Laboratory markers and radiological signs of mild versus severe COVID-19 patients

Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients

Comparison of GOLD classification and modified BODE index as staging systems of COPD

Objective: To compare GOLD classification of COPD versus the modified BODE index as staging systems of COPD. Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation. The degree of airflow limitation was poorly predictive of dyspnea and quality of life. The BODE index was the first multidimensional assessment system for COPD. Cardiopulmonary exercise testing (CPET) is the most comprehensive, and correlates best with the symptoms of COPD. In this regard, two novel mBODE indices were constructed by replacing 6MWT with V̇O2 peak expressed either as the percentage of predicted values (mBODE%) or as the absolute values in ml/min/kg (mBODE). Methods: This study included 28 patients with a wide range of severities of COPD. Cardiopulmonary exercise test and pulmonary functions were done. GOLD spirometric staging and combined assessment grouping were calculated then compared with the two mBODE indices. Results: Moderate agreement between the GOLD combined assessment grouping and GOLD spirometric staging systems and between mBODE and mBODE% in stratifying severity of COPD patients was observed. Evaluation of mBODE index as predictors of severity of COPD using GOLD spirometric staging as a diagnostic predictor of COPD revealed that mBODE index was 100% sensitive. However, 59.1% and 72.2% specificity were found for mBODE V̇O2ml/min/kg and mBODE V̇O2% predicted, respectively. Conclusion: Multidimensional staging system taking into account the exercise pulmonary function tests is better than unidimensional systems based on the resting pulmonary function tests only. Therefore this suggests the need for integration of the novel multidimensional approach in the diagnostic guidelines of COPD