# pos

id: cord-340433-h86cufyp
pos: NNP
token:
  http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic

lemma:
  http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic


# ent

id: cord-000268-480d3yfv
type: PROTEIN
entity:
  nTREM 1 above 2 55 MFI Sensitivity and Lung cancer 13 Staphulococcus aureus 3 Pulmonary embolism 6 Haemophilus influenzae 2 Congestive heart failure 5 Pseudomonas aeruginosa 2


id: cord-000268-480d3yfv
type: DISEASE
entity:
  noninfectious processes like peptic ulcer inflammatory bowel disease viral infections malignant pleural effusions


id: cord-297138-t8b3914h
type: ORG
entity:
  the University of Crete s Special Account for Research ELKE Identification of Essential Oil Components by Gas Chromatography Mass Spectorscopy Healing


id: cord-334047-xwjwt2be
type: PROTEIN
entity:
  anti human C reactive protein antibodies polyclonal host rabbit monoclonal host mouse and recombinant human IL 6


id: cord-353116-7t1prfkr
type: DNA
entity:
  interleukin IL 2 IL6 IL7 IL10 granulocyte colony stimulating factor GCSF tumor necrosis factor TNF alpha


id: cord-353116-7t1prfkr
type: GGP
entity:
  Angiotensin II receptor blockers A c c e p t e d M a n u s c r i p t A c c e p t e d M a n u s c r i p


id: cord-353116-7t1prfkr
type: ORG
entity:
  the Chinese Center for Disease Control and Prevention Clinical Characteristics of Coronavirus Disease 2019


id: cord-103653-hgnz0fkv
type: CELL_TYPE
entity:
  peripheral blood Lymphocyte Circadian Clocks Control Lymph Node Trafficking and Adaptive Immune Responses Adrenergic control of the adaptive immune response by diurnal lymphocyte


id: cord-103653-hgnz0fkv
type: PRODUCT
entity:
  Hematopoietic Extrinsic Cues Dictate Circadian Redistribution of Mature and Immature Hematopoietic Cells


id: cord-103653-hgnz0fkv
type: EVENT
entity:
  the US Population Analysis of NHANES Data Host and Environmental Factors Influencing Individual Human Cytokine Responses Seasonal


id: cord-277879-7ftu9b9q
type: ORG
entity:
  Interleukin 1 Moving Upstream to Identify Novel Targets for Atheroprotection Controlling for Time dependent Confounding


id: cord-330411-hg1cxcs7
type: PROTEIN
entity:
  protein 10 IP10 monocyte chemoattractant protein 1 MCP1 macrophage inflammatory protein 1 alpha MIP1A


id: cord-297093-ld89vmct
type: FAC
entity:
  QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients


id: cord-348053-s0ijzyaq
type: LAW
entity:
  COVID 19 Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID 19 COVID 19


id: cord-005497-w81ysjf9
type: DNA
entity:
  1st group 1st stage 15 2 10 19 4 mmol L 2nd stage 5 2 3 9 7 6 mmol L 3rd stage 6 6 5 8 7 μmol L stage 4 9 7 8 6 12 1 μmol L stage 5 9 4 7 8 11 9 μmol L


id: cord-005497-w81ysjf9
type: DNA
entity:
  2nd group 1st stage 11 9 10 15 mmol L 2nd stage 3 7 1 7 4 1 mmol L 3rd stage 3 6 2 4 4 5 μmol L stage 4 6 5 4 4 8 2 μmol L stage 5 7 6 6 5 9 4 μmol L


id: cord-005497-w81ysjf9
type: PROTEIN
entity:
  I Boussaid D Chtourou S Sfaxi W Bahria D Hamdi M Boussen M Ben Cheikh Mongi Slim Academic Hospital Emergency Department Tunis Tunisia Critical Care 2020 24 Suppl 1 P182


id: cord-005497-w81ysjf9
type: CELL_LINE
entity:
  Greek ICU population E Nanou 1 P Vasiliou 1 E Tsigou 2 V Psallida 1 E Boutzouka 2 V Zidianakis 1 G Fildissis 1 1 Agioi Anargiroi Hospital Attiki Greece 2 Agioi Anargiroi Hospital ICU


id: cord-005497-w81ysjf9
type: DNA
entity:
  groups 11 44 and 6 35 p 0 81 6 24 and 7 41 р 0 40 1 4 and 1 6 р 1 00 6 24 and 5 29 р 0 97 respectively Rate


id: cord-005497-w81ysjf9
type: CELL_LINE
entity:
  35bed Greek university ICU C Vrettou E Douka I Papachatzakis K Sarri E Gavrielatou E Mizi S Zakynthinos 1st ICU Department University


id: cord-005497-w81ysjf9
type: GGP
entity:
  MAP R 0 03 p 0 003 R 0 03 p 0 004 Figure 1 and heart rate R 0 12 p 0 001 since systemic pressure starts to drop UFRV and UFR demonstrated good clinical response to fluid administration despite the fact that systemic blood pressure


id: cord-005497-w81ysjf9
type: ORG
entity:
  Conrick Martin Mater Misericordiae University Hospital Department of Critical Care Medicine Dublin Ireland Critical Care 2020


id: cord-005497-w81ysjf9
type: ORG
entity:
  Clinical Research Investigation and Systems Modeling of Acute Illness CRISMA Center Department of Biostatistics


id: cord-005497-w81ysjf9
type: PRODUCT
entity:
  S Erel O Ermis Ö Nadastepe L Karabıyık Gazi University School of Medicine Anesthesiology and Intensive Care


id: cord-005497-w81ysjf9
type: DISEASE
entity:
  brain injury A Semenenko 1 S Semenenko 2 A Solomonchuk 3 N Semenenko 3 Depending on the nature of the brain injury


id: cord-005497-w81ysjf9
type: DISEASE
entity:
  critically ill T Chandler R Sarkar A Bowman P Hayden Medway Maritime Hospital Critical Care Gillingham United Kingdom Critical Care 2020 24 Suppl 1 P366 Frailty


id: cord-014516-r59usk02
type: PROTEIN
entity:
  24th ECVIM CA Congress date 2015 01 10 journal J Vet Intern Med DOI 10 1111 jvim 12491 sha 25a10dcacb257ac926ad42124f605189b3789d3f doc_id 14516 cord_uid r59usk02 nan Saccharomyces boulardii Sb


id: cord-014516-r59usk02
type: PROTEIN
entity:
  nLVIDs 1 1 33 1 33 1 68 1 68 1 86 and 1 86 were 1 6 0 6 4 6 p 0 35 3 4 1 0 11 5 p 0 048 78 9 6 634 p 0 030 and 47 6 7 1 316 p 0 044


id: cord-014516-r59usk02
type: DNA
entity:
  SRE hypoalbuminemia IL 0 5 SRE 10 22 FRE 1 62 ARE 1 11 p 0 000 hypocobalaminemia IL 0 3 SRE 9 20 FRE 8 63 ARE 1 11 p 0 015


id: cord-014516-r59usk02
type: PROTEIN
entity:
  E C Y Lin 1 P C Liu 1 L L Chueh 1 B L Su 2 1 Graduate Institute of Veterinary Medicine National Taiwan University Taipei Taiwan 2 Institute of Veterinary Clinical Sciences


id: cord-014516-r59usk02
type: GGP
entity:
  nLVIDs 1 1 33 1 33 1 68 1 68 1 86 and 1 86 were 1 6 0 6 4 6 p 0 35 3 4 1 0 11 5 p 0 048 78 9 6 634 p 0 030 and 47 6 7 1


id: cord-014516-r59usk02
type: GGP
entity:
  SERCA2a r 0 7425 R 2 0 5513 PLN r 0 7720 R 2 0 5959 HAX 1 r 0 6598 R 2 0 4353 although LV and PWBC showed different expression levels


id: cord-014516-r59usk02
type: GGP
entity:
  villi 3 2 0 8 16 versus 1 8 0 11 2 P 0 27 This study reports for the first time the existence of two populations of


id: cord-014516-r59usk02
type: ORG
entity:
  the Cardiology Service of the Department of Veterinary Science and Public Health University of Milan


id: cord-014516-r59usk02
type: ORG
entity:
  Consultancy Pfizer Animal Health Zoetis CEVA Animal Health Boehringer Ingelheim Vetoquinol Ltd Orion Ltd Elanco Ltd Idexx Ltd Niche Generics Ltd Triveristas Ltd Virbac Ltd Advisory


id: cord-014516-r59usk02
type: DISEASE
entity:
  inflammatory diseases 90 exocrine pancreatic insufficiency hypoadrenocorticism polyendocrinopathy dilated cardiomyopathy


id: cord-005727-li8pwigg
type: PROTEIN
entity:
  LIMON System Ò Pulsion Medical System Munchen Germany was measured once a day for 3 postoperative days POD


id: cord-005727-li8pwigg
type: GGP
entity:
  MV 7 1 1 8 vs 7 9 1 7 L min p 0 003 PEEP 9 5 vs 10 4 cmH 2 O p 0 01 FiO 2 35 13 vs 45 18 p 0 001 Vt PBW 8 1 0 8 vs 8 4 0 8 mL Kg PBW p 0 003 and Pplat 22 6 vs 24 6 cmH 2 O p 0 01 than ASV Static compliance PaO 2 FiO 2 ratio and PaCO 2


id: cord-005727-li8pwigg
type: ORG
entity:
  Hirosaki University Graduate School of Medicine Division of Intensive Care Hirosaki Japan INTRODUCTION


id: cord-005727-li8pwigg
type: PRODUCT
entity:
  A S Puxty 1 J Kinsella 1 K Anderson 1 1 Glasgow Royal Infirmary Department of Anaesthetics Glasgow UK Etomidate


id: cord-005727-li8pwigg
type: DATE
entity:
  between 1st of January of 1999 to 31st of December 2001 and 1st of January of 2007 to 31st of December 2009


id: cord-005727-li8pwigg
type: CHEMICAL
entity:
  alcohol n 7 HCV n 3 alcohol HCV n 2 alpha 1 antitrypsin deficiency n 1 budd chiari syndrome n 1 or cryptogenic n 1


id: cord-005727-li8pwigg
type: CHEMICAL
entity:
  garlic 43 apple vinegar 39 lavandula stoechas 31 cratageus 29 and ginger honey mixture 27 The average educational degree of herbal product users was


id: cord-023157-0lqlx2rv
type: PROTEIN
entity:
  LDL cholesterol apolipoprotein B 88 3 AE 27 0 vs 96 8 AE 21 1 mg dl and interleukin 6 2 37 AE 2 06 vs 3 54 AE 3 07


id: cord-023157-0lqlx2rv
type: PROTEIN
entity:
  Picu 1 L Petcu 1 D Lixandru 2 I Stoian 2 C Cristescu 3 E Rusu 3 C Ionescu Tirgoviste 1 1 NIDNMD N C Paulescu 2 Biochemistry University of Medicine and Pharmacy Carol Davila 3 Titu Maiorescu University Bucharest Romania Background


id: cord-023157-0lqlx2rv
type: PROTEIN
entity:
  I B 38 7 AE 5 5 mU ml 2 1 22 G 33 3 AE 9 8 P 0 3 HOMA IR B 8 9 AE 5 2 77 G 7 1 AE 2 P 0 5 CARO 0 2 AE 0 15 0 33 0 25 AE 0 13 P 0 8 Conclusions Obesity


id: cord-023157-0lqlx2rv
type: PROTEIN
entity:
  K Elksne 1 Z Paunina 1 A Jurka 2 D Rezeberga 1 P Tretjakovs 2 1 Obstetrics and Gynecology 2 Physiology Rigas


id: cord-023157-0lqlx2rv
type: PROTEIN
entity:
  casein protein 50 g maltodextrin 19 and 10 g lactulose or 2 50 g maltodextrin 19 and 10 g lactulose control Procedures Fifteen prediabetic and 15 healthy volunteers


id: cord-023157-0lqlx2rv
type: PROTEIN
entity:
  G Kistauri 1 G Devidze 2 M Jibladze 1 A A Kistauri 3 1 Internal Medicine Tbilisi State Medical University Tbilisi 2 Surgery Kutaisi Ortodox Christian Hospital Kutaisi Georgia 3


id: cord-023157-0lqlx2rv
type: GGP
entity:
  NO r 0 34 GGTP NO r 0 88 P 0 05 The biopsy of liver showed all signs of NAFLD including changes of tiny bilious ductules


