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Diagnostics
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Diagnosis and Management in COVID-19 Patient
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Diagnosis and Management in COVID-19 Patient

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 10310

Special Issue Editor

Dr. Marilena Minieri

E-Mail Website
Guest Editor
Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
Interests: COVID-19; laboratory biomarkers; risk stratification.

Special Issue Information

Dear Colleagues,

Over the past three years, COVID-19, the disease caused by SARS-CoV-2, has resulted an estimated 5 million deaths and 257 million cases worldwide. COVID-19 has significantly affected people lives, directly and/or indirectly, due to a virulent pathogen that continues to evolve while we are still learning how to prevent and control the disease. 

The aim of this Special Issue will be focused on the latest approaches to the diagnostics and therapy of COVID-19 by summarizing the recent clinical and experimental advances on conventional therapies, such as antiviral drugs, vaccines, anti-SARS-CoV-2 antibody treatments, and on the diagnostics of laboratory using new biomarkers useful for both the diagnosis and prognosis of COVID-19. All of these different approaches are currently the subject of extensive research and clinical trials.

Dr. Marilena Minieri
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19 clinical setting
  • diagnosis
  • biomarkers
  • antigenic tests
  • molecular tests
  • anti-SARS-CoV-2 antibody
  • pneumonia
  • endothelial dysfunction
  • therapy
  • diagnostic tools
  • emergency department
  • intensive care management
  • infection management

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Published Papers (6 papers)

