the respiratory system of patients SARS-CoV-2 associated with COVID-19 infection
No full textCorona virus disease (COVID-19) is associated with a number of clinical conditions mainly of the respiratory system, including both mild lesions of the upper respiratory tract and severe viral pneumonia. Manifestations of interstitial pneumonia are determined among at least 14.0% of infected patients, which has a significant chance of developing into a severe acute respiratory syndrome with subsequent need for intensive therapy. In addition, damage to peripheral pulmonary vessels and vessels involved in gas exchange significantly affects the balance of ventilation and perfusion, which causes the development of hypoxemia and requires a change in the patient's position during oxygenation
Concomitant pathology of patients with COVID-19 infection
No full textMany studies have shown that a more severe course of COVID-19 is associated with the presence of comorbidities. Thus, the risk of hospitalization in patients with bronchial asthma is 1.5 times higher, and in patients with chronic kidney disease and diabetes mellitus - 4 and 3 times higher, respectively. Among the risk factors that significantly affect the deterioration of COVID-19, the researchers consider the following: older age, male gender, and comorbidities. For example, in the presence of concomitant hypertension, the risk of mortality increases by at least 1.7-3.5 times, and in the presence of grade I-II obesity - by 3 times. According to Pranata et al, cardiovascular and cerebrovascular pathology was the leading comorbidity in patients with COVID-19. Another meta-analysis by Pranata et al. showed the impact of concomitant hypertension on the course of COVID-19: hypertension was significantly associated with total negative outcomes of COVID-19: hazard ratio (HR) = 2.11 [95.0% confidence intervals (CI) 1.85-2.40], p < 0.001
Value of clinical blood analysis indicators of patients with COVID-19 infection
No full textEmerging in late 2019, the coronavirus disease (COVID-19) has quickly become global with extraordinary rates of morbidity and mortality. The World Health Organization defines COVID-19 as a severe acute respiratory syndrome caused by coronavirus type 2 (SARS-CoV-2). This is the third zoonotic coronavirus that has caused an epidemic in recent years. Bats can be considered the primary reservoir of infection, as the virus isolated from them has a high affinity to SARS-CoV-2. This type of coronavirus primarily affects the epithelium of the respiratory tract, entering the cells through interaction with the receptors of the angiotensin 2-converting enzyme
Lesions in the functional state of the cardiovascular system of patients with COVID-19 infection
No full textThe coronavirus family has been known since the 20th century, but until the outbreak of severe acute respiratory syndrome coronavirus disease (COVID-19) and Middle East respiratory syndrome (MERS-CoV), they were not given appropriate clinical and epidemiological significance. Thus, the most severe respiratory diseases were caused by 3 beta coronaviruses, in particular SARS-CoV, SARS-CoV-2 and MERS-CoV. Although most patients with COVID-19 have a predominantly respiratory tract involvement, a certain cohort has a more severe course of the disease with the development of systemic involvement characterized by resistant fever, acute lung injury and severe acute respiratory syndrome, shock and subsequent multiorgan failure. The combination of diffuse intravascular coagulation with the formation of large-caliber vascular thrombosis is also associated with the development of multiple organ failure. Mortality rates from COVID-19 reach at least 10.0%
Predicting the risk of death in patients with covid-19 infection
No full textThe article presents the associations of clinical, laboratory, and clinical and instrumental features of patients with COVID-19 with increased risks of death and survival. The final model for predicting the risks of developing a lethal outcome in COVID-19 was determined, which has high classification qualities (optimal threshold value of the calculated model is equal to -1.6149; sensitivity – 97.1%; and specificity – 82.6%. The purpose of our study was to determine the risks of developing fatal outcomes in patients with COVID-19 based on their clinical, laboratory and instrumental features. The study was performed at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University in accordance with the current bioethical norms and rules. All patients signed informed consent. 179 patients with COVID-19 aged 20–88 years (average age was [58.75±13.82] years) were observed. Medical and statistical calculations were performed using the IBM SPSS 25.0 software package. The associations of indicators with the binomial dependent variable were calculated using multiple logistic regression analysis with the calcula-tion of β coefficients. The significance of differences was determined using the Mann-Whitney U-test with a threshold of statistical significance p=0.05. Based on the results, the final prog-nostic model of the risk of developing a lethal outcome of COVID-19 indicates an increased risk of death in COVID-19 with increasing age (by 13.9%), leukocyte count (by 14.4%), D-dimers (by 0.001%) on day 5–7. According to the model, an increase in the probability of sur-vival in COVID-19 was significantly proved with an increase in hemoglobin (by 6.1%) at the day of hospitalization, monocyte count (by 17.1%) on day 5–7 and the use of ceftriaxone (by 87.8%)
Clinical and laboratory characteristics of patients with coronavirus infection covid-19 and its comorbidity
No full textThe coronavirus disease has reached an alarming epidemic scale with extraordinary morbidity and mortality rates for the entire world population. The majority of patients with COVID-19 note damage to the respiratory tract and state a more severe course of the disease with the development of systemic damage. A more severe course of COVID-19 is associated with the presence of comorbid diseases
Clinical and laboratory charecteristics of patients with coronavirus infection COVID-19 and its comorbidity
No full textIntroduction. The coronavirus disease has reached an alarming epidemic scale with extraordinary morbidity and mortality rates for the entire world population. The majority of patients with COVID-19 note damage to the respiratory tract and state a more severe course of the disease with the development of systemic damage. A more severe course of COVID-19 is associated with the presence of comorbid diseases.
Aim. To investigate and analyze clinical and laboratory manifestations and to determine the main comorbidities of patients with COVID-19 infection.
Materials and methods. The research was carried out in accordance with bioethical norms and rules. 179 patients with COVID-19 (the main group) and 42 people of the control group were examined. Diagnosis and treatment of the COVID-19 coronavirus infection was carried out taking into account the relevant national recommendations. The average value and standard deviation were statistically determined. The probability of differences was performed using the Mann- Whitney U-test and the Wilcoxon W-test of signed ranks. The threshold value of the level of statistical significance of all calculated features was taken as 0.05 (p=0.05).
Results. A high comorbidity with cardiovascular system pathology was found–40.2 %, type 2 diabetes–22.3 %, respiratory system diseases–20.7 %. Disorders of the functional state of the cardiovascular system were determined: pulse values–91.01±13.44, systolic (127.9±15.19) and diastolic (79.3±11.6) blood pressure. Changes in clinical blood analysis were noted: erythrocytes–4.38±0.65 x1012/l, hemoglobin–127.6±21.2 g/l, hematocrit–0.37±0.07, leukocytes–10.7±7, 32 x109/l, segmented (65.4±14.8 %) and rod-nuclear (9.03±9.99 %) neutrophils, platelets–226.1±90.6 x109/l, lymphocytes–20.24±12.43 %, monocytes–6.60±4.37 % and erythrocyte sedimentation rate (ESR)–25.4±14.9 mm/h. Significant (almost fourfold) increases in IL-6 levels (24.56±22.9 pg/ml) and blood glucose concentrations (7.40±3.42 mmol/l) were determined.
Conclusions. A significant comorbidity of COVID-19 was determined and a significant prevalence of indicators of the functional state of the cardiovascular system and a decrease in the average levels of the quantitative composition of erythrocytes and indicators of hemoglobin and hematocrit were established. Significant leukocytosis, neutrophilia, lymphocytosis and monocytosis, significant excesses of ESR and IL-6 and blood serum glucose were determined, which confirmed the presence of a significant inflammatory reaction in response to infection with COVID-19
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