id: cord-023157-0lqlx2rv
type: GGP
entity:
  SUA r 0 27 P 0 01 and SDMA with SUA and hs CRP concentrations r 0 37 P 0 05 r 0 48 P 0 01 respectively We demonstrated that


id: cord-023157-0lqlx2rv
type: GGP
entity:
  51times 3 81 times and 13 21 times more risk of increasing regional adiposity using WHtR WHR and WC respectively Among females WHtR WHR and WC respectively showed 9 53 times 3 96 times and 6 00 times higher risk of developing regional adiposity with irregular pattern of PA The increased risk of being obese was 7 16 times more among males with irregular pattern of physical activity while among females fat percentage and obesity level using BMI category were found to be


id: cord-023157-0lqlx2rv
type: GGP
entity:
  GH R 2 17 4 P 0 001 and IGF 1 R 2 15 2 P 0 01 and negatively with disease duration R 2 12 8 P 0 04 The GH


id: cord-023157-0lqlx2rv
type: GGP
entity:
  TRIMPS P 0 05 Furthermore high workers had lower levels of fat mass percentage and 2 h glucose as well as higher lean body


id: cord-023157-0lqlx2rv
type: GGP
entity:
  fibrinogen C reactive protein uric acid creatinine triglycerides t cholesterol HDL LDL homocysteine glucose insulin


id: cord-023157-0lqlx2rv
type: GGP
entity:
  glucose 3 37 1 06 10 72 and 1 4 78 1 32 17 29 and 2 risk factors 7 16 2 38 21 54 higher than those without the phenotype Those with a high WHTR had lower clustered risk P 0 05 higher odds of having low HDL cholesterol 2 57 1 11 5


id: cord-023157-0lqlx2rv
type: GGP
entity:
  glucose 5 6 mmol l In this particulary population with coronary artery disease and or cardiovascular risk factors


id: cord-023157-0lqlx2rv
type: GGP
entity:
  growth factors IGFs sex hormones adipocytokines inflammatory cytokines c Myc oncogenic transcription factor


id: cord-023157-0lqlx2rv
type: GGP
entity:
  Cushing s disease Conclusion A longer duration of CD symptoms was associated with greater risk of metabolic complications such as prediabetes and secondary diabetes The efficacy of surgical treatment for corticotroph adenoma does not depend directly on the presence of preoperative glucose


id: cord-023157-0lqlx2rv
type: WORK_OF_ART
entity:
  A Kopp A Schmid M Mü ller A Schä ffler Internal Medicine I University Hospital Regensburg Regensburg Germany Introduction Proteins


id: cord-023157-0lqlx2rv
type: ORG
entity:
  Department of Physiology Federal University of Juiz de Fora Juiz de Fora 2 Biology State University of Maring a Maring


id: cord-023157-0lqlx2rv
type: ORG
entity:
  Clinical Endocrinology Institute for Endocrine Pathology Problems Kharkiv Ukraine Introduction Active


id: cord-023157-0lqlx2rv
type: PERCENT
entity:
  between T1 T2 and T3 and iv significant decline in LDL triglycerides and BMI between T3 T2 and T1 39 3 and 38 7 of the group and personal therapy respectively


id: cord-023157-0lqlx2rv
type: ORG
entity:
  Institute for Sport and Physical Activity Research ISPAR University of Bedfordshire Bedford UK Objective Hypertriglyceridemic


id: cord-023157-0lqlx2rv
type: ORG
entity:
  Institute of Molecular Biomedicine Comenius University Medical Faculty 2 Department of Health Bratislava Self Governing Region 3 Regional Public Health Office


id: cord-023157-0lqlx2rv
type: WORK_OF_ART
entity:
  Medical Laboratory Technology Women s Polytechnic 2 Medical Officer Government of Tripura Health Services Agartala India Introduction Saliva


id: cord-023157-0lqlx2rv
type: CHEMICAL
entity:
  Kidron 1 E Arbit 2 1 Oramed Pharmaceuticals Jerusalem Israel 2 Biomedical Engineering NYU Oramed Pharmaceuticals Englewood NJ USA


id: cord-023157-0lqlx2rv
type: DISEASE
entity:
  diabetes F Saad 1 2 A Yassin 3 4 G Doros 5 1 Results After 5 years the following changes were observed weight kg


id: cord-023157-0lqlx2rv
type: CHEMICAL
entity:
  apolipoprotein B apo B were 4 4 AE 1 2 mmol l 2 6 AE 1 0 mmol l 0 97 AE 0 27 mmol l 1 9 AE 1 4 mmol l 1 13 AE 0 18 g l and 0 91 AE 0 25 g l respectively Eighty one percent 13 and 6 of


id: cord-015324-y44sfr0c
type: PROTEIN
entity:
  MPGN1 G Stringini E Malagnino F Emma Bambino Gesu Children s Hospital and Research Institute Department of Nephrology and Urology Rome Italy Serum creatinine values may vary considerably between normal subjects These variations are in part secondary


id: cord-015324-y44sfr0c
type: PROTEIN
entity:
  N Bresolin V Fernandes F Carvalho J Goes L Araujo M Simon G Gamborgi M Zanin Hospital Infantil Joana


id: cord-015324-y44sfr0c
type: DNA
entity:
  Al Midani 1 G Koffman 2 J John 2 S Stephen 2 S Suzanne 2 R Lord 2 1 Royal Free Hospital Transplantation London United Kingdom 2 Great


id: cord-015324-y44sfr0c
type: PROTEIN
entity:
  Na H exchanger NHE3 Na K ATPase Na K 2Clcotransporter BSC 1 Na Clcotransporter TSC epithelial sodium channel ENaC subunits


id: cord-015324-y44sfr0c
type: PROTEIN
entity:
  HMG CoA reductase HMG CoAR ACAT2 cholesterol 7a hydroxylase Ch7aH LDL receptor LDLR and IL 13 receptor subunits


id: cord-015324-y44sfr0c
type: PROTEIN
entity:
  HMG CoAR 0 25 0 08 vs 0 54 0 05 p 0 02 ACAT2 0 26 0 03 vs 0 43 0 04 p 0 009 Ch7aH 0 50 0 12 vs 1 08 0 10 p 0 004 LDLR 0 10 0 01 vs 0 15 0 02 p 0 02 and IL 13Ra2 0 003 0 002 vs 0 080 0 015 p 0 001 Conclusion The


id: cord-015324-y44sfr0c
type: GGP
entity:
  NT 381 92 vs 277 62 umol l respectively p 0 0001 and in OO than NT 336 72 vs 277 62 umol l respectively p 0 0001 Total cholesterol HDL LDL


id: cord-015324-y44sfr0c
type: GGP
entity:
  NT 12 75 3 47 vs 14 55 5 32 respectively p 0 05 Conclusions New onset EH in the youth is associated with overweight obesity higher serum UA and ED UA


id: cord-015324-y44sfr0c
type: GGP
entity:
  LDH r 2 0 40 p 0 0005 and with the bioimpedance analysis BIA measure of Resistance which is an index of body hydration In conclusion 1


id: cord-015324-y44sfr0c
type: GGP
entity:
  ACAT2 0 26 0 03 vs 0 43 0 04 p 0 009 Ch7aH 0 50 0 12 vs 1 08 0 10 p 0 004 LDLR 0 10 0 01 vs 0 15 0 02 p 0 02 and IL 13Ra2 0


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  Applying Regenerative Medicine to Combat Organ Shortage Laboratory of Regenerative Nephrology Edmond


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  The Heart in Pediatric Nephrotic Syndrome Y Frishberg Shaare Zedek Medical Center Pediatric Nephrology


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  The Effect of Age Matching on the Duration of the Waiting Time A Rahmel M Slot J Smits Eurotransplant International Leiden


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  the Treatment of Peritonitis B A Warady Children s Mercy Hospital and Clinics Pediatrics Nephrology Kansas City United States


id: cord-015324-y44sfr0c
type: ORG
entity:
  Severe Henoch Schönlein Purpura Nephritis Treated with Longterm Immunosuppression M Shenoy M Bradbury L Lewis N


id: cord-015324-y44sfr0c
type: ORG
entity:
  University of Calgary Department of Pediatrics Calgary Canada 2 University of Calgary Department of Biochemistry


id: cord-015324-y44sfr0c
type: PRODUCT
entity:
  J Feber 1 P Geier 1 B Chaudry 1 H Wong 1 G Filler 2 1 Children s Hospital of Eastern Ontario Division of


id: cord-015324-y44sfr0c
type: EVENT
entity:
  A Filleron AL Adra Delenne L Ichay F Dalla Vale H Valette D Morin CHU Montpellier Pediatric Nephrology Montpellier France


id: cord-015324-y44sfr0c
type: ORG
entity:
  the Pediatric Nephrology Unit Department of Child Health School of Medicine Airlangga University Soetomo Hospital


id: cord-015324-y44sfr0c
type: ORG
entity:
  University of Belgrade Faculty of Medicine Institute of Pathology Belgrade Serbia 2 Institute of Mother and Child Health of Serbia Belgrade Serbia


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  Levels in Profliferative Forms of Glomerulonephritis in Children Russian Federation 2 Research Centre for Child Health RAMS Department of Pathology


id: cord-015324-y44sfr0c
type: ORG
entity:
  Iran University of Medical Science Atypical Hemolytic Uremic Syndrome an Unsolved Case of Complement Dysregulation


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  Heterogeneous Effect of ACEI Therapy in Children with Proteinuric Nephropathies B Kranz S Diepenbruck U Vester R Buescher A Wingen P Hoyer University


id: cord-015324-y44sfr0c
type: ORG
entity:
  Wang West China Second University Hospital Sichuan University Department of Pediatrics Chengdu People s Republic of China Objective


id: cord-015324-y44sfr0c
type: WORK_OF_ART
entity:
  The Effect of Corticosteroid Therapy on Bone Metabolism in Nephrotic Syndrome Background Nephropathic cystinosis


id: cord-015324-y44sfr0c
type: DISEASE
entity:
  dysplasia obstructive uropathy N 24 autosomal recessive polycystic kidney disease ARPKD N 10 congenital nephrotic syndrome


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  Derakhshan 2 D Derakhshan 2 M Fallahzadeh 2 Z Bazargani 3 M Basiratnia 4 1 Shiraz Organ Transplantation Center Nemazee Hospital Shiraz Nemazee


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  Derakhshan 1 H Jalaeian 2 A Derakhshan 1 B Sabet 2 M Fallahzadeh Nemazee Hospital Shiraz Iran 2 Shiraz Organ Transplantation Center Nemazee Hospital Shiraz Iran


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  SY 704 P 214 FC 211 FC 846 P 206 FC 456 P Coutinho S 868 P Coviello D 333 P 223 FC Craig J 108 OP 556 P Cransberg K 214 FC 765 P 425 P Cristino S 672 P 39 FC 532


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP 859 P 679 P 303 SA 373 P 381 P Delucchi A 633 P 821 P 338 P 439 P 485 P 653 P 284 FC 599 P 20 FC Dinda A 756 P 325 P 695 P 607 P Dittrich K


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP SY Fitoz S 408 P 117 FC 798 P 470 P Fujita H 75 OP 441 P Fujita T 769 P 443 P Fukuhara D 816 P 171 OP 843 P 803 P 171 OP 189


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP 154 OP 104 OP 115 FC 385 P 665 P 765 P 734 P 749 P 643 P 18 MR 334 P 69 OP 471 P Kondo Y 29 FC 647 P 891


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  D 910 P Krylova Olefirenko A 825 P 616 P 582 P 746 P 260 SY 118 FC 340 P 544 P Kurayama R 185 OP 599 P 266 FC Lalatta F 177 OP 515 P 257 SY 354 P 160 OP 432 P Lau


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP 115 FC 758 P 420 P 23 FC 368 P Molnár Varga M 525 P 227 FC 279 FC 487 P Montini G 209 FC 774 P 523 P 74 OP 587 P 569 P Morimoto T 187 OP 364


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP 393 P 75 OP 338 P 257 SY 567 P Ostalska Nowicka D 522 P 621 P Otukesh H 477 P 322 P 710 P 543 P Ozen A 498 P 230 SY 308


