A diagnostic model for serious COVID-19 infection among older adults in Shanghai during the Omicron wave

Bao, Suxia; Lu, Guanzhu; Kang, Yu; Zhou, Yuanyuan; Wang, Yuhuan; Yan, Lei; Yin, Dong-Lin; Bao, Yu-Jie; Yuan, Xiaoling; Xu, Jie

doi:10.3389/fmed.2022.1018516

Cited by 5 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even patients with lower prehospital NEWS2 may experience exacerbation if combined with other risk factors. Compared with predictive models and markers composed of laboratory results [ 4 , 5 , 39 ], NEWS2 can be obtained by measuring physiological parameters without blood or bronchoalveolar lavage test and can be used in risk stratification to predict serious patients quickly and cheaply. This study also suggested that NEWS2 has positive correlations with prehospital care workload and consumption of medical human resources, and it is an important independent predictor for severe/critical categories of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic model composed of white blood cells, CD4 positive T cells, and D-dimer can effectively discriminate the severe/critical state from the mild/moderate state in COVID-19 caused by SARS-CoV-2 Omicron variant BA.2 infection. This model shows a C-statistic of 0.962, a sensitivity of 97.14%, and a specificity of 90.27% [ 5 ]. However, such diagnostic models and biomarkers must be obtained by laboratory testing, which are inconvenient, time consuming, and uneconomical.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prehospital physiological parameters related illness severity scores can accurately discriminate the severe/critical state in adult patients with COVID-19

Li,

Wang,

et al. 2023

Annals of Medicine

View full text Add to dashboard Cite

Background Whether the National Early Warning Score 2 (NEWS2) can effectively discriminate the severe/critical state of patients with coronavirus disease 2019 (COVID-19) at the prehospital stage remains unknown. We aimed to assess the performance of NEWS2 in rapidly discriminating severe/critical COVID-19 and its relationship with prehospital medical services. Methods Six illness severity scores of 414 patients were calculated at the prehospital stage. Receiver operating characteristic curves were generated to explore the ability of these scores to discriminate severe/critical patients from mild/moderate patients. A logistic regression analysis was conducted to evaluate independent predictors associated with severe/critical state. Results The age, numbers of comorbidities, prehospital care workload, consumption of medical human resources, and illness severity scores of severe/critical patients were higher than those of mild/moderate patients ( p < 0.05). When NEWS2 scores >2, the sensitivity, specificity, positive predictive value, and negative predictive value were 93.5%, 90.7%, 74.1%, and 98.0%, respectively. The C-statistic of NEWS2 (0.963) was higher than that of quick Sequential Organ Failure Assessment (0.680, p < 0.001), CRB-65 (0.879, p < 0.001), Rapid Acute Physiology Score (0.692, p < 0.001), and Rapid Emergency Medicine Score (0.879, p < 0.001). NEWS2 was positively correlated with the numbers of prehospital treatment measures ( r = 0.732, p < 0.001), numbers of medical staff ( r = 0.615, p < 0.001), and total transport time ( r = 0.595, p < 0.001). Age ≥65 years (OR = 5.43, p = 0.016), hypertension (OR = 5.39, p < 0.001), active malignancy (OR = 5.94, p = 0.005), and NEWS2 scores >2 (OR = 124.88, p < 0.001) were independent predictors to discriminate severe/critical patients. Oxygen saturation (SpO 2 ) (OR =1.87, p < 0.001) was the unique independent predictor to discriminate false positive patients from true positive patients. Conclusions Prehospital NEWS2 can accurately and rapidly discriminate severe/critical COVID-19 during the Omicron variant wave. High levels of NEWS2 indicate an increase in prehospital care workload and consumption of medical human resources.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prehospital physiological parameters related illness severity scores can accurately discriminate the severe/critical state in adult patients with COVID-19

Li,

Wang,

et al. 2023

Annals of Medicine

View full text Add to dashboard Cite

show abstract

“…1.5 may further undermine the efficacy of the current COVID-19 vaccine and lead to a surge in breakthrough infections and re-infections. At the same time, on October 14, 2022, studies suggested that age over 80, suffering from a variety of underlying diseases, the use of immunosuppressants, chronic kidney disease, and other factors are the risk factors for developing severe disease after novel coronavirus infection, so these people need additional vaccination ( Agrawal et al., 2022 ; Bao et al., 2022 ).…”

Section: Introductionmentioning

confidence: 99%

The antiviral activity of a small molecule drug targeting the NSP1-ribosome complex against Omicron, especially in elderly patients

