Evaluation of the Roche® Elecsys and the Diasorin® Liaison S100 kits in the management of mild head injury in the emergency room

Introduction: The aim of this single-center prospective study is to compare two commercially available S100 beta kits (the Roche (R) Elecsys and the Diasorin (R) Liaison S100 kits) in terms of analytical and clinical performances in a population admitted in the emergency room for mild traumatic brain injury (mTBI). Material and method: 110 patients were enrolled from September 2014 to May 2015. Blood sample draws were performed within 3 h after head trauma and the study population was split into pediatric and adult sub-populations (> 18 years of age). Results: Although both kits correlated well, we observed a significant difference in terms of S100 beta levels (P value < 0.05) in both subpopulations. In the pediatric subpopulation, both kits showed elevated S100 beta levels for the only patient (3.5%) who displayed abnormal findings on a CT-scan. However, we observed a poor agreement between both kits (Cohen's kappa = 0.345, P value = 0.077). In the adult subpopulation, a total of 10 patients (12.2%) had abnormal head computed tomography scans. Using the Roche (R) (cut off = 0.1 mu g/L) and the Diasorin (R) (cut off = 0.15 mu g/L) S100 beta kits, brain injuries were detected with a sensitivity of 100% (95% CI: 65-100%) and 100% (95% CI: 63-100%) and a specificity of 15.28% (95% CI: 7.9-25.7%) and 24.64% (95% CI: 15-36.5) respectively. Finally, a moderate agreement was concluded between both kits (Cohen's kappa = 0.569, P value = 0.001). Conclusion: Although a good correlation could be found between both kits, emergency physicians should be aware of discrepancies observed between both methods, making those immunoassays not interchangeable. Furthermore, more studies are still needed to validate cut off used according to technique and to age, especially in the population below the age of 2 years

Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants

Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across&nbsp;various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use&nbsp;of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19&nbsp;hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group)&nbsp;were compared with patients treated with supportive care only (no-HCQ group) using a competing risks&nbsp;proportional hazards regression with discharge alive as competing risk, adjusted for demographic and&nbsp;clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May&nbsp;2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the&nbsp;multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard&nbsp;ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617–0.758]. Compared with the no-HCQ group,&nbsp;mortality in the HCQ group was reduced both in patients diagnosed ≤5 days ( n = 3975) and &gt; 5 days ( n =&nbsp;3487) after symptom onset [aHR = 0.701 (95% CI 0.617–0.796) and aHR = 0.647 (95% CI 0.525–0.797),&nbsp;respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently&nbsp;associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later&nbsp;after symptom&nbsp;onset.</p

Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants

Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617-0.758]. Compared with the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ≤5 days (n = 3975) and >5 days (n = 3487) after symptom onset [aHR = 0.701 (95% CI 0.617-0.796) and aHR = 0.647 (95% CI 0.525-0.797), respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after symptom onset.status: publishe