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP 869 P Seeherunvong W 40 FC 887 P 185 OP 468 P Semama D 76 OP 748 P 470 P 656 P 657 P Shin YH 382 P 564 P 22 FC 372 P 416 P 519 P 652 P Siwiñska A 343 P 276 FC 154 OP 717 P Spasojevic B 612 P 647 P 910 P Spasojevic Dimitrijeva B


id: cord-015324-y44sfr0c
type: CHEMICAL
entity:
  OP 652 P 154 OP 219 FC Urdaneta Carruyo E 551 P 872 P Urdaneta Contreras A 277 FC 572 P 587 P Valverde S 638 P 713 P Van


id: cord-015021-pol2qm74
type: PROTEIN
entity:
  endotoxln endorphins complement interleukins tumor necrosis factor eieosanoids platelet activating factor


id: cord-015021-pol2qm74
type: DNA
entity:
  BIRGIT NENTWIG MARION HOCKENSCHNtEDER DIRK RAUTHMANN SALIM BALIKCIOGLU ROLF COLDEWEy HELMUTH DEICHER MD Endotoxin


id: cord-015021-pol2qm74
type: PROTEIN
entity:
  rhlL lra Phase I Sepsis Syndrome Study Group The Cleveland Clinic Foundation A murine anti human TNF monoclonal antibody


id: cord-015021-pol2qm74
type: ORG
entity:
  Division of Cell Biology and Immunology Department of Pathology University of Utah School of Medicine


id: cord-015021-pol2qm74
type: WORK_OF_ART
entity:
  Dept of Surgery Klinikum Grosshadern Ludwig Maximilians University Munich Germany Dept of Surgery University of Cincinnati


id: cord-015021-pol2qm74
type: PRODUCT
entity:
  William G Cheadle M D Department of Surgery University of Louisville School of Medicine Louisville KY 40292


id: cord-015021-pol2qm74
type: DISEASE
entity:
  chronic disease sepsis OSFsi e cardiovascular CF pulmonary PF renal RF neurological NF haematological HF hepatic LF


# bib

id: cord-000268-480d3yfv
author: Porfyridis, Ilias
date: 2010-09-29
txt: ./txt/cord-000268-480d3yfv.txt
cache: ./cache/cord-000268-480d3yfv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955686/
doi: 10.1186/1471-2334-10-286
summary:
  title: Diagnostic value of triggering receptor expressed on myeloid cells-1 and C-reactive protein for patients with lung infiltrates: an observational study The aim of the present study was to define whether expression of TREM-1 on cell membranes of neutrophils (nTREM-1), of monocytes (mTREM-1) and serum sTREM-1 may help in the diagnosis of acute bacterial infections for patients admitted with a new pulmonary infiltrate or pleural effusion. In conclusion, the presented results indicate that serum sTREM-1 and expression of TREM-1 on neutrophils and monocytes may serve as markers of CAP in patients with pulmonary infiltrates. Increased levels of soluble triggering receptor expressed on myeloid cells-1 in patients with acute pancreatitis Prognosis of community acquired pneumonia(CAP): value of triggering receptor expressed on myeloid cells-1 (TREM-1) and other mediators of the inflammatory response Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU

title:
  Diagnostic value of triggering receptor expressed on myeloid cells-1 and C-reactive protein for patients with lung infiltrates: an observational study

abstract:
  BACKGROUND: Differential diagnosis of patients with lung infiltrates remains a challenge. Triggering receptor expressed on myeloid cells (TREM)-1 is a neutrophil and monocyte receptor up-regulated during infection. The aim of this study was to evaluate the diagnostic accuracy of TREM-1 and of C-reactive protein (CRP) from patients with lung infiltrates to discern community acquired lung infections. METHODS: 68 patients admitted to a medical ward with acute respiratory illness were enrolled in the study. Neutrophil and monocyte TREM-1 expression were measured by flow cytometry, sTREM-1 by an enzyme immunoassay and C-reactive protein by nephelometry. Clinical pulmonary infection score was recorded. RESULTS: 34 patients were diagnosed with bacterial community acquired pneumonia (group A) and 34 with non-bacterial pulmonary disease (group B). Median serum TREM-1 concentration was 102.09 pg/ml in group A and lower than 15.10 pg/ml (p < 0.0001) in group B. Mean±SE neutrophil TREM-1 expression was 4.67 ± 0.53 MFI in group A and 2.64 ± 0.25 MFI (p = 0.001) in group B. Monocyte TREM-1 expression was 4.2 ± 0.42 MFI in group A and 2.64 ± 0.35 MFI (p = 0.007) in group B and mean±SE CRP was 18.03 ± 2 mg/ml in group A and 7.1 ± 1.54 mg/ml (p < 0.001) in group B. A cut-off of 19.53 pg/ml of sTREM-1 with sensitivity 82.6% and specificity 63% to discriminate between infectious and non-infectious pulmonary infiltrates was found. sTREM-1 at admission greater than 180 pg/ml was accompanied with unfavourable outcome. CONCLUSION: TREM-1 myeloid expression and sTREM-1 are reliable markers of bacterial infection among patients with pulmonary infiltrates; sTREM-1 is a predictor of final outcome.


id: cord-000753-gowyfu55
author: Kafkas, Nikolaos
date: 2012-09-04
txt: ./txt/cord-000753-gowyfu55.txt
cache: ./cache/cord-000753-gowyfu55.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440856/
doi: 10.1155/2012/189797
summary:
  In patients with acute coronary syndromes, serum levels of NGAL have high negative predictive value and reflecting the inflammatory status could show the severity of coronary clinical syndrome. In this study, we hypothesized that levels NGAL in blood may reflect the extent of neutrophil activation in various stages of ACS and could discriminate various types of ACS (UA, NSTEMI, and STEMI) and stable from unstable coronary syndromes. The higher levels of serum-NGAL observed in patients with ACS compared to SA could be explained by International Journal of Inflammation 7 the fact that neutrophil activation is present only in patients with acute coronary events (10, 11) . In conclusion, our study shows that serum levels of NGAL increase in patients with CAD with every coronary clinical syndrome and reflect the inflammatory status in the same population. Also in patients with ACS, serum levels of NGAL reflecting the inflammatory status could show the severity of coronary clinical syndrome (UA, NSTEMI, and STEMI).

title:
  Serum Levels of Gelatinase Associated Lipocalin as Indicator of the Inflammatory Status in Coronary Artery Disease

abstract:
  Background. Atherosclerosis is a chronic inflammatory disease and the acute clinical manifestations represent acute on chronic inflammation. Neutrophil gelatinase-associated lipocalin (NGAL) is found in the granules of human neutrophils, with many diverse functions. The aim of this study was to evaluate the hypothesis that levels NGAL in blood may reflect the inflammatory process in various stages of coronary artery disease. Methods. We studied 140 patients, with SA 40, UA 35, NSTEMI 40, and STEMI 25, and 20 healthy controls. Serum NGAL was measured upon admission and before coronary angiography. Results. Significant differences were observed in median serum-NGAL(ng/mL) between patients with SA (79.23 (IQR, 37.50–100.32)), when compared with UA (108.00 (68.34–177.59)), NSTEMI (166.49 (109.24–247.20)), and STEMI (178.63 (111.18–305.92)) patients and controls (50.31 (44.30–69.78)) with significant incremental value from SA to STEMI. We observed a positive and significant correlation between serum-NGAL and hs-CRP (spearman coefficient rho = 0.685, P < 0.0001) as well as with neutrophil counts (r = 0.511, P < 0.0001). Conclusions. In patients with coronary artery disease serum levels of NGAL increase and reflect the degree of inflammatory process. In patients with acute coronary syndromes, serum levels of NGAL have high negative predictive value and reflecting the inflammatory status could show the severity of coronary clinical syndrome.


id: cord-004378-g1rxygef
author: Leinisch, Fabian
date: 2020-02-20
txt: ./txt/cord-004378-g1rxygef.txt
cache: ./cache/cord-004378-g1rxygef.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033146/
doi: 10.1038/s41598-020-59855-x
summary:
  In this study we show that exposure of isolated dimeric CRP-cAMP to UV modifies specific Met, Trp, Tyr, and Pro side-chains, induces inter-protein Tyr63-Tyr41 cross-links, and decreases DNA binding via oxidation of Met114/Pro110 residues in close proximity at the CRP dimer interface. The modifications at the CRP dimer interface, and the site-specific DNA strand cleavage are proposed to occur via oxidation of two species Met residues (Met114 and Met189, respectively) to reactive persulfoxides that damage neighbouring amino acids and DNA bases. Panel B: Material balance for Trp and Tyr residues determined by UPLC analysis with direct fluorescence detection on acid-hydrolysed UV-exposed CRP-cAMP complex. UPLC analysis of native and oxidized CRP showed that UV exposure of CRP resulted in significant modification (relative to controls) to Trp, Tyr, Ser, Met and Arg residues (Fig. 3A) . Q-TOF MS analysis of cAMP-CRP-DNA complexes exposed to UV light showed a similar pattern of damage, but higher extents of Met modification (7.6%; Fig. 3C ).

title:
  UV oxidation of cyclic AMP receptor protein, a global bacterial gene regulator, decreases DNA binding and cleaves DNA at specific sites

abstract:
  UV light is a widely-employed, and environmentally-sensitive bactericide but its mechanism of action is not fully defined. Proteins are major chromophores and targets for damage due to their abundance, but the role of proteins in inducing damage to bound DNA, and the effects on DNA-protein interactions is less well characterized. In E. coli (and other Gram-negative bacteria) the cyclic AMP receptor protein (CRP/CAP) regulates more than 500 genes. In this study we show that exposure of isolated dimeric CRP-cAMP to UV modifies specific Met, Trp, Tyr, and Pro side-chains, induces inter-protein Tyr63-Tyr41 cross-links, and decreases DNA binding via oxidation of Met114/Pro110 residues in close proximity at the CRP dimer interface. UV exposure also modifies DNA-bound cAMP-CRP, with this resulting in DNA cleavage at specific G/C residues within the sequence bound to CRP, but not at other G/C sites. Oxidation also increases CRP dissociation from DNA. The modifications at the CRP dimer interface, and the site-specific DNA strand cleavage are proposed to occur via oxidation of two species Met residues (Met114 and Met189, respectively) to reactive persulfoxides that damage neighbouring amino acids and DNA bases. These data suggest that modification to CRP, and bound DNA, contributes to UV sensitivity.


id: cord-005497-w81ysjf9
author: nan
date: 2020-03-24
txt: ./txt/cord-005497-w81ysjf9.txt
cache: ./cache/cord-005497-w81ysjf9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092506/
doi: 10.1186/s13054-020-2772-3
abstract: nan
summary:
  The positive NC group had more plasma transfusion (p-value 0.03) and a lower median hematocrit at 24 hrs (p-value 0.013), but similar hospital length of stay (p=0.17) and mortality rate (p=0.80) Conclusions: NC at ICU admission identifies subclinical AKI in TBI patients and it maight be used to predictclinical AKI. In patients with pneumonia requiring intensive care (ICU) admission, we hypothesise that abnormal right ventricular (RV) function is associated with an increased 90-day mortality. The objective of this study was to describe the incidence of each AKI stages as defined by KDIGO definition (with evaluation of urine output, serum creatinine and initiation of renal replacement therapy (RRT)), in a mixed medical and surgical population of patients hospitalized in ICU and PCU over a 10-year period (2008-2018). This study aimed at investigating the relationship of goal-directed energy and protein adequacy on clinical outcomes which includes mortality, intensive care unit(ICU) and hospital length of stay (LOS), and length of mechanical ventilation (LOMV).

title:
  40th International Symposium on Intensive Care & Emergency Medicine: Brussels, Belgium. 24-27 March 2020


id: cord-005727-li8pwigg
title: ESICM 2010 MONDAY SESSIONS 11 October 2010
author: nan
date: 2010-08-31
txt: ./txt/cord-005727-li8pwigg.txt
cache: ./cache/cord-005727-li8pwigg.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095301/
doi: 10.1007/s00134-010-1999-x
abstract: nan
summary:
  Since, continuous epidural analgesia provides the required level of analgesia to support early mobilization and significant reduction in pulmonary and cardiovascular morbidity in the early postoperative period, we postulated that the use of low dose of continuous epidural morphine might improve postoperative analgesia and reduce undesirable side effects in elderly patientsTherefore, the present study was designed to evaluate the effects of morphine administered via epidural patients controlled analgesia and intravenous tramadol + metamizol on postoperative pain control and side effects in elderly patients after major abdominal surgery. For each ventilated patient the following data was registered:Age, APACHE II, the reason of admission, risk factors, use NIV, MV duration, timing of tracheostomy, time of diagnosis of VAP, microbiological data, length of stay and mortality in ICU. 23rd ESICM ANNUAL CONGRESS -BARCELONA, SPAIN -9-13 OCTOBER 2010 S131 Evaluated factors: patient characteristics, signs, symptoms, abscess location, time between symptoms and hospital admission and surgery, lab results, microbiology, antibiotic therapy, APACHE2, SAPS2, SOFA, length of ICU stay, surgical re-intervention, duration of mechanical ventilation, infectious complications, critical illness myopathy (CIM), renal replacement therapy (RRT), re-intubation, tracheotomy, mortality.


