Clinical diagnosis of pandemic <scp>A</scp>(<scp>H</scp>1<scp>N</scp>1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower <scp>C</scp>‐reactive protein levels

Wang, Lin; Chang, Ling‐Sai; Lee, Ing-Kit; Tang, Kuo-Shu; Li, Chung-Chen; Eng, Hock‐Liew; You, Hua; Yang, Kuender D.

doi:10.1111/irv.12182

Cited by 18 publications

(16 citation statements)

References 30 publications

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“…Although immunoglobulins may play an important role in the innate immune response during ARDS, nonspecific immunoglobulins may not be as effective in a lymphopenia environment. Lymphopenia has been described in ARDS patients and in animal models after viral infection or mycoplasma infection and affects all lymphoid tissue [26][27][28]. However, in our small group of non-survivors, the percentage of lymphocytes rather than impaired kinetics over time was impressive.…”

Section: Discussionmentioning

confidence: 59%

Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy

Prohaska¹,

Schirner²,

Bashota³

et al. 2018

j intensive care

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BackgroundAcute respiratory distress syndrome (ARDS) is associated with high mortality rates. ARDS patients suffer from severe hypoxemia, and extracorporeal membrane oxygenation (ECMO) therapy may be necessary to ensure oxygenation. ARDS has various etiologies, including trauma, ischemia-reperfusion injury or infections of various origins, and the associated immunological responses may vary. To support the immunological response in this patient collective, we used intravenous IgM immunoglobulin therapy to enhance the likelihood of pulmonary recovery.MethodsARDS patients admitted to the intensive care unit (ICU) who were placed on ECMO and treated with (IVIG group; n = 29) or without (control group; n = 28) intravenous IgM-enriched immunoglobulins for 3 days in the initial stages of ARDS were analyzed retrospectively.ResultsThe baseline characteristics did not differ between the groups, although the IVIG group showed a significantly reduced oxygenation index compared to the control group. We found no differences in the length of ICU stay or ventilation parameters. We did not find a significant difference between the groups for the extent of inflammation or for overall survival.ConclusionWe conclude that administration of IgM-enriched immunoglobulins as an additional therapy did not have a beneficial effect in patients with severe ARDS requiring ECMO support.Trial registrationClinical Trials: NCT02961166; retrospectively registered.

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Section: Discussionmentioning

confidence: 59%

Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy

Prohaska¹,

Schirner²,

Bashota³

et al. 2018

j intensive care

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“…The present ndings showed that CRP greater more than 100 mg/L was signi cantly associated with case fatality. A signi cant increase in CRP levels, as documented for bacterial infections, can also occur with viral infections [15]. It is well known that CRP is a classic acute phase protein.…”

Section: Discussionmentioning

confidence: 94%

Risk factors and electrocardiogram characteristics for mortality of critical inpatients with COVID-19

Zhang

et al. 2020

Preprint

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Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has subsequently spread worldwide. The number of death has increased rapidly. However, the possible risk factors that lead to death in critical inpatients with coronavirus disease 2019 (COVID-19) are not yet fully known. This study was to explore the risk factors for mortality of critical inpatients with COVID-19. Methods In this single-centered, retrospective study, we enrolled 113 critical patients with COVID-19 in Renmin Hospital of Wuhan University between Feb 1, 2020 and Mar 15, 2020. Data were collected using a standard method including clinical records and laboratory findings. Outcomes of survivors and death were compared. Results A total of 113 critical patients (from 29 to 95 years) with COVID-19 were recruited, 50 (44.25%) died and 63 recovered (55.75%). The proportion of patients with ventricular arrhythmia was higher in the death group than the recovery group (24.0% vs 4.4%; p = 0.021), and was higher among myocardial damage cases than non-myocardial damage cases (26.1% vs 4.3%; p = 0.013). Multivariate analysis confirmed four independent predictors related to mortality of COVID-19: age > 70 yrs (HR 1.84, 95% CI 1.03–3.28), initial neutrophil count more than 6.5 × 109/L (HR 3.43, 95% CI 1.84–6.40), C-reactive protein greater more than 100 mg/L (HR 1.93, 95% CI 1.04–3.59), and lactate dehydrogenase more than 300 U/L (HR 2.90, 95% CI 1.26–6.67). Immunoglobulin treatment (HR 0.39, 95% CI 0.21–0.73) can reduce the risk of death. There was no significant difference in the QT interval between patients with and without hydroxychloroquine treatment. Conclusions Old age (> 70 years), neutrophilia, C-reactive protein greater more than 100 mg/L and lactate dehydrogenase more than 300 U/L are high-risk factors for mortality of critical patients with COVID-19. The incidence of ventricular arrhythmia was higher in deceased patients than survivors.

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“…Lymphocytopenia is more closely associated with viral infections. 28 The presence of increased leukocytes and neutrophils may be associated with the heterogeneous inflammatory response, possibly attributable to preexisting inflammation due to asthma that might be worsened by exposure to the virus. Production of chemokines by bronchial epithelium in response to a viral infection leads to the entry of neutrophils to the respiratory airways, as confirmed on experimental and naturally induced common cold among asthmatic patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of asthmatic patients with influenza-like illness and risk of severe exacerbations in Mexico

Paulin-Prado

Nishimura

Freimanis-Hance

et al. 2016

Annals of Allergy, Asthma & Immunology

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Background Patients with chronic inflammatory lung diseases, such as asthma, are at higher risk for influenza-like illness (ILI) complications. Viral infections are known to trigger asthma exacerbations, but a thorough description of the clinical characteristics of ILI-associated asthma exacerbations and the role of viruses as a risk factor for severe exacerbation (SE) in ILI has not been published yet. Objective To investigate risk factors for SE in patients with ILI and asthma. Methods Patients with ILI symptoms were recruited from 6 hospitals of Mexico (LaRed sites) during 2010 to 2014. Those with a previous asthma diagnosis and ILI symptoms and who were 5 years or older were included. Patients were assigned as cases or controls based on symptoms reported. SE was defined when participants presented with wheezing or dyspnea and required hospitalization. Results A total of 486 patients with ILI and a diagnosis of asthma were included. There were no differences in the proportion, number, or type of viral illness among those with and without SE. Those with SE were less likely to report ILI symptoms. Muscle pain and nasal drip were predictors for patients not progressing to SE. A delay in seeking medical care was associated with SE (odds ratio, 2.93; 95% CI, 1.46-5.88). Conclusion The presence of a particular virus did not predict SE. ILI symptoms in asthma patients are not associated with severe exacerbation. Patients with asthma should be encouraged to seek early medical care when ILI symptoms are first noticed to prevent serious complications.

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Clinical diagnosis of pandemic A(H1N1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower C‐reactive protein levels

Cited by 18 publications

References 30 publications

Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy

Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy

Risk factors and electrocardiogram characteristics for mortality of critical inpatients with COVID-19

Clinical characteristics of asthmatic patients with influenza-like illness and risk of severe exacerbations in Mexico

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