COVID‑19: Main findings after a year and half of unease and the proper scientific progress (Review)

Abstract

numerous studies have been published to date regarding clinical, laboratory and treatment aspects associated with COVID-19. The present study attempts to compare and unify the clinical, para-clinical and therapeutic aspects that have come to light regarding coronavirus disease-19 (COVID 19), mainly in adults. Between April 2020 and September 2021, a comprehensive systematic literature review was performed, which we added to from our own medical experiences. The search was performed on the PubMed, Scopus and Google Scholar databases, comprising studies with analyzable data that were identified alongside studies and documents containing general scientific data. All published studies were written in English, and were from different countries. A 95% confidence interval (CI95) was also calculated for almost each study using the Wilson formula. When compared with preliminary reports between December 2019 and January 2020, the most frequent symptoms were still identified as being fever (68.6%; CI95: 67.5-69.7) and cough (72.7%; CI95: 71.7-73.8). Nevertheless, asymptomatic cases also increased (by 21.4%; CI95: 16.6-27.1). Severe and critical cases accounted for 10.4% (CI95: 9.6-11.1) of all cases. The mean fatality rate was found to be 4% (CI95: 3.6-4.5). The primary co-morbidity found was hypertension (28.9%; CI95: 27-30.8), followed by other underlying cardiovascular diseases (15.4%; CI95: 13.9-16.9) and diabetes (14.5%; CI95: 13.1-16.1). The majority of studies showed lower white blood cell numbers with neutropenia and lymphopenia, and lower platelet levels. The levels of the biomarkers C-reaction protein and erythrocyte sedimentation rate were positive in all studied cases alongside other lab tests, such as examining the D-dimer levels and those of other hepatic, cardiac and renal injury markers. The procalcitonin level was also found to be elevated in many cases, resulting in high usage of antibiotics (83.7%; CI95: 81.2-85.9). Approximately 31.6% (CI95: 29.1-34.1) of the patients required non-invasive ventilation, whereas 9.9% (CI95: 8.1-12.1) of the patients were intubated or placed on extracorporeal membrane oxygenation. The most used antivirals were ribavirin (67.3%; CI95: 63.4-70.9), oseltamivir (52.5%; CI95: 49.4-55.5) and Arbidol™ (34.5%; CI95: 32-37.1). General admittance to the intensive care unit was ~7.2% (CI95: 6.5-7.9) of patients.

Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study

“…In addition to exposing the flaws in our international health systems, the COVID-19 pandemic has brought to light the already-existing inequalities across different social groups. During this crisis, vulnerable populations—defined by variables including socio-economic position, race, and access to healthcare—have been disproportionately affected [ 2 , 3 , 4 ]. Research consistently highlights the heightened vulnerability of certain populations to severe outcomes from COVID-19.…”

“…It can cause a wide range of symptoms, from mild respiratory illness to severe pneumonia, acute respiratory distress syndrome (ARDS), and death. Vulnerable populations, including the elderly and individuals with underlying health conditions, are at a higher risk of severe disease and mortality [ 2 , 3 , 4 , 5 ].…”

Validation of the T-Lymphocyte Subset Index (TLSI) as a Score to Predict Mortality in Unvaccinated Hospitalized COVID-19 Patients

“…The present study confirmed these results, showing an association between the alteration of these laboratory parameters and higher mortality. Lymphopenia has been consistently reported as a peculiar finding in SARS-CoV-2 infection, even in non-severe patients, although the most marked reduction has been observed in severe patients and non-survivors [ 5 , 19 ]. The reason for this profound lymphopenia in severe COVID-19 patients is still not fully understood.…”

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

“…The identification of high-risk patients and the proper allocation of healthcare resources during the pandemic may be carried out with the use of laboratory data, which have the potential to be utilized as early indicators to enhance the management of COVID-19 patients. Numerous proinflammatory cytokines, including c-reactive protein (CRP), lactate dehydrogenase (LDH), aspartate transaminase (AST), neutrophil count, neutrophils-tolymphocytes ratio (NLR), troponins (Tn s), creatine kinase (CK), D-dimers, and brain natriuretic peptide (BNP), are among the most often utilized COVID-19 indicators (Figure 1) [2,[9][10][11][12]. The present paper is a narrative review focusing on laboratory findings in COVID-19 patients from Romania.…”