id: cord-014516-r59usk02
title: Research Communications of the 24th ECVIM‐CA Congress
author: nan
date: 2015-01-10
txt: ./txt/cord-014516-r59usk02.txt
cache: ./cache/cord-014516-r59usk02.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858066/
doi: 10.1111/jvim.12491
abstract: nan
summary:
  Serum prolactin concentration measured in 22/23 dogs at time zero, 6 weeks and 6 months was 3.35 ng/ml (range, 1.4-6.36), 3.57 ng/ml (range, 1.87-7.39) and 3.92 ng/ml (range, 2.01-12.92) and did not differ significantly in either time period when compared with time zero (P = 0.99 and P = 0.52).Altogether, results of this study failed to demonstrate a significant role of thyroid supplementation on the majority of evaluated behavioural symptoms as well as neurohormonal status of hypothyroid dogs during 6 months of therapy. The aims of the present study were (1) to describe a clinical series of recent autochtonous cases and (2) to retrospectively assess Angiostrongylus vasorum qPCR in bronchoalveolar lavage fluid (BALF) samples, collected over the last 7 years from a larger series of dogs, healthy or with other respiratory conditions, in order to investigate the past prevalence of the disease in Belgium.


id: cord-015021-pol2qm74
author: nan
date: 1994
txt: ./txt/cord-015021-pol2qm74.txt
cache: ./cache/cord-015021-pol2qm74.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095072/
doi: 10.1007/bf02258437
abstract: nan
summary:
  It is our current understanding that LPS is responsible for many of the pathophysiological events observed during gramnegative infections and that one of the major mechanisms leading to shock and death is the LPS-induced activation of macrophages resulting in the production and release of lipid and peptide mediators, among which tumor necrosis factor seems to be the most important. However plasma IL-6 estimation revealed a statistically significant reduction at 6 hours in tanrine-treated animals compared to glycino and TW controls ( Objective: To evaluate the effects of allogeneic blood transfusion, thermal injury and bacterial garage on interteukin 4 (IL-4), tumor necrosis factor alpha (TNF) production and host mortality and to study if the administration of thymopentth (THY) could affect these events.

title:
  Third International Congress on the Immune Consequences of Trauma, Shock and Sepsis —Mechanisms and Therapeutic Approaches


id: cord-015324-y44sfr0c
title: Scientific Programme
author: nan
date: 2007-09-01
txt: ./txt/cord-015324-y44sfr0c.txt
cache: ./cache/cord-015324-y44sfr0c.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101932/
doi: 10.1007/s00467-007-0558-3
abstract: nan
summary:
  In order to further validate this approach, we performed a prospective randomized open-label multicenter trial in 41 low-risk pediatric renal transplant recipients (12 f, 29 m; mean age 10.1 yrs; range, 3.4 to 17.8) on CsA (target trough level 100-200 ng/ml), MMF (1200 mg/m 2 per day) and methylprednisolone (3) (4) mg/m 2 per day), who were randomly assigned >1 year posttransplant to continue steroids or to withdraw over a period of 3 months. We evaluated MMF in 15 children with LN, 11 F/4 M, mean age: 12.4±3.9 yrs, proteinuria >3 g/day, decreased C3 and increased anti-dsDNA serum levels, normal renal function. Patients and methods: 91 children and adolescents (60 male, 31 female, mean age at transplantation 9.7±5.2 years) with stable renal function and observation period exceeding 6 months were included.


id: cord-023157-0lqlx2rv
title: Poster Sessions
author: nan
date: 2013-04-18
txt: ./txt/cord-023157-0lqlx2rv.txt
cache: ./cache/cord-023157-0lqlx2rv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7167176/
doi: 10.1111/1753-0407.12032_1
abstract: nan
summary:
  The patients revealed the increase of free fatty acids level (2.19 AE 0.10) mmol/l/ml, that meaningfully differed from such indexes in the control group (P < 0.001) and low level of adiponektin (3.70 AE 0.70) mg/ml that confirms their role in development of NAFLD even for persons with normal body weight after the presence of abdominal type of adipose tissue distribution. Results: This study has shown effectiveness in reduction in fasting blood glucose (P < 0.01), systolic blood pressure (P = 0.03), diastolic blood pressure (P = 0.01), weight (P = 0.03), added sugar (P = 0.03) and fat consumption (P < 0.01) while improving physical activity (P < 0.01) and insulin sensitivity (P < 0.01) in the intervention group when compared with the control group at follow up assessment. Conclusion: Our study shows that infiltration of macrophages in human adipose tissue, estimated by the expression of macrophage markers, is increased in subjects with obesity and diabetes and associated with insulin sensitivity and serum lipid levels independent of BMI.


id: cord-024631-yvek5vjz
author: Althaus, T.
date: 2020-05-11
txt: ./txt/cord-024631-yvek5vjz.txt
cache: ./cache/cord-024631-yvek5vjz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211754/
doi: 10.1016/j.ijid.2020.05.016
summary:
  OBJECTIVES: We investigated causes of fever in the primary levels of care in Southeast Asia, and evaluated whether C-reactive protein (CRP) could distinguish bacterial from viral pathogens. In this study, we aim to identify key organisms among acutely febrile children and adults attending primary health care in Southeast Asia, and to evaluate the performance of CRP for discriminating between bacteria and viruses. Specimens were collected from febrile patients recruited into a previously described multi-centre randomised-controlled trial evaluating the impact of C-reactive protein (CRP) testing on antibiotic prescription in primary care [38] . We investigated the spectrum of organisms among febrile children and adults in the community and evaluated the performance of CRP in distinguishing bacteria from viruses including its potential impact on antibiotic prescription compared with current practice. Investigating non-malarial acute febrile illness remains challenging in resource-poor areas [8] , and despite screening for multiple organisms on blood and respiratory specimens, we were only able to identify a probable cause of fever in 227 (29.4%) of patients.

title:
  Causes of fever in primary care in Southeast Asia and the performance of C-reactive protein in discriminating bacterial from viral pathogens

abstract:
  OBJECTIVES: We investigated causes of fever in the primary levels of care in Southeast Asia, and evaluated whether C-reactive protein (CRP) could distinguish bacterial from viral pathogens. METHODS: Blood and nasopharyngeal swab specimens were taken from children and adults with fever (>37.5˚C) or history of fever (<14 days) in Thailand and Myanmar. RESULTS: Of 773 patients with at least one blood or nasopharyngeal swab specimen collected, 227 (29.4%) had a target organism detected. Influenza virus type A was detected in 85/227 cases (37.5%), followed by dengue virus (30 cases, 13.2%), respiratory syncytial virus (24 cases, 10.6%) and Leptospira spp. (9 cases, 4.0%). Clinical outcome was similar between patients with a bacterial or a viral organism, regardless of antibiotic prescription. CRP was higher among patients with a bacterial organism compared to those with a viral organism (median 18 mg/L, interquartile range [10-49] versus 10 mg/L [≤8-22], p-value 0.003), with an area under the curve of 0.65, 95% confidence interval (0.55-0.75). CONCLUSIONS: Serious bacterial infections requiring antibiotics are exceptions rather than the rule in the first lines of care. CRP-testing could assist in ruling out such cases in settings where diagnostic uncertainty is high and routine antibiotic prescription is common. The original CRP randomised-controlled trial (RCT) was registered with ClinicalTrials.gov, number NCT02758821.


id: cord-030277-x9zvx3fp
author: Ohta, Yoshinori
date: 2020-08-10
txt: ./txt/cord-030277-x9zvx3fp.txt
cache: ./cache/cord-030277-x9zvx3fp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416813/
doi: 10.1186/s13054-020-03207-8
summary:
  title: Effect of dexmedetomidine on inflammation in patients with sepsis requiring mechanical ventilation: a sub-analysis of a multicenter randomized clinical trial We explored the effects of administering dexmedetomidine on the levels of C-reactive protein (CRP) and procalcitonin, and thus on inflammation, in patients with sepsis enrolled in a randomized clinical trial. METHODS: The DESIRE trial was a multicenter randomized clinical trial in which adult patients with sepsis were sedated with (DEX group) or without (non-DEX group) dexmedetomidine while on mechanical ventilators. We analyzed data derived from a randomized clinical trial and found that the administration of dexmedetomidine to patients with sepsis on ventilators improved CRP and PCT levels during the first 14 days in the ICU. In the present study, the use of dexmedetomidine for sedation reduced both CRP and PCT levels in patients with sepsis. Effect of dexmedetomidine on mortality and ventilator-free days in patients requiring mechanical ventilation with sepsis: a randomized clinical trial

title:
  Effect of dexmedetomidine on inflammation in patients with sepsis requiring mechanical ventilation: a sub-analysis of a multicenter randomized clinical trial

abstract:
  BACKGROUND: Administration of dexmedetomidine has been reported to improve inflammatory response in animals. We explored the effects of administering dexmedetomidine on the levels of C-reactive protein (CRP) and procalcitonin, and thus on inflammation, in patients with sepsis enrolled in a randomized clinical trial. METHODS: The DESIRE trial was a multicenter randomized clinical trial in which adult patients with sepsis were sedated with (DEX group) or without (non-DEX group) dexmedetomidine while on mechanical ventilators. As a prespecified sub-analysis, we compared CRP and procalcitonin levels during the first 14 days of treatment between the two groups. The 14-day mortality rate, albumin level, and the number of patients with disseminated intravascular coagulation (DIC) were also assessed. We used generalized linear models to estimate the differences in these outcomes between groups. We also used the Kaplan-Meier method to estimate the 14-day mortality rate and the log-rank test to assess between-group differences. RESULTS: Our study comprised 201 patients: 100 in the DEX group and 101 in the non-DEX group. CRP and procalcitonin levels were lower in the DEX vs. non-DEX group during the 14-day treatment period [CRP—range, 5.6–20.3 vs. 8.3–21.1 mg/dL (P = 0.03); procalcitonin—range, 1.2–37.4 vs. 1.7–52.9 ng/mL (P = 0.04)]. Albumin levels were higher in the DEX group (range, 2.3–2.6 g/dL) than in the non-DEX group (range, 2.1–2.7 g/dL; P = 0.01). The percentage of patients with DIC did not significantly differ between the groups (range, 21–59% and 17–56% for the DEX and non-DEX groups, respectively; P = 0.49). The 14-day mortality rates in the DEX and non-DEX groups were 13 and 21%, respectively (P = 0.16). CONCLUSION: Sedation using dexmedetomidine reduced inflammation in patients with sepsis requiring mechanical ventilation. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01760967. Registered on 4 January 2013.


id: cord-103653-hgnz0fkv
author: Wyse, C.
date: 2020-10-27
txt: ./txt/cord-103653-hgnz0fkv.txt
cache: ./cache/cord-103653-hgnz0fkv.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.10.23.20218305v1?rss=1
doi: 10.1101/2020.10.23.20218305
summary:
  Making use of extensive data from the UK Biobank cohort, we investigate seasonal and daytime variability in multiple immune parameters (inflammatory markers, white blood cell counts and antibody titres), and test for associations with a wide range of environmental and lifestyle factors. Individual-level data were linked to other factors that vary over seasonal and daily cycles, including changes in day length, outdoor temperature and vitamin D at the time the blood sample was collected. 45 The acute phase protein, CRP showed a weak daily pattern in this study, with levels higher in daytime, again corroborating previous reports of diurnal patterns of CRP humans 73, 52, 74, 75 Circadian rhythms in circulation and tissue migration of monocytes in mice are regulated through an innate cell-intrinsic clock mechanism and their oscillation coincides with an enhanced inflammatory response when monocytes are decreasing at the beginning of the rest phase 72 and increased lethality of endotoxic challenge at this time.