Shen

Ding

Luan

et al. 2023

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

IntroductionWith the emergence of SARS-CoV-2 mutant strains, especially the epidemic of Omicron, it continues to evolve to strengthen immune evasion. Omicron BQ. 1 and XBB pose a serious threat to the current COVID-19 vaccine (including bivalent mRNA vaccine for mutant strains) and COVID-19-positive survivors, and all current therapeutic monoclonal antibodies are ineffective against them. Older people, those with multimorbidity, and those with specific underlying health conditions remain at increased risk of COVID-19 hospitalization and death after the initial vaccine booster. However, small-molecule drugs for conserved targets remain effective and urgently needed.MethodsThe non-structural protein of SARS-CoV-2 non-structural protein 1(Nsp1) can bind to the host 40S ribosomal subunit and activate the nuclease to hydrolyze the host RNA, while the viral RNA is unaffected, thus hijacking the host system. First, the present study analyzed mutations in the Nsp1 protein and then constructed a maximum-likelihood phylogenetic tree. A virtual drug screening method based on the Nsp1 structure (Protein Data Bank ID: 7K5I) was constructed, 7495 compounds from three databases were collected for molecular docking and virtual screening, and the binding free energy was calculated by the MM/GBSA method.ResultsOur study shows that Nsp1 is relatively conserved and can be used as a comparatively fixed drug target and that therapies against Nsp1 will target all of these variants. Golvatinib, Gliquidone, and Dihydroergotamine were superior to other compounds in the crystal structure of binding conformation and free energy. All effectively interfered with Nsp1 binding to 40S protein, confirming the potential inhibitory effect of these three compounds on SARS-CoV-2.DiscussionIn particular, Golwatinib provides a candidate for treatment and prophylaxis in elderly patients with Omicjon, suggesting further evaluation of the anti-SARS-CoV-2 activity of these compounds in cell culture. Further studies are needed to determine the utility of this finding through prospective clinical trials and identify other meaningful drug combinations.

show abstract

“…In the current environment where most countries cancel normalized nucleic acid testing, it is of great significance for clinicians to understand the identification of the above two diseases. Besides, most of the previous studies focused on elderly patients [12,13] , and the difference between Omicron and H1N1 influenza in young patients is rarely reported. Although young patients are often mild [14] , they should also be noticed.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 or seasonal influenza? How to distinguish in people younger than 65 years old — — A retrospective observational cohort study comparing the 2009 pandemic influenza A H1N1 with 2022 SARS-CoV-2 Omicron BA.2 outbreaks in China

Zhong

Yue

et al. 2023

Preprint

View full text Add to dashboard Cite

ObjectiveThis study attempted to explore the difference of clinical characteristics in H1N1 influenza infection and SARS-CoV-2 Omicron infection in people younger than 65 years old, in order to better identify the two diseases.MethodsA total of 127 H1N1 influenza patients diagnosed from May 2009 to July 2009 and 3265 patients diagnosed and identified as SARS-CoV-2 Omicron BA.2 variant from March 2022 to May 2022 were admitted in this study. Through the 1 : 2 match based on age (The difference is less than 2 years), gender and underlying diseases, 115 patients with H1N1 infection and 230 patients with SARS-CoV-2 Omicron BA.2 infection(referred to as H1N1 group and Omicron group) were included in the statistics. The clinical manifestations of H1N1 group were compared with those of Omicron group. Logistic regression was performed to analyze the possible independent risk factors of H1N1 group and Omicron group. And multiple linear regression was used to analyze the factors for time for nucleic acid negativization (NAN).ResultsThe median age of the two groups was 21 [11,26] years. Compared with the H1N1 group, the Omicron group had lower white blood cell count and CRP levels, less fever, nasal congestion, sore throat, cough, sputum and headache, while more olfactory loss, muscle soreness and LDH abnormalities. The Omicron group used less antibiotics and antiviral drugs, and the NAN time was longer (17 [14,20] VS 4 [3,5], P < 0.001). After logistic regression, it was found that fever, cough, headache, and increased white blood cell count were more correlated with the H1N1 group, while muscle soreness and LDH abnormalities were more correlated with the Omicron group. After analyzing the factors of NAN time, it was found that fever (B 1.529, 95 % CI [0.149,2.909], P = 0.030) significantly predicted longer NAN time in Omicron patients.ConclusionThis study comprehensively evaluated the similarities and differences in clinical characteristics between SARS-CoV-2 Omicron infection and 2009 H1N1 influenza infection, which is of great significance for a better understanding for these diseases.

show abstract

A diagnostic model for serious COVID-19 infection among older adults in Shanghai during the Omicron wave

Cited by 5 publications

References 34 publications

Prehospital physiological parameters related illness severity scores can accurately discriminate the severe/critical state in adult patients with COVID-19

Prehospital physiological parameters related illness severity scores can accurately discriminate the severe/critical state in adult patients with COVID-19

The antiviral activity of a small molecule drug targeting the NSP1-ribosome complex against Omicron, especially in elderly patients

COVID-19 or seasonal influenza? How to distinguish in people younger than 65 years old — — A retrospective observational cohort study comparing the 2009 pandemic influenza A H1N1 with 2022 SARS-CoV-2 Omicron BA.2 outbreaks in China

Contact Info

Product

Resources

About