Incidence, risk factors, clinical characteristics and outcomes of deep venous thrombosis in patients with COVID-19 attending the Emergency Department: results of the UMC-19-S8

Background and importance: A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19. Objective: We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization. Methods: We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls. Results: We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50‰; 95% confidence interval (CI), 1.23-1.80‰]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52‰; 95% CI, 1.45-1.69‰; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03-2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77-2.45). Conclusions: DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis

IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study

Background: Patients with coronavirus disaese 2019 (COVID-19) can develop a cytokine release syndrome that eventually leads to acute respiratory distress syndrome requiring invasive mechanical ventilation (IMV). Because IL-6 is a relevant cytokine in acute respiratory distress syndrome, the blockade of its receptor with tocilizumab (TCZ) could reduce mortality and/or morbidity in severe COVID-19. Objective: We sought to determine whether baseline IL-6 serum levels can predict the need for IMV and the response to TCZ. Methods: A retrospective observational study was performed in hospitalized patients diagnosed with COVID-19. Clinical information and laboratory findings, including IL-6 levels, were collected approximately 3 and 9 days after admission to be matched with preadministration and postadministration of TCZ. Multivariable logistic and linear regressions and survival analysis were performed depending on outcomes: need for IMV, evolution of arterial oxygen tension/fraction of inspired oxygen ratio, or mortality. Results: One hundred forty-six patients were studied, predominantly males (66%); median age was 63 years. Forty-four patients (30%) required IMV, and 58 patients (40%) received treatment with TCZ. IL-6 levels greater than 30 pg/mL was the best predictor for IMV (odds ratio, 7.1; P < .001). Early administration of TCZ was associated with improvement in oxygenation (arterial oxygen tension/fraction of inspired oxygen ratio) in patients with high IL-6 (P = .048). Patients with high IL-6 not treated with TCZ showed high mortality (hazard ratio, 4.6; P = .003), as well as those with low IL-6 treated with TCZ (hazard ratio, 3.6; P = .016). No relevant serious adverse events were observed in TCZ-treated patients. Conclusions: Baseline IL-6 greater than 30 pg/mL predicts IMV requirement in patients with COVID-19 and contributes to establish an adequate indication for TCZ administrationThis study was funded by Spanish Ministry of Economy, Industry and Competitiveness (MINECO) and Instituto de Salud Carlos III (grant nos. RD16/0011/0012 and PI18/ 0371 to I.G.A., grant no. PI19/00549 to A.A., and grant no. SAF2017-82886-R to F.S.-M.) and co-funded by the European Regional Development Fund. The study was also funded by ‘‘La Caixa Banking Foundation’’ (grant no. HR17-00016 to F.S.-M.) and ‘‘Fondos Supera COVID19’’ by Banco de Santander and CRUE. None of these sponsors have had any role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publicatio

Observation of Several Sources of CPCP Violation in B+→π+π+π−B^+ \to \pi^+ \pi^+ \pi^- Decays

International audienceObservations are reported of different sources of CP violation from an amplitude analysis of B+→π+π+π- decays, based on a data sample corresponding to an integrated luminosity of 3  fb-1 of pp collisions recorded with the LHCb detector. A large CP asymmetry is observed in the decay amplitude involving the tensor f2(1270) resonance, and in addition significant CP violation is found in the π+π-S wave at low invariant mass. The presence of CP violation related to interference between the π+π-S wave and the P wave B+→ρ(770)0π+ amplitude is also established; this causes large local asymmetries but cancels when integrated over the phase space of the decay. The results provide both qualitative and quantitative new insights into CP -violation effects in hadronic B decays

Evidence of a J/ψΛJ/\psi\Lambda structure and observation of excited Ξ−\Xi^- states in the Ξb−→J/ψΛK−\Xi^-_b \to J/\psi\Lambda K^- decay

First evidence of a structure in the $J/\psi{\Lambda}$ invariant mass distribution is obtained from an amplitude analysis of $\Xi_b^-{\rightarrow}J/\psi{\Lambda}K^-$ decays. The observed structure is consistent with being due to a charmonium pentaquark with strangeness with a significance of $3.1\sigma$ including systematic uncertainties and look-elsewhere effect. Its mass and width are determined to be $4458.8\pm2.9^{+4.7}_{-1.1}$ MeV and $17.3\pm6.5^{+8.0}_{-5.7}$ MeV, respectively, where the quoted uncertainties are statistical and systematic. The structure is also consistent with being due to two resonances. In addition, the narrow excited $\Xi^-$ states, $\Xi(1690)^-$ and $\Xi(1820)^-$, are seen for the first time in a $\Xi^-_b$ decay, and their masses and widths are measured with improved precision. The analysis is performed using $pp$ collision data corresponding to a total integrated luminosity of 9 fb$^{-1}$, collected with the LHCb experiment at centre-of-mass energies of 7, 8 and 13 TeV

Amplitude analysis of the B+→π+π+π−B^+ \rightarrow \pi^+\pi^+\pi^- decay

International audienceThe results of an amplitude analysis of the charmless three-body decay B+→π+π+π-, in which CP-violation effects are taken into account, are reported. The analysis is based on a data sample corresponding to an integrated luminosity of 3  fb-1 of pp collisions recorded with the LHCb detector. The most challenging aspect of the analysis is the description of the behavior of the π+π-  S-wave contribution, which is achieved by using three complementary approaches based on the isobar model, the K-matrix formalism, and a quasi-model-independent procedure. Additional resonant contributions for all three methods are described using a common isobar model, and include the ρ(770)0, ω(782) and ρ(1450)0 resonances in the π+π- P-wave, the f2(1270) resonance in the π+π- D-wave, and the ρ3(1690)0 resonance in the π+π- F-wave. Significant CP-violation effects are observed in both S- and D-waves, as well as in the interference between the S- and P-waves. The results from all three approaches agree and provide new insight into the dynamics and the origin of CP-violation effects in B+→π+π+π- decays