title:
  Seasonal and Daytime Variation in Multiple Immune Parameters in Humans: Evidence from 329,261 Participants of the UK Biobank Cohort

abstract:
  Abstract [275 words] Background: Seasonal disease outbreaks are perennial features of human infectious disease but the factors generating these patterns are unclear. In animal studies, seasonal and circadian (daily) rhythms in immune function generate periodicity in vulnerability to disease, although it is not known whether the same applies to humans. Making use of extensive data from the UK Biobank cohort, we investigate seasonal and daytime variability in multiple immune parameters (inflammatory markers, white blood cell counts and antibody titres), and test for associations with a wide range of environmental and lifestyle factors. Methods and Findings: Markers of inflammation (CRP), and white blood cell counts were measured between 8am and 7pm over a 4-year time period in 329,261 participants in UK Biobank. Individual-level data were linked to other factors that vary over seasonal and daily cycles, including changes in day length, outdoor temperature and vitamin D at the time the blood sample was collected. Analyses were further adjusted for potentially confounding lifestyle factors. Seasonal patterns were evident in lymphocyte and neutrophil counts, and CRP, but not monocytes, and these were independent of lifestyle, demographic and environmental factors. All the immune parameters assessed demonstrated significant daytime variation that was independent of confounding factors. Conclusions: At a population level, human immune parameters vary across season and across time of day, independent of multiple confounding factors. Both season and time of day are fundamental dimensions of immune function that should be considered in all studies of immuno-prophylaxis and disease transmission. Strategic alignment of human activities to seasons and times of the day when we are less susceptible to infection could be an important additional tool for limiting population-level impacts of infectious diseases.


id: cord-256154-i6bs536s
title: New markers in pneumonia
author: Cheng, Chao-Wen
date: 2013-04-18
txt: ./txt/cord-256154-i6bs536s.txt
cache: ./cache/cord-256154-i6bs536s.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0009898113000338
doi: 10.1016/j.cca.2013.01.011
summary:
  These biomarkers, as reflected in specific biological responses to infections, have been reported to demonstrate the ability to facilitate the diagnosis, risk stratification, and management of pneumonia. According to this definition, a qualified biomarker of pneumonia should be used to accomplish at least one or more of the following tasks: perform a rapid and accurate diagnosis and less affected by other diseases, identify the types of pathogenic microorganisms for specific antibiotics treatment, and reflect the status of successful prognosis therapy or remain elevated with the infectious stimulus [9, 10] . In addition to discriminating the accurate diagnosis of pneumonia, PCT levels demonstrated their prognostic value in CAP patients [52, 53] . Circulating levels of the long pentraxin PTX3 correlate with severity of infection in critically ill patients Plasma long pentraxin 3 (PTX3) concentration is a novel marker of disease activity in patients with community-acquired pneumonia

abstract:
  Abstract Pneumonia is one of the most common causes of death from infectious diseases worldwide, and the most common fatal infection acquired in hospitals. Despite advances in prevention strategies, such as antibiotic therapies and intensive care, significant improvement in the mortality rate is still lacking. This high mortality is largely due to the limitations in current clinical practices and laboratory tests, which delay the timing of adequate antibiotic therapy. In recent years, many indicators (biomarkers) are present in scenarios where infectious pathogens invade into the body. These biomarkers, as reflected in specific biological responses to infections, have been reported to demonstrate the ability to facilitate the diagnosis, risk stratification, and management of pneumonia. This review provides a schematic overview of these new potential biomarkers based on the categories of (1) microorganisms and their derivatives, (2) inflammation mediators, (3) inflammation response proteins, and (4) stress-sensing proteins. In addition, approaches to identifying new biomarkers are also briefly introduced. Although no current biomarker can solely achieve a definitive diagnosis, many of them can be complemented, rather than replaced outright, in routine clinical practices to improve decision-making processes regarding pneumonia.


id: cord-258108-l9nzq9rv
title: Pentraxin 3 as a clinical marker in children with lower respiratory tract infection
author: Kim, Hwan Soo
date: 2015-04-01
txt: ./txt/cord-258108-l9nzq9rv.txt
cache: ./cache/cord-258108-l9nzq9rv.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/ppul.23199
doi: 10.1002/ppul.23199
summary:
  OBJECTIVE: We aimed to evaluate the usefulness of PTX‐3 as a clinical marker in children with lower respiratory tract infection (LRTI) and examine the correlation of PTX‐3 with other biomarkers such as C‐reactive protein (CRP) and procalcitonin (PCT). 5 A previous study found that plasma PTX-3 levels could be used to diagnose the severity of community acquired pneumonia with higher sensitivity compared to CRP, and also correlated with the length of hospital stay. Upon admission, total white blood cell (WBC) count, ESR, and CRP levels were measured from blood samples before any medical treatment and multiplex respiratory virus polymerase chain reaction (PCR) was performed using nasal swabs. PCT levels showed a significant correlation with the peak temperature and duration of fever before admission as well as hospital stay. [12] [13] [14] We found that the level of PTX-3 reflects disease severity in children with LRTI by showing a significant correlation with the peak temperature and duration of fever before admission.

abstract:
  BACKGROUND: Pentraxin 3 (PTX‐3) is an acute‐phase protein that increases in the plasma during inflammation. OBJECTIVE: We aimed to evaluate the usefulness of PTX‐3 as a clinical marker in children with lower respiratory tract infection (LRTI) and examine the correlation of PTX‐3 with other biomarkers such as C‐reactive protein (CRP) and procalcitonin (PCT). METHODS: We enrolled 117 consecutive patients admitted to Seoul St. Mary's Hospital with LRTI using the WHO criteria. We recorded data on fever duration and peak temperature before admission, duration of fever after admission, respiratory rate, heart rate, oxygen saturation upon admission, duration of oxygen supplementation, and duration of hospital stay. Upon admission, white blood cell (WBC) count, erythrocyte sedimentation rate, CRP level were measured. Multiplex respiratory virus polymerase chain reaction was performed using nasal swabs. PTX‐3, PCT, and various cytokines were measured after the study had been completed. RESULTS: We found that there was no significant difference in the level of PTX‐3 according to the type of viral infection. PTX‐3 levels showed a significant correlation with PCT levels, but not with levels of CRP. The level of PTX‐3 showed a significant correlation with peak temperature and duration of fever before admission as well as interleukin (IL)‐6 levels. PCT levels showed a significant correlation with IL‐6 and granulocyte‐colony stimulating factor levels, peak temperature, and duration of fever before admission, and duration of hospital stay. CRP levels showed a significant correlation with duration of fever before admission, total WBC count, and neutrophil count. PCT levels significantly predicted a hospital stay of 7 days or more. PTX‐3, PCT, and CRP levels showed no correlation with any other clinical features. CONCLUSION: PTX‐3 reflected disease severity but failed to predict length of hospital stay. Further studies evaluating the use of PTX‐3 as a biomarker in mild LRTI would be useful. Pediatr Pulmonol. 2016;51:42–48. © 2015 Wiley Periodicals, Inc.


id: cord-277879-7ftu9b9q
author: Martinez-Sanz, J.
date: 2020-06-09
txt: ./txt/cord-277879-7ftu9b9q.txt
cache: ./cache/cord-277879-7ftu9b9q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.06.08.20125245
doi: 10.1101/2020.06.08.20125245
summary:
  Propensity score logistic models predicted exposure at baseline and censoring over time as a result of recognized confounders of severe COVID-19 17, 18 including age, gender, comorbidities (hypertension, diabetes, ischemic heart disease, kidney disease, congestive heart failure, lung disease), oxygen blood saturation and need for oxygen therapy at baseline, and time-varying parameters of clinical severity (blood pressure, heart rate, total lymphocyte and neutrophil count, lactate dehydrogenase, alanine aminotransferase, urea, D-dimers, and CRP). . https://doi.org/10.1101/2020.06.08.20125245 doi: medRxiv preprint Figure 3 and Table S2 show the adjusted hazard ratios for exploratory sensitivity analyses restricted to patients with baseline lymphocyte count <1000 cell/µl and baseline D-dimer >1000 ng/mL segregated by CRP levels. 14 However, there are key analytical issues in this setting, including the risk of immortal time bias (i.e., the requirement for patients to survive long enough to receive the intervention of interest, which can lead to a potentially incorrect estimation of a positive treatment effect), and indication bias from time-varying confounding (e.g., the use of tocilizumab following elevations of CRP).

title:
  Effects of Tocilizumab on Mortality in Hospitalized Patients with COVID-19: A Multicenter Cohort Study

abstract:
  Background While there are no treatments with proven efficacy for patients with severe coronavirus disease 2019 (COVID 19), tocilizumab has been proposed as a candidate therapy, especially among patients with higher systemic inflammation. Methods We conducted a cohort study of patients hospitalized with COVID 19 in Spain. The primary outcome was time to death and the secondary outcome time to intensive care unit admission (ICU) or death. We used inverse probability weighting to fit marginal structural models adjusted for time varying covariates to determine the causal relationship between tocilizumab use and the outcomes. Results A total of 1,229 and 10,673 person/days were analyzed. In the adjusted marginal structural models, a significant interaction between tocilizumab use and high C reactive protein (CRP) levels was detected. Tocilizumab was associated with decreased risk of death (aHR 0.34, 95% CI 0.16 to 0.72, p=0.005) and ICU admission or death (aHR 0.38, 95% CI 0.19 to 0.81, p=0.011) among patients with baseline CRP >150 mg/L, but not among those with CRP [≤]150 mg/L. Exploratory subgroup analyses yielded point estimates that were consistent with these findings. Conclusions In this large observational study, tocilizumab was associated with a lower risk of death or ICU or death in patients with higher CRP levels. While the results of ongoing clinical trials of tocilizumab in patients with COVID 19 will be important to establish its safety and efficacy, our findings have implications for the design of future clinical trials and support the use of tocilizumab among subjects with higher CRP levels.


id: cord-280629-vb0002nx
author: Liu, Kuan-Ting
date: 2008-05-31
txt: ./txt/cord-280629-vb0002nx.txt
cache: ./cache/cord-280629-vb0002nx.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1607551X08701499
doi: 10.1016/s1607-551x(08)70149-9
summary:
  title: Characteristics of Febrile Patients with Normal White Blood Cell Counts and High C-Reactive Protein Levels in an Emergency Department Many febrile patients have markedly elevated C-reactive protein (CRP) levels and normal white blood cell (WBC) counts. Factors other than malignant neoplasm or hematologic illness may be associated with the WBC response, and CRP may be a better indicator of infection under such conditions. Because the period of study was within 1 year of the severe acute respiratory syndrome (SARS) outbreak, all febrile patients received blood examinations including WBC count and CRP level. χ 2 and Fisher''s exact tests were used to examine the correlation between gender, cause of fever, hospitalization, type of infection and mortality with underlying malignant neoplasm and/or hematologic disease. Many studies have focused on the use of CRP in patients with malignancy, hematologic disease or neutropenia, because these patients do not have normal WBC response to infection [3, 4, 12, [15] [16] [17] [18] [19] [20] [21] [22] .

title:
  Characteristics of Febrile Patients with Normal White Blood Cell Counts and High C-Reactive Protein Levels in an Emergency Department

abstract:
  Fever is one of the more common chief complaints of patients who visit emergency departments (ED). Many febrile patients have markedly elevated C-reactive protein (CRP) levels and normal white blood cell (WBC) counts. Most of these patients have bacterial infection and no previous underlying disease of impaired WBC functioning. We reviewed patients who visited our ED between November 2003 and July 2004. The WBC count and CRP level of patients over 18 years of age who visited the ED because of or with fever were recorded. Patients who had normal WBC count (4,000–10,000/mL) and high CRP level (> 100 mg/L) were included. The data, including gender, age and length of hospital stay, were reviewed. Underlying diseases, diagnosis of the febrile disease and final condition were recorded according to the chart. Within the study period, 54,078 patients visited our ED. Of 5,628 febrile adults, 214 (3.8%) had elevated CRP level and normal WBC count. The major cause of febrility was infection (82.24%). Most of these patients were admitted (92.99%). There were 32 patients with malignant neoplasm, nine with liver cirrhosis, 66 with diabetes mellitus and 11 with uremia. There were no significant differences in age and gender between patients with and those without neoplasm. However, a higher inhospital mortality rate and other causes of febrility were noted in patients with neoplasm. It was not rare in febrile patients who visited the ED to have a high CRP level but normal WBC count. These patients did not necessarily have an underlying malignant neoplasm or hematologic illness. Factors other than malignant neoplasm or hematologic illness may be associated with the WBC response, and CRP may be a better indicator of infection under such conditions.


