No abstract

COVID-19 infections have imposed immense pressure on the healthcare system of most countries. While the initial studies have identified better therapeutic and diagnostic approaches, the disease severity is still assessed by close monitoring of symptoms by healthcare professionals due to the lack of biomarkers for disease stratification. In this study, we have probed the immune and molecular profiles of COVID-19 patients at 48-hour intervals after hospitalization to identify early markers, if any, of disease progression and severity. Our study reveals that the molecular profiles of patients likely to enter the host-immune response mediated moderate or severe disease progression are distinct even in the early phase of infection when severe symptoms are not yet apparent. Our data from 37 patients suggest that at hospitalization, IL6 (>300pg/ml) and IL8 levels (>200pg/ml) identify cytokine-dependent disease progression. Monitoring their levels will facilitate timely intervention using available immunomodulators or precision medicines in those likely to progress due to cytokine storm and help improve outcomes. Additionally, it will also help identify cytokine-independent progressive patients, not likely to benefit from immuno-modulators or precision drugs.

Malnutrition in the elderly has been associated with deleterious effects on health care outcomes such as functional decline, cognitive impairment, depression, increased hospital stays, and increased morbidity and mortality. This cross-sectional study aims to determine the association of malnutrition with functional status and cognition and duration of hospitalization among 200 elderly patients admitted to medical wards of a tertiary care hospital in India. The nutritional screening was done using Mini Nutritional assessment- short form (MNA-SF). The functional activity was assessed using the Barthel’s Index. Cognitive assessment and screening for depression was done using the Mini-cog test and Geriatric Depression score – 4 respectively. Descriptive analyses were used to estimate the prevalence of malnutrition and associations were assessed using the Pearson chi square test. Among the total patients, 136 (68%) were malnourished. Of these, 45 (22.5%) were severely undernourished. The malnourished patients had poorer functional scores (p<0.001), were likely to be cognitively impaired (33%, 45 of 136) (p < 0.001) and stayed longer in the hospital (n= 9.13 days) compared to the normally nourished. The nutritional status of hospitalized elderly may therefore serve as a surrogate marker of disability and poor clinical outcome. Keywords: Malnutrition, Geriatric, Nutritional assessment, Undernourishment, Functional decline, Elderly

No abstract

COVID-19 infections have imposed immense pressure on the healthcare system of most countries. While the initial studies have identified better therapeutic and diagnostic approaches, the disease severity is still assessed by close monitoring of symptoms by healthcare professionals due to the lack of biomarkers for disease stratification. In this study, we have probed the immune and molecular profiles of COVID-19 patients at 48-hour intervals after hospitalization to identify early markers, if any, of disease progression and severity. Our study reveals that the molecular profiles of patients likely to enter the host-immune response mediated moderate or severe disease progression are distinct even in the early phase of infection when severe symptoms are not yet apparent. Our data from 37 patients suggest that at hospitalization, IL6 (>300pg/ml) and IL8 levels (>200pg/ml) identify cytokine-dependent disease progression. Monitoring their levels will facilitate timely intervention using available immunomodulators or precision medicines in those likely to progress due to cytokine storm and help improve outcomes. Additionally, it will also help identify cytokine-independent progressive patients, not likely to benefit from immuno-modulators or precision drugs.