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13 pages, 608 KiB  
Article
Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department
by Cartesio D’Agostini, Jacopo M. Legramante, Marilena Minieri, Vito N. Di Lecce, Maria Stella Lia, Massimo Maurici, Ilaria Simonelli, Marco Ciotti, Carla Paganelli, Alessandro Terrinoni, Alfredo Giovannelli, Massimo Pieri, Mariacarla Gallù, Vito Dell’Olio, Carla Prezioso, Dolores Limongi, Sergio Bernardini and Antonio Orlacchio
Diagnostics 2023, 13(17), 2829; https://doi.org/10.3390/diagnostics13172829 - 31 Aug 2023
Cited by 2 | Viewed by 1077
Abstract
Background: It has been reported that mid-regional proadrenomedullin (MR-proADM) could be considered a useful tool to stratify the mortality risk in COVID-19 patients upon admission to the emergency department (ED). During the COVID-19 outbreak, computed tomography (CT) scans were widely used for their [...] Read more.
Background: It has been reported that mid-regional proadrenomedullin (MR-proADM) could be considered a useful tool to stratify the mortality risk in COVID-19 patients upon admission to the emergency department (ED). During the COVID-19 outbreak, computed tomography (CT) scans were widely used for their excellent sensitivity in diagnosing pneumonia associated with SARS-CoV-2 infection. However, the possible role of CT score in the risk stratification of COVID-19 patients upon admission to the ED is still unclear. Aim: The main objective of this study was to assess if the association of the CT findings alone or together with MR-proADM results could ameliorate the prediction of in-hospital mortality of COVID-19 patients at the triage. Moreover, the hypothesis that CT score and MR-proADM levels together could play a key role in predicting the correct clinical setting for these patients was also evaluated. Methods: Epidemiological, demographic, clinical, laboratory, and outcome data were assessed and analyzed from 265 consecutive patients admitted to the triage of the ED with a SARS-CoV-2 infection. Results and conclusions: The accuracy results by AUROC analysis and statistical analysis demonstrated that CT score is particularly effective, when utilized together with the MR-proADM level, in the risk stratification of COVID-19 patients admitted to the ED, thus helping the decision-making process of emergency physicians and optimizing the hospital resources. Full article
(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)
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11 pages, 447 KiB  
Article
The Predictive Value of Risk Factors and Prognostic Scores in Hospitalized COVID-19 Patients
by Milica Brajkovic, Miodrag Vukcevic, Sofija Nikolic, Marija Dukic, Marija Brankovic, Ana Sekulic, Viseslav Popadic, Mihailo Stjepanovic, Aleksandra Radojevic, Ljiljana Markovic-Denic, Nina Rajovic, Natasa Milic, Srdjan Tanasilovic, Zoran Todorovic and Marija Zdravkovic
Diagnostics 2023, 13(16), 2653; https://doi.org/10.3390/diagnostics13162653 - 11 Aug 2023
Cited by 3 | Viewed by 1123
Abstract
Introduction: Risk stratification in patients with COVID-19 is a challenging task. Early warning scores (EWSs) are commonly used tools in the initial assessment of critical patients. However, their utility in patients with COVID-19 is still undetermined. Aim: This study aimed to discover the [...] Read more.
Introduction: Risk stratification in patients with COVID-19 is a challenging task. Early warning scores (EWSs) are commonly used tools in the initial assessment of critical patients. However, their utility in patients with COVID-19 is still undetermined. Aim: This study aimed to discover the most valuable predictive model among existing EWSs for ICU admissions and mortality in COVID-19 patients. Materials and methods: This was a single-center cohort study that included 3608 COVID-19 patients admitted to the University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia, between 23 June 2020, and 14 April 2021. Various demographic, laboratory, and clinical data were collected to calculate several EWSs and determine their efficacy. For all 3608 patients, five EWSs were calculated (MEWS, NEWS, NEWS2, REMS, and qSOFA). Model discrimination performance was tested using sensitivity, specificity, and positive and negative predictive values. C statistic, representing the area under the receiver operating characteristic (ROC) curve, was used for the overall assessment of the predictive model. Results: Among the evaluated prediction scores for 3068 patients with COVID-19, REMS demonstrated the highest diagnostic performance with the sensitivity, PPV, specificity, and NPV of 72.1%, 20.6%, 74.9%, and 96.8%, respectively. In the multivariate logistic regression analysis, aside from REMS, age (p < 0.001), higher CT score (p < 0.001), higher values of urea (p < 0.001), and the presence of bacterial superinfection (p < 0.001) were significant predictors of mortality. Conclusions: Among all evaluated EWSs to predict mortality and ICU admission in COVID-19 patients, the REMS score demonstrated the highest efficacy. Full article
(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)
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12 pages, 695 KiB  
Article
Effects of SARS-CoV-2 on Pulmonary Function and Muscle Strength Testing in Military Subjects According to the Period of Infection: Cross-Sectional Study
by Josuel Ora, Paola Rogliani, Federica Ferron, Marilisa Vignuoli, Letizia Valentino, Giancarlo Pontoni, Francesca Di Ciuccio, Roberto Ferrara and Tommaso Sciarra
Diagnostics 2023, 13(10), 1679; https://doi.org/10.3390/diagnostics13101679 - 9 May 2023
Cited by 1 | Viewed by 1581
Abstract
Background: Pulmonary function can be impaired as a long-term consequence of SARS-CoV-2 infection. The aim of this study was to evaluate the effect of SARS-CoV-2 infection on pulmonary function, exercise tolerance, and muscle strength in healthy middle-aged military outpatients according during the period [...] Read more.
Background: Pulmonary function can be impaired as a long-term consequence of SARS-CoV-2 infection. The aim of this study was to evaluate the effect of SARS-CoV-2 infection on pulmonary function, exercise tolerance, and muscle strength in healthy middle-aged military outpatients according during the period of infection. Methods: A cross-sectional study was carried out from March 2020 to November 2022 at the Military Hospital “Celio” (Rome, Italy). If someone had a diagnosis of SARS-CoV-2 infection certified by molecular nasal swab and if they performed pulmonary function tests, diffusion of carbon monoxide (DL’co), a six Minute Walk Test (6MWT), a Handgrip (HG) Test, and a One Minute Sit to Stand Test (1′STST). The included subjects were divided into two groups, A and B, according to the period of infection: A) from March 2020 to August 2021 and B) from September 2021 to October 2022. Results: One hundred fifty-three subjects were included in the study: 79 in Group A and 74 in Group B. Although the values were within the normal range, Group A had smaller FVC, FEV1, and DL’co compared to Group B. Group A also walked a shorter distance at the 6MWT and performed fewer repetitions in the 1′STS test compared to Group B. In both groups, the DL’co (%predicted) correlated with the 6MWT distance (R2 = 0.107, p < 0.001), the number of repetitions of the 1′STST (R2 = 0.086, p = 0.001), and the strength at the HG test (R2 = 0.08, p < 0.001). Conclusions: This study shows that the SARS-CoV-2 infection in healthy middle-aged military outpatients was more severe in the first waves than in the later ones and that, in healthy and physically fit individuals, even a marginal reduction in resting respiratory test values can have a major impact on exercise tolerance and muscles strength. Moreover, it shows that those infected more recently had symptoms related to the upper respiratory tract infection compared to those of the first waves. Full article
