AB0709 CHARACTERIZATION of Nailfold Capillaroscopy in COVID-19: A Case Control Study (original) (raw)
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Rheumatology (Bulgaria)
The infectious disease COVID-19, caused by the SARS-CoV-2 virus, is characterized by a wide range of clinical manifestations (pulmonary and extrapulmonary) and in some cases with post-infectious manifestations in persons who survived the infection. The vascular tropism of SARS-CoV-2 is the basis for the interest in using nailfold capillaroscopy to assess the microcirculation in children and adults who have recovered from COVID-19. Most often, non-specific changes are observed, without certain manifestations of microangiopathy and without a specific combination of microvascular findings, on the basis of which to define a specific capillaroscopic picture of the "COVID - 19" type. The possibility that capillaroscopy in combination with other findings can be used for personalized approach and determination of prognosis in patients with post-COVID syndrome needs further studies.
Clinical Chemistry and Laboratory Medicine (CCLM)
The timely and accurate diagnosis of infection with severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), remains the cornerstone of efforts to provide appropriated treatment for patients, to limit further spread of the virus and ultimately to eliminate the virus from the human society. We focus this article on (a) developments for improvement of diagnosis of specific SARS-CoV-2 virus, (b) laboratory changes in the immunologic and coagulation system, (c) therapeutic options for anticoagulant treatment of seriously affected patients and (d) on the perspectives through improvement of diagnostic and therapeutic medical procedures.
Self-sampling of capillary blood for SARS-CoV-2 serology
Scientific Reports, 2021
Serological testing is emerging as a powerful tool to progress our understanding of COVID-19 exposure, transmission and immune response. Large-scale testing is limited by the need for in-person blood collection by staff trained in venepuncture, and the limited sensitivity of lateral flow tests. Capillary blood self-sampling and postage to laboratories for analysis could provide a reliable alternative. Two-hundred and nine matched venous and capillary blood samples were obtained from thirty nine participants and analysed using a COVID-19 IgG ELISA to detect antibodies against SARS-CoV-2. Thirty eight out of thirty nine participants were able to self-collect an adequate sample of capillary blood (≥ 50 µl). Using plasma from venous blood collected in lithium heparin as the reference standard, matched capillary blood samples, collected in lithium heparin-treated tubes and on filter paper as dried blood spots, achieved a Cohen’s kappa coefficient of > 0.88 (near-perfect agreement, 95%...
Coagulopathy in SARS-CoV-2 Infected Patients: Implication for the Management of COVID-19
Journal of Blood Medicine, 2021
COVID-19 disease has led to an extraordinary inclusive health crisis globally. Elevation of D-dimer is the major remarkable abnormal coagulation test in seriously ill COVID-19 patients. In nearly 50% of COVID-19 patients, the value of D-dimer was significantly enhancing. Recent literature indicated that COVID-19 patients were at higher risk of developing disseminated intravascular coagulation. Pro-inflammatory cytokines and chemokines are some of the factors leading to these conditions. The majority of COVID-19 patients showed a higher profile of pro-inflammatory cytokines and chemokines in severe clinical conditions. Tumor necrosis factor-α (TNF-α) and interleukins (ILs) elevated in COVID-19 infected patients. TNF-α, IL-6, and IL-1 are major cytokines vital for the inhibition of intrinsic anticoagulant pathways. COVID-19 becomes a higher complication with a significant effect on blood cell production and hemostasis cascades. Deep vein thrombosis and arterial thrombosis are common c...
2020
Background: The number of COVID-19 patients is exponentially increasing worldwide since December, 2019. Management in intensive care units (ICU) has become a major challenge; therefore, time demanding laboratory markers for early recognition of morbid forms is utmost important for timely triaging of patients. Objective: The present study aimed to evaluate the role of haemotological and Coagulation profile in the assessment of disease severity of COVID-19. Methods: The current study is an observational study done prospectively in Armed Forces Institute of Pathology (AFIP) during the period of 28 March 2020 to 15 May 2020. The study subjects were haematological and coagulation profile data of 100 COVID-19 patients grouped in non-ICU and ICU at the baseline and at 4th day of admission in Combined Military Hospital (CMH), Dhaka. All the data were recorded and analyzed by SPSS 20.0 programme. Results: Here subjects with featured of lymphopenia were detected prominently in our COVID-19 IC...
International Journal of Laboratory Hematology, 2021
IntroductionCoronavirus disease 2019 (COVID‐19) caused by SARS‐CoV2 can present from mild flu‐like symptoms to acute respiratory distress syndrome. There is multi‐organ involvement; particularly, hematopoietic system can be associated with morphological changes in blood cells of COVID‐19 patients.MethodWe conducted a cross‐sectional study on a cohort of 50 COVID‐19 patients, confirmed on RT‐PCR with documented cycle threshold (Ct) value. Peripheral blood sample of these patients was collected and examined for complete blood counts (CBC) on automated haematological analyser as well as Leishman‐stained blood smears to look for morphological changes in blood cells. Morphological changes were evaluated with reference to clinical severity and Ct value. Additionally, association between Ct value and clinical severity was also performed. Statistical tests were performed, and P value <.05 was considered significant.ResultsMean age of our study group was 42.16 ± 15.55 years, with male pre...