id: cord-286544-ipmcqz8n
title: Predictors of progression from moderate to severe COVID-19: a retrospective cohort
author: Cheng, Biao
date: 2020-07-02
txt: ./txt/cord-286544-ipmcqz8n.txt
cache: ./cache/cord-286544-ipmcqz8n.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32622952/
doi: 10.1016/j.cmi.2020.06.033
summary:
  METHODS: All adult patients with COVID-19 of moderate severity diagnosed using qRT-PCR and hospitalized at the Central Hospital of Wuhan, China, from Jan 1 to Mar 20, 2020 were enrolled in this retrospective study. The area under the receiver operating characteristic (ROC) curve (AUC) for NLR and CRP in predicting progression to critical condition was 0.77 (95% CI 0.694-0.846, P < 0.001) and 0.84 (95% CI 0.780-0.905, P < 0.001), with a cut-off value of 2.79 and 25.95 mg/l, respectively. CONCLUSIONS: Higher levels of NLR and CRP at admission were associated with poor prognosis of moderate COVID-19 patients. In this study, we focus on the clinical features and outcomes of patients with moderate COVID-19 treated at a single institution and explore the factors and indicators associated with their prognosis. However, older age, male gender, and NLR and CRP levels on admission were significantly associated with poor prognoses in patients with moderate COVID-19. In conclusion, age, gender, and NLR and CRP levels at admission are associated with poor prognoses of patients with moderate COVID-19.

abstract:
  OBJECTIVE: Most coronavirus disease 2019 (COVID-19) cases were identified as moderate, which is defined as having a fever or dry cough and lung imaging with ground-glass opacities. The risk factors and predictors of prognosis in such cohorts remain uncertain. METHODS: All adult patients with COVID-19 of moderate severity diagnosed using qRT-PCR and hospitalized at the Central Hospital of Wuhan, China, from Jan 1 to Mar 20, 2020 were enrolled in this retrospective study. The main outcomes were progression from moderate to severe or critical condition or death. RESULTS: Among the 456 enrolled patients with moderate COVID-19, 251/456 (55.0%) had poor prognosis. Multivariate logistic regression analysis identified higher NLR on admission (OR =1.032, 95%CI 1.042-1.230, P = 0.004) and higher CRP on admission (OR =3.017, 95%CI 1.941-4.690, P < 0.001) were associated with increased odds ratios of poor prognosis. The area under the receiver operating characteristic (ROC) curve (AUC) for NLR and CRP in predicting progression to critical condition was 0.77 (95% CI 0.694-0.846, P < 0.001) and 0.84 (95% CI 0.780-0.905, P < 0.001), with a cut-off value of 2.79 and 25.95 mg/l, respectively. The AUC of NLR and CRP in predicting death was 0.81 (95% CI, 0.732-0.878, P < 0.001) and 0.89 (95% CI 0.825-0.946, P < 0.001), with a cut-off value of 3.19 and 33.4 mg/l, respectively. CONCLUSIONS: Higher levels of NLR and CRP at admission were associated with poor prognosis of moderate COVID-19 patients. NLR and CRP were good predictors of progression to critical condition and death.


id: cord-289832-092dtzrd
author: Villard, Orianne
date: 2020-07-21
txt: ./txt/cord-289832-092dtzrd.txt
cache: ./cache/cord-289832-092dtzrd.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32708205/
doi: 10.3390/jcm9072315
summary:
  The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). Moreover, aldosterone levels were also gradually and significantly increased when we compared clinical status of patients in the three following categories: mild (OS ≤ 3), moderate (OS = 4) and severe (OS ≥ 5) on Day 2 and at OS max (analysis of variance, p = 0.001 and p = 0.006, respectively) ( Figure 2B) . In the present study, higher plasmatic aldosterone and CRP levels at inclusion are associated with severe clinical course of Covid-19 in hospitalized patients, and both parameters appear to be correlated.

title:
  The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study

abstract:
  Background. The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic. Methods. Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients’ clinical courses. Results. Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L. Conclusions. Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.


id: cord-291140-8c8lsy8g
author: Yufei, Yan
date: 2020-08-17
txt: ./txt/cord-291140-8c8lsy8g.txt
cache: ./cache/cord-291140-8c8lsy8g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32804580/
doi: 10.1080/00365513.2020.1803587
summary:
  This study is aimed at testing the combined usability of NLR and CRP as laboratory parameters, which may provide additional benefits in both the diagnosis of SARS-CoV-2 pneumonia and the early recognition of complications that may develop as a result of these clinical pictures. Logistic regression analysis was performed using NLR, CRP, WBC, lymphocyte percentage, gender, and age as independent variables and SARS-CoV-2 infection as the dependent variable. The results showed that NLR, CRP, and lymphocyte percentage were possible risk factors for SARS-CoV-2 infection, among which NLR was the most strongly associated with COVID-19 (OR ¼ 21.517, 95% CI: 5.912-78.317, p < .001). Moreover, our study found that patients with higher severity of pneumonia may have lower lymphocyte percentages and higher NLR, and logistic regression analysis showed that both lymphocyte percentage (OR ¼ 1.248, 95% CI: 1.113-1.399, p < .001) and NLR (OR ¼ 21.517, 95% CI: 5.912-78.317, p < .001) were independent risk factors predicting SARS-CoV-2 infection.

title:
  Utility of the neutrophil-to-lymphocyte ratio and C-reactive protein level for coronavirus disease 2019 (COVID-19)

abstract:
  To investigate the value of the combined detection of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein level (CRP) in the diagnosis of COVID-19. A total of 191 patients with COVID-19 were recruited at the Third Hospital of Wuhan from 21 January 2020 to 20 February 2020. Fifty healthy volunteers were randomly selected as the control group. Age, gender, white blood cell count (WBC), CRP, lymphocyte percentage, and NLR were extracted. Quantitative clinical characteristics and laboratory values were compared between groups. Risk factors and receiver operating characteristic (ROC) curves for COVID-19 were analyzed. We found that the NLR and CRP were higher, while the lymphocyte percentage was lower in patients with COVID-19 than in healthy controls. Among patients confirmed to have COVID-19, the NLR and CRP of the moderate group were lower than those of severely ill patients (severe, critical and death groups), and the lymphocyte percentage of the moderate group was higher than that of the critical and death group. There were no significant differences in WBC among all groups. Logistic regression analysis showed that the NLR, CRP, and lymphocyte percentage were independent risk factors for COVID-19. The AUC of the combined determination of NLR and CRP was 0.863, which was higher than that of NLR, CRP, WBC, and lymphocyte percentage (AUC: 0.835, 0.775, 0.416, and 0.749, respectively). Our results showed that the NLR and CRP were independent risk factors for COVID-19, and the combined detection of the NLR and CRP showed improved diagnostic performance for COVID-19.


id: cord-297093-ld89vmct
title: Safety of intravenous Anakinra in COVID-19 with evidence of hyperinflammation, a case series
author: Clark, Kristina E N
date: 2020-08-04
txt: ./txt/cord-297093-ld89vmct.txt
cache: ./cache/cord-297093-ld89vmct.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1093/rap/rkaa040
doi: 10.1093/rap/rkaa040
summary:
  CONCLUSION: Intravenous anakinra is safe to use in patients with COVID-19 and evidence of supra-added bacterial infection. These patients all showed evidence of hyperinflammation with raised inflammatory markers, and CRP, and were given intravenous anakinra, with safe and successful use, suggesting the potential benefit from IL-1 blockade in this subgroup of patients with confirmed COVID-19. We present four cases of immunosuppressed patients, receiving beneficial effects from the use of intravenous anakinra to treat severe COVID-19 with hyperinflammation and concomitant bacterial infections. Our case series supports the hypothesis of IL-1 blockade as an important disease modifying treatment in those patients with severe late stage COVID-19, with evidence of cytokine storm. We believe that administering intravenous anakinra at the height of the cytokine storm has profound beneficial effects, both clinically and biochemically on patients with severe COVID-19 infection.

abstract:
  OBJECTIVES: Anakinra is a selective IL-1 inhibitor, which has been used in the context of secondary haemophagocytic lymphohistiocytosis. Although usually given in the subcutaneous form, previous anecdotal reports have emphasized its utility when given intravenously. Our aim is to report our experience on the beneficial effects of intravenous anakinra in patients with SARS-CoV-2 and evidence of hyperinflammation. METHODS: We report 4 patients with severe COVID-19 infection requiring intensive care admission and ventilatory support. RESULTS: All four patients showed evidence of deterioration with hyperferritinaemia, and increasing oxygen requirements, with supra-added bacterial infections. Upon commencement of intravenous anakinra, there was subsequent improvement in the patients clinically with reducing ventilatory support and inotropic support, and biochemically, with rapid improvement in inflammatory markers. CONCLUSION: Intravenous anakinra is safe to use in patients with COVID-19 and evidence of supra-added bacterial infection. Although its utility has not been confirmed in a randomized trial, current research in the COVID-19 pandemic aims to establish the utility of immunosuppression, including IL-1 blockade on the outcomes of patients with moderate to severe disease. Our case series support its use in patients with severe-life threatening COVID-19 and evidence of hyperinflammation.


id: cord-297138-t8b3914h
author: Duijker, G.
date: 2015-04-02
txt: ./txt/cord-297138-t8b3914h.txt
cache: ./cache/cord-297138-t8b3914h.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jep.2015.01.030
doi: 10.1016/j.jep.2015.01.030
summary:
  Conclusions Compared with placebo the essential-oil extract of three Cretan aromatic plants provided no detectable statistically significant benefit or harm in the patients with upper respiratory illness, although descriptive differences were identified in favorable direction mainly in the virus-positive population. As stated above, this study reports the results of the effectiveness of an extract based on three Cretan aromatic plants in the reduction of duration and severity of symptoms of patients with upper respiratory tract infections, utilizing a standardized questionnaire, physical examination measurements and the decrease of inflammation assayed by C-reactive protein [CRP] levels. Severity of symptoms over the study period was compared between intervention and control groups, using the 19-item WURSS-21 scores, with both univariate techniques and multiple linear regression models, adjusting for age, sex, initial CRP level, body mass index (BMI) and the presence of chronic diseases.

title:
  Reporting effectiveness of an extract of three traditional Cretan herbs on upper respiratory tract infection: Results from a double-blind randomized controlled trial

abstract:
  Abstract Ethnopharmacological relevance Observations from the island of Crete, Greece suggest that infusions of traditional Cretan aromatic plants, well known for their ethnopharmacological use in Eastern Mediterranean region and Near East, could be effective in the prevention and treatment of upper respiratory tract infections, including viral-induced infections. The aim of this study was to report the effectiveness of an essential-oil extract of three Cretan aromatic plants in the treatment of cases with an upper respiratory tract infection. Materials and methods A double blind randomized controlled trial was implemented between October 2013 and February 2014. An essential-oil extract of Cretan aromatic plants in olive oil (total volume of 15ml of essential oil per litre of olive oil) was administered as 0.5ml soft gel capsules, twice a day, for 7 days. Placebo treatment was 0.5ml olive oil in soft gel capsules. Eligible patients were those presenting for clinical examination in the selected setting with signs and symptoms of upper respiratory tract infection that had begun within the previous 24hours. Real-Time Polymerase Chain Reaction (PCR) was used for the detection of respiratory viruses. The primary outcome was the severity and duration of symptoms of upper respiratory tract infection, assessed using the Wisconsin Upper Respiratory System Survey (WURSS-21) questionnaire. A secondary outcome of interest was the change in C-reactive protein (CRP) status. Results One hundred and five patients completed the study: 51 in the placebo group, and 54 in the intervention (treated) group. Baseline characteristics were similar in the two groups. No statistically significant differences were found in symptom duration or severity between the two groups, although small and clinically favorable effects were observed. When the analysis was restricted to subjects with a laboratory-documented viral infection, the percentage of patients with cessation of symptoms after 6 days of treatment was 91% in the intervention group and 70% in the control group (p=0.089). At baseline, one third of the patients in each group had elevated CRP levels. At follow-up, the respective proportions were 0% in the intervention group and 15% in the placebo group (p=0.121). The data were also in a favorable direction when 50% and 80% symptom reduction points were considered for specific virus types. Conclusions Compared with placebo the essential-oil extract of three Cretan aromatic plants provided no detectable statistically significant benefit or harm in the patients with upper respiratory illness, although descriptive differences were identified in favorable direction mainly in the virus-positive population.


