Objective: The majority of patients with COVID-19 showed mild symptoms. However, approximately 5% of them were critically ill and require intensive care unit admission for advanced life supports. Patients in the intensive care unit were high risk for venous thromboembolism and hemorrhage due to the immobility and anticoagulants used during advanced life supports. The aim of the study was to report the incidence and treatments of the two complications in such patients. Method: Patients with COVID-19 (Group 1) and patients with community-acquired pneumonia (Group 2) that required intensive care unit admission were enrolled in this retrospective study. Their demographics, laboratory results, ultrasound findings and complications such as venous thromboembolism and hemorrhage were collected and compared. Results: Thirty-four patients with COVID-19 and 51 patients with community-acquired pneumonia were included. The mean ages were 66 and 63 years in Groups 1 and 2, respectively. Venous thromboembolism was detected in 6 (18%) patients with COVID-19 and 18 (35%) patients with community-acquired pneumonia (P = 0.09). The major type was distal deep venous thrombosis. Twenty-one bleeding events occurred in 12 (35%) patients with COVID-19 and 5 bleeding events occurred in 5 (10%) patients with community-acquired pneumonia, respectively (P = 0.01). Gastrointestinal system was the most common source of bleeding. With the exception of one death due to intracranial bleeding, blood transfusion with or without surgical/endoscopic treatments was able to manage the bleeding in the remaining patients. Multivariable logistic regression showed increasing odds of hemorrhage with extracorporeal membrane oxygenation (odds ratio: 13.9, 95% confidence interval: 4.0–48.1) and COVID-19 (odds ratio: 4.7, 95% confidence interval: 1.2–17.9). Conclusion: Venous thromboembolism and hemorrhage were common in both groups. The predominant type of venous thromboembolism was distal deep venous thrombosis, which presented a low risk of progression. COVID-19 and extracorporeal membrane oxygenation were risk factors for hemorrhage. Blood transfusion with or without surgical/endoscopic treatments was able to manage it in most cases.

Background The purpose of this study was to clarify the prognostic value of Pentraxin-3 (PTX3) on the mortality of patients with sepsis. Methods Publications published up to January 2021 were retrieved from PubMed, EMBASE, and the Cochrane library. Data from eligible cohort and case–control studies were extracted for the meta-analysis. Multivariate regression analysis was used to evaluate the correlation of the outcomes with sample size and male proportion. Results A total of 17 studies covering 3658 sepsis patients were included. PTX3 level was significantly higher in non-survivor compared to survivor patients (SMD (95% CI): −1.06 (−1.43, −0.69), P < 0.001). Increased PTX3 level was significantly associated with mortality (HR (95% CI): 2.09 (1.55, 2.81), P < 0.001). PTX3 showed good predictive capability for mortality (AUC:ES (95% CI): 0.73 (0.70, 0.77), P < 0.001). The outcome comparing PTX3 level in non-survivors vs. survivors and the outcome of the association between PTX3 and mortality were associated with sample size but not male proportion. AUC was associated with both sample size and male proportion. Conclusions PTX3 level was significantly higher in non-survivor compared to survivor patients with sepsis. Elevated PTX3 level was significantly associated with mortality. Furthermore, the level of PTX3 might predict patient mortality.

Acute type A aortic dissection (ATAAD) is a life-threatening disease. The understanding of its pathogenesis and treatment approaches remains unclear. In the present work, differentially expressed genes (DEGs) from two ATAAD datasets GSE52093 and GSE98770 were filtered. Transcription factor TEAD4 was predicted as a key modulator in protein-protein interaction (PPI) network. Weighted correlation network analysis (WGCNA) identified five modules in GSE52093 and four modules in GSE98770 were highly correlated with ATAAD. 71 consensus DEGs of highly correlated modules were defined and functionally annotated. L1000CDS2 was executed to predict drug for drug repositioning in ATAAD treatment. Eight compounds were filtered as potential drugs. Integrative analysis revealed the interaction network of five differentially expressed miRNA and 16 targeted DEGs. Finally, master DEGs were validated in human ATAAD samples and AD cell model in vitro. TIMP3 and SORBS1 were downregulated in ATAAD samples and AD cell model, while PRUNE2 only decreased in vitro. Calcium channel blocker and glucocorticoid receptor agonist might be potential drugs for ATAAD. The present study offers potential targets and underlying molecular mechanisms ATAAD pathogenesis, prevention and drug discovery.

Patients with sepsis are prone to fluid overload (FO) due to fluid resuscitation, irrespective of stage of acute kidney injury (AKI). The aim of our study was to analyze the association between FO at continuous renal replacement therapy (CRRT) initiation and 28-day mortality in patients with sepsis associated AKI (S-AKI). In this retrospective study, data for patient characteristics were collected and 28-day mortality were studied. We also analyze association of variables, including FO degrees with 28-day mortality. Earlier commencement of CRRT showed better outcome. Non-survivors had higher FO than survivor (9.17% vs. 5.20%; p = 0.016). Survival in patients with FO > 10% over 28 days was significantly worse compared to those with FO ≤ 10% (p = 0.006). Multivariate analysis showed, FO > 10% (95%CI [1.721, 17.195], p = 0.004) was significantly associated with increased 28-day mortality. In S-AKI requiring CRRT, FO > 10% at CRRT initiation was independently associated with 28-day mortality.