Arteriosclerosis, Thrombosis, and Vascular Biology
The world is amid a pandemic caused by severe acute respiratory syndrome-coronavirus 2. Severe acute respiratory syndrome-coronavirus causes serious respiratory tract infections that can lead to viral pneumonia, acute respiratory distress syndrome, and death. Some patients with coronavirus disease 2019 (COVID-19) have an activated coagulation system characterized by elevated plasma levels of d -dimer—a biomarker of fibrin degradation. Importantly, high levels of D -dimer on hospital admission are associated with increased risk of mortality. Venous thromboembolism is more common than arterial thromboembolism in hospitalized COVID-19 patients. Pulmonary thrombosis and microvascular thrombosis are observed in autopsy studies, and this may contribute to the severe hypoxia observed in COVID-19 patients. It is likely that multiple systems contribute to thrombosis in COVID-19 patients, such as activation of coagulation, platelet activation, hypofibrinolysis, endothelial cell dysfunction, i...
COVID-19: the key role of pulmonary capillary leakage. An observational cohort study
Background: COVID-19 induces progressive hypoxemic respiratory failure and acute respiratory distress syndrome, mostly due to a dysregulated inflammatory response. Since the first observations of COVID-19 patients, significant hypoalbuminemia was detected. This study aimed to investigate the hypothesis that hypoalbuminemia in COVID-19 patients is due to pulmonary capillary leakage and to test its correlation with indicators of respiratory function. Methods: 174 COVID-19 patients, 92 admitted to the Intermediate Medicine ward (IMW), and 82 to the Intensive Care Unit (ICU) at Luigi Sacco Hospital in Milan were included in this study. Findings: Serum albumin concentration was decreased in the whole cohort, with ICU patients displaying lower values than IMW patients [20 (18-23) vs 28 (24-33) g/L, p<0.0001]. Lower albumin values were found in patients belonging to a more compromised group (lower PaO2 to FiO2 ratio and worst chest X-ray findings). In a subset of 26 patients, analysis o...
A comprehensive review of vascular complications in COVID-19
Journal of Thrombosis and Thrombolysis, 2021
This study aims to review the available literature pertinent to vascular complications in COVID-19. A systematic search was performed using PubMed and Google Scholar to identify all relevant studies based on our study objective. Multiple studies have reported widespread systemic inflammation and procoagulant/hypercoagulable state in COVID-19, including thrombotic microangiopathy, endothelial dysfunction, bleeding disorder, and thrombosis. However, large specialised studies on vascular complications are lacking despite current evidence indicating dysfunctional coagulation pathways. Furthermore, there are no clear and definitive recommendations regarding thromboprophylaxis or full therapeutic anticoagulation in COVID-19. Several studies have reported hypercoagulability and vascular complications as important predictors of patient outcome in COVID-19. Therefore, it is important to understand the pathogenesis, epidemiology, management, and outcomes of patients who develop venous or arterial thrombosis and those with a pre-existing thrombotic disease who contract COVID-19 for risk stratification, thromboprophylaxis, optimal antithrombotic therapy during active infection and long-term anticoagulation following discharge or recovery. Keywords COVID-19 • Vascular complications • Blood coagulation disorders, review Highlights • SARS-CoV-2 induces proinflammatory cytokines and/ or procoagulant factors that could activate coagulation cascades, leading to thrombosis, atherosclerotic plaque rupture, and ischemia. • Noting changes in coagulation profile in critically ill COVID-19 patients are of utmost importance, as studies have shown that hypercoagulability and vascular complications are important predictors of optimal patient outcomes. • Despite current evidence indicating dysfunctional coagulation pathways, specific studies concerning vascular complications in COVID-19 are lacking. • It is crucial to have large-scale multicentre studies to establish and ascertain the vascular complications in COVID-19 and formulate management strategies.
Osong Public Health and Research Perspectives
This review compared coronavirus disease 2019 (COVID-19) laboratory findings, comorbidities, and clinical outcomes in patients from the general population versus medical staff to aid diagnosis of COVID-19 in a more timely, efficient, and accurate way. Electronic databases were searched up to 23 rd March, 2020. The initial search yielded 6,527 studies. Following screening, 24 studies were included [18 studies (11,564 cases) of confirmed COVID-19 cases in the general public, and 6 studies (394 cases) in medical staff] in this review. Significant differences were observed in white blood cell counts (p < 0.001), lymphocyte counts (p < 0.001), platelet counts (p = 0.04), procalcitonin levels (p < 0.001), lactate dehydrogenase levels (p < 0.001), and creatinine levels (p = 0.03) when comparing infected medical staff with the general public. The mortality rate was higher in the general population than in medical staff (8% versus 2%). This review showed that during the early stages of COVID-19, laboratory findings alone may not be significant predictors of infection and may just accompany increasing C-reactive protein levels, erythrocyte sedimentation rates, and lactate dehydrogenase levels. In the symptomatic stage, the lymphocyte and platelet counts tended to decrease. Elevated D-dimer fibrin degradation product was associated with poor prognosis.