Comparison of clinical, para-clinical and laboratory findings in survived and deceased patients with COVID-19: diagnostic role of inflammatory indications in determining the severity of illness

Rokni, Mohsen; Ahmadikia, Kazem; Asghari, Somaye; Mashaei, Shahabodin; Hassanali, Fahimeh

doi:10.1186/s12879-020-05540-3

Cited by 48 publications

(41 citation statements)

References 35 publications

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“…This hyperresponsiveness was also found in other studies [ 224 ]. Some clinical studies report that thrombocytopenia is associated with increased mortality [ 4 , 5 ], whereas other do not [ 215 , 225 ]. This discrepancy might depend on disease severity, comorbidities or the type of care provided.…”

Section: Resultsmentioning

confidence: 99%

Thrombocytopenia in Virus Infections

Raadsen

Toit

Langerak

et al. 2021

JCM

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Thrombocytopenia, which signifies a low platelet count usually below 150 × 109/L, is a common finding following or during many viral infections. In clinical medicine, mild thrombocytopenia, combined with lymphopenia in a patient with signs and symptoms of an infectious disease, raises the suspicion of a viral infection. This phenomenon is classically attributed to platelet consumption due to inflammation-induced coagulation, sequestration from the circulation by phagocytosis and hypersplenism, and impaired platelet production due to defective megakaryopoiesis or cytokine-induced myelosuppression. All these mechanisms, while plausible and supported by substantial evidence, regard platelets as passive bystanders during viral infection. However, platelets are increasingly recognized as active players in the (antiviral) immune response and have been shown to interact with cells of the innate and adaptive immune system as well as directly with viruses. These findings can be of interest both for understanding the pathogenesis of viral infectious diseases and predicting outcome. In this review, we will summarize and discuss the literature currently available on various mechanisms within the relationship between thrombocytopenia and virus infections.

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Section: Resultsmentioning

confidence: 99%

Thrombocytopenia in Virus Infections

Raadsen

Toit

Langerak

et al. 2021

JCM

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“…Very recently, two studies including small cohorts have been published exploring the usefulness of known hemogram-derived ratios. One describes laboratory and radiological findings in a small group of patients 21 and another compares blood inflammatory markers in SARS-CoV-2 virus infection to influenza A. 22 …”

Section: Discussionmentioning

confidence: 99%

Hemogram as Marker of In-Hospital Mortality in Covid-19

López-Escobar

Madurga

Castellano

et al. 2021

Journal of Investigative Medicine

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The clinical impact of COVID-19 disease calls for the identification of routine variables to identify patients at increased risk of death. Current understanding of moderate-to-severe COVID-19 pathophysiology points toward an underlying cytokine release driving a hyperinflammatory and procoagulant state. In this scenario, white blood cells and platelets play a direct role as effectors of such inflammation and thrombotic response. We investigate whether hemogram-derived ratios such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio and the systemic immune-inflammation index may help to identify patients at risk of fatal outcomes. Activated platelets and neutrophils may be playing a decisive role during the thromboinflammatory phase of COVID-19 so, in addition, we introduce and validate a novel marker, the neutrophil-to-platelet ratio (NPR).Two thousand and eighty-eight hospitalized patients with COVID-19 admitted at any of the hospitals of HM Hospitales group in Spain, from March 1 to June 10, 2020, were categorized according to the primary outcome of in-hospital death.Baseline values, as well as the rate of increase of the four ratios analyzed were significantly higher at hospital admission in patients who died than in those who were discharged (p<0.0001). In multivariable logistic regression models, NLR (OR 1.05; 95% CI 1.02 to 1.08, p=0.00035) and NPR (OR 1.23; 95% CI 1.12 to 1.36, p<0.0001) were significantly and independently associated with in-hospital mortality.According to our results, hemogram-derived ratios obtained at hospital admission, as well as the rate of change during hospitalization, may easily detect, primarily using NLR and the novel NPR, patients with COVID-19 at high risk of in-hospital mortality.

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“…Another immune dysregulated feature is the remarkable increase in neutrophil-to-lymphocyte ratio (NLR) [8,32], which usually depicts a higher disease severity and poor clinical outcome [33]. NLR may also work as an independent prognostic marker to predict COVID-19 disease severity [34]. In a retrospective study of the 55 COVID-19 patients, transcriptional profiling of the immune cells revealed excessive neutrophils count and the associated NET.…”

Section: Changes Of Immune Cellsmentioning

confidence: 99%

Immune dysregulation and system pathology in COVID-19

et al. 2021

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The coronavirus disease 19 (COVID-19) caused by the novel coronavirus known as SARS-CoV-2 has caused a global public health crisis. As of 7 January 2021, 87,640,402 confirmed cases and 1,891,692 mortalities have been reported worldwide. Studies focusing on the epidemiological and clinical characteristics of COVID-19 patients have suggested a dysregulated immune response characterized by lymphopenia and cytokine storm in these patients. The exaggerated immune response induced by the cytokine storm causes septic shock, acute respiratory distress syndrome (ARDS), and/or multiple organs failure, which increases the fatality rate of patients with SARS-CoV-2 infection. Herein, we review the recent research progress on epidemiology, clinical features, and system pathology in COVID-19. Moreover, we summarized the recent therapeutic strategies, which are either approved, under clinical trial, and/or under investigation by the local or global health authorities. We assume that treatments should focus on the use of antiviral drugs in combination with immunomodulators as well as treatment of the underlying comorbidities.

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Comparison of clinical, para-clinical and laboratory findings in survived and deceased patients with COVID-19: diagnostic role of inflammatory indications in determining the severity of illness

Cited by 48 publications

References 35 publications

Thrombocytopenia in Virus Infections

Thrombocytopenia in Virus Infections

Hemogram as Marker of In-Hospital Mortality in Covid-19

Immune dysregulation and system pathology in COVID-19

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