id: cord-317605-s9vv7rw4
title: A New Predictor of Disease Severity in Patients with COVID-19 in Wuhan, China
author: Zhou, Y.
date: 2020-03-27
txt: ./txt/cord-317605-s9vv7rw4.txt
cache: ./cache/cord-317605-s9vv7rw4.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.03.24.20042119v1?rss=1
doi: 10.1101/2020.03.24.20042119
summary:
  This study sought to elucidate a novel predictor of disease severity in patients with coronavirus disease-19 (COVID-19) cased by SARS-CoV-2. The outcomes of patients with severe pneumonia and those with non-severe pneumonia were compared using the Statistical Package for the Social Sciences (IBM Corp., Armonk, NY, USA) to explore clinical characteristics and risk factors. The ROC curve was used to analyze the predictive value of N/L, CRP, and D-dimer for determining disease severity in patients with COVID-19. To further explore the predictive value of N/L*CRP*D-dimer in the severity of COVID-19, we also conducted an internal validation. Patients with N/L*CRP*D-dimer results of less than 5.32 were classified as patients with non-severe pneumonia in predicted groups. Although N/L, CRP, and D-dimer were independent risk factors for the severity of COVID-19, the ROC curve showed that they have a low predictive value for the severity of the infection. In general, the product of N/L*CRP*D-dimer is a new predictive value for the severity of COVID-19.

abstract:
  Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan, Hubei, China. This study sought to elucidate a novel predictor of disease severity in patients with coronavirus disease-19 (COVID-19) cased by SARS-CoV-2. Methods: Patients enrolled in this study were all hospitalized with COVID-19 in the Central Hospital of Wuhan, China. Clinical features, chronic comorbidities, demographic data, and laboratory and radiological data were reviewed. The outcomes of patients with severe pneumonia and those with non-severe pneumonia were compared using the Statistical Package for the Social Sciences (IBM Corp., Armonk, NY, USA) to explore clinical characteristics and risk factors. The receiver operating characteristic curve was used to screen optimal predictors from the risk factors and the predictive power was verified by internal validation. Results: A total of 377 patients diagnosed with COVID-19 were enrolled in this study, including 117 with severe pneumonia and 260 with non-severe pneumonia. The independent risk factors for severe pneumonia were age [odds ratio (OR): 1.059, 95% confidence interval (CI): 1.036-1.082; p < 0.001], N/L (OR: 1.322, 95% CI: 1.180-1.481; p < 0.001), CRP (OR: 1.231, 95% CI: 1.129-1.341; p = 0.002), and D-dimer (OR: 1.059, 95% CI: 1.013-1.107; p = 0.011). We identified a product of N/L*CRP*D-dimer as having an important predictive value for the severity of COVID-19. The cutoff value was 5.32. The negative predictive value of less than 5.32 for the N/L*CRP*D-dimer was 93.75%, while the positive predictive value was 46.03% in the test sets. The sensitivity and specificity were 89.47% and 67.42%. In the training sets, the negative and positive predictive values were 93.80% and 41.32%, respectively, with a specificity of 70.76% and a sensitivity of 89.87%. Conclusions: A product of N/L*CRP*D-dimer may be an important predictor of disease severity in patients with COVID-19.


id: cord-330411-hg1cxcs7
title: Laboratory biomarkers associated with COVID-19 severity and management
author: Keddie, S.
date: 2020-10-22
txt: ./txt/cord-330411-hg1cxcs7.txt
cache: ./cache/cord-330411-hg1cxcs7.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.clim.2020.108614
doi: 10.1016/j.clim.2020.108614
summary:
  This study investigates the routine laboratory tests and cytokines implicated in COVID-19 for their potential application as biomarkers of disease severity, respiratory failure and need of higher-level care. From analysis of 203 samples, CRP, IL-6, IL-10 and LDH were most strongly correlated with the WHO ordinal scale of illness severity, the fraction of inspired oxygen delivery, radiological evidence of ARDS and level of respiratory support (p ≤ 0.001). This study comprehensively explored clinical disease features and routine laboratory tests against specialist cytokine biomarkers associated with COVID-19 disease and its complications, to address their association with disease severity, respiratory intervention and outcome. Biomarker analysis of CRP, LDH and the cytokines IL-6, IL-10 and TNFα, alongside thorough clinical assessment of COVID-19 patients, enables more accurate stratification of high from low risk cases and the need for intensive care support.

abstract:
  The heterogeneous disease course of COVID-19 is unpredictable, ranging from mild self-limiting symptoms to cytokine storms, acute respiratory distress syndrome (ARDS), multi-organ failure and death. Identification of high-risk cases will enable appropriate intervention and escalation. This study investigates the routine laboratory tests and cytokines implicated in COVID-19 for their potential application as biomarkers of disease severity, respiratory failure and need of higher-level care. From analysis of 203 samples, CRP, IL-6, IL-10 and LDH were most strongly correlated with the WHO ordinal scale of illness severity, the fraction of inspired oxygen delivery, radiological evidence of ARDS and level of respiratory support (p ≤ 0.001). IL-6 levels of ≥3.27 pg/ml provide a sensitivity of 0.87 and specificity of 0.64 for a requirement of ventilation, and a CRP of ≥37 mg/L of 0.91 and 0.66. Reliable stratification of high-risk cases has significant implications on patient triage, resource management and potentially the initiation of novel therapies in severe patients.


id: cord-334047-xwjwt2be
author: Ruppert, Christoph
date: 2020-09-10
txt: ./txt/cord-334047-xwjwt2be.txt
cache: ./cache/cord-334047-xwjwt2be.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32912236/
doi: 10.1186/s12951-020-00688-1
summary:
  title: Duplex Shiny app quantification of the sepsis biomarkers C-reactive protein and interleukin-6 in a fast quantum dot labeled lateral flow assay Fast point-of-care (POC) diagnostics represent an unmet medical need and include applications such as lateral flow assays (LFAs) for the diagnosis of sepsis and consequences of cytokine storms and for the treatment of COVID-19 and other systemic, inflammatory events not caused by infection. To increase the information obtainable from each test line, we combined green and red emitting quantum dots (QDs) as labels for C-reactive protein (CRP) and interleukin-6 (IL-6) antibodies in an optical duplex immunoassay. The app software provides advanced tools for image processing, including assisted extraction of line intensities, advanced background correction and an easy workflow for creation and handling of experimental data in quantitative LFAs. The results generated with our MultiFlow-Shiny app were superior to those generated with the popular software ImageJ and resulted in lower detection limits.

title:
  Duplex Shiny app quantification of the sepsis biomarkers C-reactive protein and interleukin-6 in a fast quantum dot labeled lateral flow assay

abstract:
  Fast point-of-care (POC) diagnostics represent an unmet medical need and include applications such as lateral flow assays (LFAs) for the diagnosis of sepsis and consequences of cytokine storms and for the treatment of COVID-19 and other systemic, inflammatory events not caused by infection. Because of the complex pathophysiology of sepsis, multiple biomarkers must be analyzed to compensate for the low sensitivity and specificity of single biomarker targets. Conventional LFAs, such as gold nanoparticle dyed assays, are limited to approximately five targets—the maximum number of test lines on an assay. To increase the information obtainable from each test line, we combined green and red emitting quantum dots (QDs) as labels for C-reactive protein (CRP) and interleukin-6 (IL-6) antibodies in an optical duplex immunoassay. CdSe-QDs with sharp and tunable emission bands were used to simultaneously quantify CRP and IL-6 in a single test line, by using a single UV-light source and two suitable emission filters for readout through a widely available BioImager device. For image and data processing, a customized software tool, the MultiFlow-Shiny app was used to accelerate and simplify the readout process. The app software provides advanced tools for image processing, including assisted extraction of line intensities, advanced background correction and an easy workflow for creation and handling of experimental data in quantitative LFAs. The results generated with our MultiFlow-Shiny app were superior to those generated with the popular software ImageJ and resulted in lower detection limits. Our assay is applicable for detecting clinically relevant ranges of both target proteins and therefore may serve as a powerful tool for POC diagnosis of inflammation and infectious events. [Image: see text]


id: cord-340433-h86cufyp
title: C-reactive protein: a promising biomarker for poor prognosis in COVID-19 infection
author: Sahu, Bikash R
date: 2020-06-05
txt: ./txt/cord-340433-h86cufyp.txt
cache: ./cache/cord-340433-h86cufyp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32511972/
doi: 10.1016/j.cca.2020.06.013
summary:
  Although increased C reactive protein (CRP) has been associated with death due to COVID-19 infections, results from different populations remain inconsistent. The results of the meta-analysis demonstrated a significant role of CRP in COVID-19 infection outcome (Standard difference in means= 1.371, P=0.000). Inclusion of a report in the current meta-analysis must have a) added analysis for death and survivors, b) plasma/serum CRP concentrations, c) data must be presented in mean± standard deviation (S.D) or median (interquartile range). Two authors BRS and AP extracted data such as authors'' details, years of publication, population, number of COVID-19 infected subjects, death and survivors, CRP concentrations in mean± S.D. or median (interquartile range), significance value. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study

abstract:
  BACKGROUND: The novel coronavirus disease 2019 (COVID-19) break out from Wuhan, China, spread over 227 countries and caused approximately 0.3 million death worldwide. Several biomolecules have been explored for possible biomarkers for prognosis outcome. Although increased C reactive protein (CRP) has been associated with death due to COVID-19 infections, results from different populations remain inconsistent. For a conclusive result, the present meta-analysis was performed. METHODS: We conducted a literature survey in PubMed and Scopus database for the association of CRP concentration with COVID-19 disease outcomes. A total of 16 eligible studies were enrolled in the present analysis comprising of 1896 survivors and 849 non-survivors cases. Concentrations of CRP were compared and analyzed by a meta-analysis. RESULTS: Egger’s regression analysis (intercept=0.04, P=0.98, 95%CI=-5.48 to 5.58) and funnel plot revealed an absence of publication bias in the included studies. Due to the presence of significant heterogeneity across the studies (Q=252.03, P(heterogeneity)= 0.000, I(2)=93.65) random model was used for the analysis of the present study. The results of the meta-analysis demonstrated a significant role of CRP in COVID-19 infection outcome (Standard difference in means= 1.371, P=0.000). CONCLUSIONS: Concentrations of CRP remained increased in patients who died in COVID-19 infection and could be a promising biomarker for accessing disease lethality.


id: cord-343986-mneil7gn
title: Respiratory tract virus infections in the elderly with pneumonia
author: Aronen, Matti
date: 2019-04-16
txt: ./txt/cord-343986-mneil7gn.txt
cache: ./cache/cord-343986-mneil7gn.txt
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url: https://www.ncbi.nlm.nih.gov/pubmed/30991957/
doi: 10.1186/s12877-019-1125-z
summary:
  Respiratory virus detections did not correlate to WBC or CRP values, signs and symptoms or prognosis of radiographically-verified pneumonia episodes. Logistic regression with full model was used to analyse the association between clinical outcomes and virus etiology, pneumonia, chronic illnesses (cardiovascular diseases, respiratory diseases, other diseases), age, gender and laboratory findings (WBC, CRP). In study episodes diagnosed with pneumonia, the presence of a respiratory virus was neither associated with clinical outcomes (i.e. over 13-night hospital stay, number of revisits or death at ward) nor with WBC values over 15 × 10 9 /L or CRP values over 100 mg/l (all P > .1, Table 4 ). Moreover, in the studied episodes of hospital care diagnosed with pneumonia, the presence of a respiratory virus was associated neither with clinical outcomes, nor with WBC or CRP values.

abstract:
  BACKGROUND: In children suffering from severe lower airway illnesses, respiratory virus detection has given good prognostic information, but such reports in the elderly are scarce. Therefore, our aim was to study whether the detection of nasopharyngeal viral pathogens and conventional inflammatory markers in the frail elderly correlate to the presence, signs and symptoms or prognosis of radiographically-verified pneumonia. METHODS: Consecutive episodes of hospital care of patients 65 years and older with respiratory symptoms (N = 382) were prospectively studied as a cohort. Standard clinical questionnaire was filled by the study physician. Laboratory analyses included PCR diagnostics of nasopharyngeal swab samples for 14 respiratory viruses, C-reactive protein (CRP) and white blood cell count (WBC). Chest radiographs were systematically analysed by a study radiologist. The length of hospital stay, hospital revisit and death at ward were used as clinical endpoints. RESULTS: Median age of the patients was 83 years (range 76–90). Pneumonia was diagnosed in 112/382 (29%) of the studied episodes. One or more respiratory viruses were detected in 141/382 (37%) episodes and in 34/112 (30%) episodes also diagnosed with pneumonia. Pneumonia was associated with a WBC over 15 × 10(9)/L (P = .006) and a CRP value over 80 mg/l (P < .05). A virus was detected in 30% of pneumonia episodes and in 40% of non-pneumonia episodes, but this difference was not significant (P = 0.09). The presence of a respiratory virus was associated with fewer revisits to the hospital (P < .05), whereas a CRP value over 100 mg/l was associated with death during hospital stay (P < .05). Respiratory virus detections did not correlate to WBC or CRP values, signs and symptoms or prognosis of radiographically-verified pneumonia episodes. CONCLUSION: Among the elderly with respiratory symptoms, respiratory virus detection was not associated with an increased risk of pneumonia or with a more severe clinical course of the illness. CRP and WBC remain important indicators of pneumonia, and according to our findings, pneumonia should be treated as a bacterial disease regardless of the virus findings. Our data does not support routine virus diagnostics for the elderly patients with pneumonia outside the epidemic seasons. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1125-z) contains supplementary material, which is available to authorized users.


