Blood lactate in mild and moderate ARDS secondary to SARS COV 2

Pagano, Antonio; Porta, Giovanni; Bosso, Giorgio; Allegorico, Enrico; Serra, Claudia; Mercurio, Valentina; Sansone, G.; Orefice, S.; Numis, Fabio Giuliano

doi:10.1016/j.ajem.2023.01.032

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Consequently, researchers have started to explore new prediction models that incorporate admission lactate levels for patients with CAP [1,2,11]. The primary factors contributing to excessive lactate production include hypoxia, alterations in mitochondrial oxidation, and glycolysis [13]. There are many studies in the literature about the prognostic power of lactate in critically ill geriatric patients, hemorrhagic shock, and trauma, where there is tissue hypoperfusion [5,14,15,16].…”

Section: Discussionmentioning

confidence: 99%

The relationship of CURB65-L and CURB65-LC (lactate clearance) with mortality in pneumonia patients admitted to the emergency department

Ertekin,

Acar,

Tuncar

et al. 2024

Eu Clin Anal Med

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Aim: The study aims to examine the correlation between lactate, lactate clearance, CURB-65, CURB65-L, and CURB65-LC scores with mortality in pneumonia patients who were admitted to the emergency department. Material and Methods: A total of 123 patients diagnosed with pneumonia who applied to the emergency department were assessed prospectively. Lactate clearance (%): [lactate at admission -lactate at 24th hour / lactate at admission) × 100]. Statistical comparisons were made across patient groups based on lactate, lactate clearance, and CURB-65 scores. These groups included survivors and non-survivors, patients in the intensive care unit and those who were not, patients receiving mechanical ventilation and vasopressor support, and those who did not, as well as patients with a hospital stay ≤10 days and those with a hospital stay > 10 days. Results: Among patients with severe illness who did not survive and required intensive care unit admission, mechanical ventilation and vasopressor support, the lactate and CURB-65 scores were significantly higher, while the lactate clearance score was lower (p < 0.001 for all). The predictive power of CURB65-L and CURB65-LC for mortality was determined to be higher than CURB-65 and lactate clearance alone (AUC: 0.904, 0.855, 0.783, 0.834, respectively) (p<0.001 for all). Discussion: The presence of lactate, the CURB-65 score, and lactate clearance level assessed upon admission to the emergency department can serve as predictors of negative results in patients with pneumonia. In addition, the combination of CURB65-L and CURB65-LC enhances the predictive power of CURB-65 and LC individually in determining mortality.

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Section: Discussionmentioning

confidence: 99%

The relationship of CURB65-L and CURB65-LC (lactate clearance) with mortality in pneumonia patients admitted to the emergency department

Ertekin,

Acar,

Tuncar

et al. 2024

Eu Clin Anal Med

View full text Add to dashboard Cite

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The metabolic footprint of Vero E6 cells highlights the key metabolic routes associated with SARS-CoV-2 infection and response to drug combinations

Melis,

Braca,

Pagnozzi

et al. 2024

Sci Rep

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SARS-CoV-2 burdens healthcare systems worldwide, yet specific drug-based treatments are still unavailable. Understanding the effects of SARS-CoV-2 on host molecular pathways is critical for providing full descriptions and optimizing therapeutic targets. The present study used Nuclear Magnetic Resonance-based metabolic footprinting to characterize the secreted cellular metabolite levels (exometabolomes) of Vero E6 cells in response to SARS-CoV-2 infection and to two candidate drugs (Remdesivir, RDV, and Azithromycin, AZI), either alone or in combination. SARS-CoV-2 infection appears to force VE6 cells to have increased glucose concentrations from extra-cellular medium and altered energetic metabolism. RDV and AZI, either alone or in combination, can modify the glycolic-gluconeogenesis pathway in the host cell, thus impairing the mitochondrial oxidative damage caused by the SARS-CoV-2 in the primary phase. RDV treatment appears to be associated with a metabolic shift toward the TCA cycle. Our findings reveal a metabolic reprogramming produced by studied pharmacological treatments that protects host cells against virus-induced metabolic damage, with an emphasis on the glycolytic-gluconeogenetic pathway. These findings may help researchers better understand the relevant biological mechanisms involved in viral infection, as well as the creation of mechanistic hypotheses for such candidate drugs, thereby opening up new possibilities for SARS-CoV-2 pharmacological therapy.

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Lung ultrasound-guided PEEP titration in COVID–19 patients treated with CPAP

Bosso

Papillo

et al. 2023

Journal of Basic and Clinical Physiology and Pharmacology

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Objectives An increasing number of COVID–19 patients were treated with continuous positive airways pressure (CPAP). To evaluate the clinical effects of personalized positive end-expiratory pressure (PEEP) compared to standard fixed PEEP in COVID-19 patients requiring CPAP. Methods This is a single center, prospective, randomized clinical study. Sixty-three COVID-19 patients with hypoxemic respiratory failure and bilateral pneumonia were randomized in two Groups: Group A received CPAP with fixed PEEP of 10 cm H2O, Group B performed the “PEEP trial”, that consists in the evaluation of best PEEP defined as the PEEP value that precedes the echographic appearance of “lung pulse” determining a PaO2/FiO2 increase. Primary outcome was composite in-hospital mortality + intubation, secondary outcome was the percentage increase of PaO2/FiO2. As safety indicator, the incidence of pneumothorax was collected. Results Thirty-two patients were enrolled in Group A and 31 in Group B. The two groups were comparable for clinical characteristics and laboratory parameters. The primary outcome occurred in 36 (57.1 %) patients: 23 (71.8 %) in Group A and 13 (41.9 %) in Group B (p<0.01). Mortality was higher in Group A (53.1 vs. 19.3 %, p<0.01), while intubation rate was comparable between groups. Group B showed a higher PaO2/FiO2 increase than Group A (34.9 vs. 13.1 %, p<0.01). Five cases of pneumothorax were reported in Group A, none in Group B. Conclusions Lung ultrasound-guided PEEP trial is associated with lower mortality in COVID-19 patients treated with CPAP. Identifying the best PEEP is useful to increase oxygenation and reduce the incidence of complications.

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Blood lactate in mild and moderate ARDS secondary to SARS COV 2

Cited by 3 publications

References 10 publications

The relationship of CURB65-L and CURB65-LC (lactate clearance) with mortality in pneumonia patients admitted to the emergency department

The relationship of CURB65-L and CURB65-LC (lactate clearance) with mortality in pneumonia patients admitted to the emergency department

The metabolic footprint of Vero E6 cells highlights the key metabolic routes associated with SARS-CoV-2 infection and response to drug combinations

Lung ultrasound-guided PEEP titration in COVID–19 patients treated with CPAP

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