Test of lepton universality with Λb0→pK−ℓ+ℓ− {\Lambda}_b^0\to {pK}^{-}{\mathrm{\ell}}^{+}{\mathrm{\ell}}^{-} decays

International audienceThe ratio of branching fractions of the decays ${\Lambda}_b^0$ → pK$^{−}$e$^{+}$e$^{−}$ and ${\Lambda}_b^0$ → pK$^{−}$μ$^{+}$μ$^{−}$,${R}_{pK}^{-1}$, is measured for the first time using proton-proton collision data corresponding to an integrated luminosity of 4.7 fb$^{−1}$ recorded with the LHCb experiment at center-of-mass energies of 7, 8 and 13 TeV. In the dilepton mass-squared range 0.1 < q$^{2}$< 6.0 GeV$^{2}$/c$^{4}$ and the pK$^{−}$ mass range m(pK$^{−}$) < 2600 MeV/c$^{2}$, the ratio of branching fractions is measured to be ${R}_{pK}^{-1}={1.17}_{-0.16}^{+0.18}\pm 0.07$, where the first uncertainty is statistical and the second systematic. This is the first test of lepton universality with b baryons and the first observation of the decay ${\Lambda}_b^0$ → pK$^{−}$e$^{+}$e$^{−}$.[graphic not available: see fulltext

Measurement of the Λb0→J/ψΛ\Lambda^0_b\rightarrow J/\psi\Lambda angular distribution and the Λb0\Lambda^0_b polarisation in pppp collisions

International audienceThis paper presents an analysis of the ${\Lambda}_b^0$→ J/ψΛ angular distribution and the transverse production polarisation of ${\Lambda}_b^0$ baryons in proton-proton collisions at centre-of-mass energies of 7, 8 and 13 TeV. The measurements are performed using data corresponding to an integrated luminosity of 4.9 fb$^{−1}$, collected with the LHCb experiment. The polarisation is determined in a fiducial region of ${\Lambda}_b^0$ transverse momentum and pseudorapidity of 1 < p$_{T}$< 20 GeV/c and 2 < η < 5, respectively. The data are consistent with ${\Lambda}_b^0$ baryons being produced unpolarised in this region. The parity-violating asymmetry parameter of the Λ → pπ$^{−}$ decay is also determined from the data and its value is found to be consistent with a recent measurement by the BES III collaboration.[graphic not available: see fulltext

First observation of excited Ωb−\Omega_b^- states

International audienceWe report four narrow peaks in the Ξb0K- mass spectrum obtained using pp collisions at center-of-mass energies of 7, 8, and 13 TeV, corresponding to a total integrated luminosity of 9  fb-1 recorded by the LHCb experiment. Referring to these states by their mass, the mass values are m[Ωb(6316)-]=6315.64±0.31±0.07±0.50  MeV, m[Ωb(6330)-]=6330.30±0.28±0.07±0.50  MeV, m[Ωb(6340)-]=6339.71±0.26±0.05±0.50  MeV, m[Ωb(6350)-]=6349.88±0.35±0.05±0.50  MeV, where the uncertainties are statistical, systematic, and the last is due to the knowledge of the Ξb0 mass. The natural widths of the three lower mass states are consistent with zero, and the 90% confidence-level upper limits are determined to be Γ[Ωb(6316)-]<2.8  MeV, Γ[Ωb(6330)-]<3.1  MeV and Γ[Ωb(6340)-]<1.5  MeV. The natural width of the Ωb(6350)- peak is 1.4-0.8+1.0±0.1  MeV, which is 2.5σ from zero and corresponds to an upper limit of 2.8 MeV. The peaks have local significances ranging from 3.6σ to 7.2σ. After accounting for the look-elsewhere effect, the significances of the Ωb(6316)- and Ωb(6330)- peaks are reduced to 2.1σ and 2.6σ, respectively, while the two higher mass peaks exceed 5σ. The observed peaks are consistent with expectations for excited Ωb- resonances

Isospin amplitudes in Λb0→J/ψΛ(Σ0)\Lambda_b^0\to J/\psi \Lambda(\Sigma^0) and Ξb0→J/ψΞ0(Λ)\Xi_b^0\to J/\psi \Xi^0(\Lambda) decays

International audienceRatios of isospin amplitudes in hadron decays are a useful probe of the interplay between weak and strong interactions and allow searches for physics beyond the standard model. We present the first results on isospin amplitudes in b-baryon decays, using data corresponding to an integrated luminosity of 8.5  fb-1, collected with the LHCb detector in pp collisions at center of mass energies of 7, 8, and 13 TeV. The isospin amplitude ratio |A1(Λb0→J/ψΣ0)/A0(Λb0→J/ψΛ)|, where the subscript on A indicates the final-state isospin, is measured to be less than 1/21.8 at 95% confidence level. The Cabibbo suppressed Ξb0→J/ψΛ decay is observed for the first time, allowing for the measurement |A0(Ξb0→J/ψΛ)/A1/2(Ξb0→J/ψΞ0)|=0.37±0.06±0.02, where the uncertainties are statistical and systematic, respectively