id: cord-347014-88zmtky7
author: Esposito, Susanna
date: 2016-11-15
txt: ./txt/cord-347014-88zmtky7.txt
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url: https://doi.org/10.1371/journal.pone.0163262
doi: 10.1371/journal.pone.0163262
summary:
  STUDY DESIGN: This study aimed to evaluate the diagnostic accuracy of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), midregional proatrial natriuretic peptide (MR-proANP) and midregional proadrenomedullin (MR-proADM) to distinguish bacterial from viral community-acquired pneumonia (CAP) and to identify severe cases in children hospitalized for radiologically confirmed CAP. CONCLUSIONS: This study indicates that in children with CAP, sTREM-1, MR-proANP, and MR-proADM blood levels have poor abilities to differentiate bacterial from viral diseases or to identify severe cases, highlighting that PCT maintains the main role at this regard. A global evaluation of the results of this study seemed to indicate that in children with CAP, sTREM-1, MR-proANP, and MR-proADM blood levels are unable to differentiate bacterial from viral diseases or to identify severe cases.

title:
  Sensitivity and Specificity of Soluble Triggering Receptor Expressed on Myeloid Cells-1, Midregional Proatrial Natriuretic Peptide and Midregional Proadrenomedullin for Distinguishing Etiology and to Assess Severity in Community-Acquired Pneumonia

abstract:
  STUDY DESIGN: This study aimed to evaluate the diagnostic accuracy of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), midregional proatrial natriuretic peptide (MR-proANP) and midregional proadrenomedullin (MR-proADM) to distinguish bacterial from viral community-acquired pneumonia (CAP) and to identify severe cases in children hospitalized for radiologically confirmed CAP. Index test results were compared with those derived from routine diagnostic tests, i.e., white blood cell (WBC) counts, neutrophil percentages, and serum C-reactive protein (CRP) and procalcitonin (PCT) levels. METHODS: This prospective, multicenter study was carried out in the most important children’s hospitals (n = 11) in Italy and 433 otherwise healthy children hospitalized for radiologically confirmed CAP were enrolled. Among cases for whom etiology could be determined, CAP was ascribed to bacteria in 235 (54.3%) children and to one or more viruses in 111 (25.6%) children. A total of 312 (72.2%) children had severe disease. RESULTS: CRP and PCT had the best performances for both bacterial and viral CAP identification. The cut-off values with the highest combined sensitivity and specificity for the identification of bacterial and viral infections using CRP were ≥7.98 mg/L and ≤7.5 mg/L, respectively. When PCT was considered, the cut-off values with the highest combined sensitivity and specificity were ≥0.188 ng/mL for bacterial CAP and ≤0.07 ng/mL for viral CAP. For the identification of severe cases, the best results were obtained with evaluations of PCT and MR-proANP. However, in both cases, the biomarker cut-off with the highest combined sensitivity and specificity (≥0.093 ng/mL for PCT and ≥33.8 pmol/L for proANP) had a relatively good sensitivity (higher than 70%) but a limited specificity (of approximately 55%). CONCLUSIONS: This study indicates that in children with CAP, sTREM-1, MR-proANP, and MR-proADM blood levels have poor abilities to differentiate bacterial from viral diseases or to identify severe cases, highlighting that PCT maintains the main role at this regard.


id: cord-348053-s0ijzyaq
title: Inflammatory biomarker trends predict respiratory decline in COVID-19 patients
author: Mueller, Alisa A.
date: 2020-10-29
txt: ./txt/cord-348053-s0ijzyaq.txt
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url: https://www.ncbi.nlm.nih.gov/pubmed/33163981/
doi: 10.1016/j.xcrm.2020.100144
summary:
  In this single-center retrospective cohort analysis of hospitalized COVID-19 patients, we investigate whether inflammatory biomarker levels predict respiratory decline in patients who initially present with stable disease. We hypothesized that inflammatory biomarker profiles would stratify patients into three cohorts: (1) stable and non-intubated throughout their hospital admission ("mild"); (2) initially stable and nonintubated but then had respiratory deterioration requiring intubation or high-flow nasal cannula later in their hospital course ("progressive"); and (3) patients who were unstable and required intubation within 12 hours of admission ("severe"). We classified COVID-19 inpatients into three cohorts according to the stability and severity of their respiratory failure: 1) "Mild" (remained on room air or supplemental oxygen); 2) "Progressive" (initially on room air or supplemental oxygen then later required intubation or high-flow nasal cannula); or 3) "Severe" (required intubation within 12 hours of admission) ( Figure S1 and Table 1 ).

abstract:
  In this single-center retrospective cohort analysis of hospitalized COVID-19 patients, we investigate whether inflammatory biomarker levels predict respiratory decline in patients who initially present with stable disease. Examination of C-reactive protein (CRP) trends reveals that a rapid rise in CRP levels precedes respiratory deterioration and intubation, while CRP levels plateau in patients that remain stable. Increasing CRP during the first 48 hours of hospitalization is a better predictor (with higher sensitivity) of respiratory decline than initial CRP levels or ROX indices (a physiological score). CRP, the pro-inflammatory cytokine IL-6 and physiological measures of hypoxemic respiratory failure are correlated, which suggests a mechanistic link. Our work shows that rising CRP predicts subsequent respiratory deterioration in COVID-19 and may suggest mechanistic insights and a potential role for targeted immunomodulation in a subset of patients early during hospitalization.


id: cord-348348-vt87zwfr
author: Semmekrot, B. A.
date: 2008
txt: ./txt/cord-348348-vt87zwfr.txt
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mime: text/plain
url: https://doi.org/10.1007/bf03078168
doi: 10.1007/bf03078168
summary:
  Purpose: Evaluating the guideline ''Diagnosis and treatment of respiratory syncytial (RS) virus bronchiolitis'' on the number of chest X-rays, C-reactive proteïn (CRP) counts, leukocyte counts, and antibiotic prescriptions in infants admitted to hospital with RS bronchiolitis. Bij een ernstige infec-a r t i k e l e n Samenvatting Doel: Evalueren of invoering van een protocol ''Diagnostiek en behandeling van RS-virus-bronchiolitis'' leidt tot minder thoraxfoto''s, minder C-reactieve proteïne (CRP-) en leukocytenbepalingen en minder antibioticavoorschriften bij opgenomen kinderen met respiratoir syncytieel (RS-)bronchiolitis. Onze gegevens ondersteunen een restrictief beleid met betrekking tot het verrichten van thoraxfoto''s, CRP-en leukocytenbepalingen bij in het ziekenhuis opgenomen kinderen met RS-virus-bronchiolitis. [13] [14] [15] Het op onze afdeling in 2003 ingevoerde protocol ''Diagnostiek en behandeling van RS-virus-bronchiolitis'' gaat uit van terughoudendheid in het verrichten van aanvullend onderzoek (CRP, leukocyten, thoraxfoto) en het geven van antibiotica, omdat het immers om een virale aandoening gaat.

title:
  Vermindering van diagnostiek en overbehandeling bij RS-virus-bronchiolitis na geprotocolleerde behandeling

abstract:
  Purpose: Evaluating the guideline ‘Diagnosis and treatment of respiratory syncytial (RS) virus bronchiolitis’ on the number of chest X-rays, C-reactive proteïn (CRP) counts, leukocyte counts, and antibiotic prescriptions in infants admitted to hospital with RS bronchiolitis. Design: Retrospective ‘before-after’ cohort study. Location: Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Patients: Infants admitted with proven RS virus infection. Methods: Guidelines, including sound restriction of performance of X-rays, CRP and leukocytes, were introduced in February 2003. Data from infants admitted with RS virus infection during 1997- 1999 (cohort A) were compared with those admitted from 2003- April 2006 (cohort B) Results: There were 155 infants in cohort A and 170 in cohort B. Implementation of guidelines led to significant reductions of CRP and leukocyte determinations: 49.0% and 48.2%, respectively (both p<0.001) and X-rays: 30.3% (p=0.020). Numbers of antibiotic prescriptions decreased with 55% (p<0.001). The chance of antibiotic prescription increased significantly when X-rays (OR=5.2), CRP (OR=5.4), or leukocytes (OR=4.2) were done. After implementation of the guidelines, the median stay in hospital decreased significantly from 8.0 to 6.0 days (p<0.001; ranges 1-13 days and 2-23 days, respectively). Performing X-ray, CRP or leukocytes, or antibiotic prescription did not significantly alter the total duration of hospital stay. Conclusion: Implementation of the guidelines led to significant decreases in numbers of X-rays, CRP and leukocytes determinations, and antibiotic prescriptions. Our data support the restrictive use of chest X-rays, CRP and leukocyte determinations in infants, admitted to hospital with RS virus bronchiolitis.


id: cord-353116-7t1prfkr
title: Predictors for Severe COVID-19 Infection
author: Bhargava, Ashish
date: 2020-05-30
txt: ./txt/cord-353116-7t1prfkr.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32472676/
doi: 10.1093/cid/ciaa674
summary:
  BACKGROUND: COVID-19 is a pandemic disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In multivariable logistic regression analysis, risk factors for severe infection included pre-existing renal disease (odds ratio [OR], 7.4; 95% CI 2.5-22.0), oxygen requirement at hospitalization (OR, 2.9; 95% CI, 1.3-6.7), acute renal injury (OR, 2.7; 95% CI 1.3-5.6) and initial CRP (OR,1.006; 95% CI, 1.001-1.01). CONCLUSIONS: Acute or pre-existing renal disease, supplemental oxygen at the time of hospitalization and initial CRP were independent predictors for the development of severe COVID-19 infections. The most common symptoms at the onset of illness in the studied cohort were cough (141 including higher white blood cell counts, lower lymphocyte and platelet counts, and increased C-reactive protein (CRP) levels compared with those patients with non-severe infection. In our study we report pre-existing renal disease, supplemental oxygen requirement at admission, acute renal insufficiency, and initial CRP value as independent predictors of severe COVID-19 infections.

abstract:
  BACKGROUND: COVID-19 is a pandemic disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Predictors for severe COVID-19 infection have not been well defined. Determination of risk factors for severe infection would enable identifying patients who may benefit from aggressive supportive care and early intervention. METHODS: We conducted a retrospective observational study of 197 patients with confirmed COVID-19 infection admitted to a tertiary academic medical center. RESULTS: Of 197 hospitalized patients, the mean (SD) age of the cohort was 60.6 (16.2) years, 103 (52.3%) were male and 156 (82.1%) were black. Severe COVID-19 infection was noted in 74 (37.6%) patients, requiring intubation. Patients aged above 60 were significantly more likely to have severe infection. Patients with severe infection were significantly more likely to have diabetes, renal disease, chronic pulmonary disease and had significantly higher white blood cell counts, lower lymphocyte counts, and increased C-reactive protein (CRP) compared to patients with non-severe infection. In multivariable logistic regression analysis, risk factors for severe infection included pre-existing renal disease (odds ratio [OR], 7.4; 95% CI 2.5-22.0), oxygen requirement at hospitalization (OR, 2.9; 95% CI, 1.3-6.7), acute renal injury (OR, 2.7; 95% CI 1.3-5.6) and initial CRP (OR,1.006; 95% CI, 1.001-1.01). Race, age and socioeconomic status were not identified as independent predictors. CONCLUSIONS: Acute or pre-existing renal disease, supplemental oxygen at the time of hospitalization and initial CRP were independent predictors for the development of severe COVID-19 infections. Every 1 unit increase in CRP increased the risk of severe disease by 0.06%.