(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)
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10 pages, 515 KiB  
Article
Blood Type Associated with the Risk of COVID-19 Infection in Pregnant Women
by Rosalba Sevilla-Montoya, Addy C. Helguera-Reppeto, Irma E. Monroy-Muñoz, Tania A. Vargas-Pavia, Elías I. Valdés-Montoya, Mario Solis-Paredes, Johnatan Torres-Torres, Rafael Velazquez-Cruz, José Esteban Muñoz-Medina, Claudia Martinez-Cordero and Alberto Hidalgo-Bravo
Diagnostics 2023, 13(7), 1338; https://doi.org/10.3390/diagnostics13071338 - 4 Apr 2023
Cited by 1 | Viewed by 2013
Abstract
COVID-19 forced us to investigate risk factors to provide the best medical attention, especially in vulnerable groups, such as pregnant patients. Studies in other populations have analyzed blood groups in relation to infection, complications, and death. The present study aimed to analyze the [...] Read more.
COVID-19 forced us to investigate risk factors to provide the best medical attention, especially in vulnerable groups, such as pregnant patients. Studies in other populations have analyzed blood groups in relation to infection, complications, and death. The present study aimed to analyze the association of blood groups with the risk of infection and complications in pregnant women and newborns from the Mexican-Mestizo population. We studied 1906 individuals. Quantitative variables were analyzed through the Student’s t-test. Categorical variables were analyzed through Pearson’s chi-square test, and logistic regression was used to analyze the association between categorical variables and outcomes. No significant association was observed between blood groups and infection risk. Individuals with the AB blood type are at higher risk for developing severe disease, although blood groups do not seem to be involved in the risk of SARS-CoV-2 infection. However, the AB blood group could be considered a risk factor for developing severe COVID-19 in the Mexican population. Full article
(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)
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10 pages, 929 KiB  
Article
Neutralizing Antibodies against SARS-CoV-2 Beta and Omicron Variants Inhibition Comparison after BNT162b2 mRNA Booster Doses with a New PETIA sVNT Assay
by Marta Fogolari, Bruno Daniele Leoni, Marina De Cesaris, Rita Italiano, Flavio Davini, Ginevra Azzurra Miccoli, Daniele Donati, Luigi Clerico, Andrea Stanziale, Giovanni Savini, Nicola Petrosillo, Massimo Ciccozzi, Lorenzo Sommella, Elisabetta Riva, Paolo Fazii and Silvia Angeletti
Diagnostics 2023, 13(5), 889; https://doi.org/10.3390/diagnostics13050889 - 26 Feb 2023
Cited by 1 | Viewed by 1852
Abstract
Background: Monitoring antibody response following SARS-CoV-2 vaccination is strategic, and neutralizing antibodies represent the gold standard. The neutralizing response to Beta and Omicron VOCs was evaluated versus the gold standard by a new commercial automated assay. Methods: Serum samples from 100 healthcare workers [...] Read more.
Background: Monitoring antibody response following SARS-CoV-2 vaccination is strategic, and neutralizing antibodies represent the gold standard. The neutralizing response to Beta and Omicron VOCs was evaluated versus the gold standard by a new commercial automated assay. Methods: Serum samples from 100 healthcare workers from the Fondazione Policlinico Universitario Campus Biomedico and the Pescara Hospital were collected. IgG levels were determined by chemiluminescent immunoassay (Abbott Laboratories, Wiesbaden, Germany) and serum neutralization assay as the gold standard. Moreover, a new commercial immunoassay, the PETIA test Nab (SGM, Rome, Italy), was used for neutralization evaluation. Statistical analysis was performed with R software, version 3.6.0. Results: Anti-SARS-CoV-2 IgG titers decayed during the first ninety days after the vaccine second dose. The following booster dose significantly (p < 0.001) increased IgG levels. A correlation between IgG expression and neutralizing activity modulation was found with a significant increase after the second and the third booster dose (p < 0.05. Compared to the Beta variant of the virus, the Omicron VOC was associated with a significantly larger quantity of IgG antibodies needed to achieve the same degree of neutralization. The best Nab test cutoff for high neutralization titer (≥1:80) was set for both Beta and Omicron variants. Conclusion: This study correlates vaccine-induced IgG expression and neutralizing activity using a new PETIA assay, suggesting its usefulness for SARS-CoV2 infection management. Full article
(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)
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15 pages, 644 KiB  
Systematic Review
Routine Brain MRI Findings on the Long-Term Effects of COVID-19: A Scoping Review
by Yuriy Vasilev, Ivan Blokhin, Anna Khoruzhaya, Maria Kodenko, Vasiliy Kolyshenkov, Olga Nanova, Yuliya Shumskaya, Olga Omelyanskaya, Anton Vladzymyrskyy and Roman Reshetnikov
Diagnostics 2023, 13(15), 2533; https://doi.org/10.3390/diagnostics13152533 - 30 Jul 2023
Cited by 5 | Viewed by 1953
Abstract
Rationale and Objectives: Post-COVID condition (PCC) is associated with long-term neuropsychiatric symptoms. Magnetic resonance imaging (MRI) in PCC examines the brain metabolism, connectivity, and morphometry. Such techniques are not easily available in routine practice. We conducted a scoping review to determine what is [...] Read more.
Rationale and Objectives: Post-COVID condition (PCC) is associated with long-term neuropsychiatric symptoms. Magnetic resonance imaging (MRI) in PCC examines the brain metabolism, connectivity, and morphometry. Such techniques are not easily available in routine practice. We conducted a scoping review to determine what is known about the routine MRI findings in PCC patients. Materials and Methods: The PubMed database was searched up to 11 April 2023. We included cohort, cross-sectional, and before–after studies in English. Articles with only advanced MRI sequences (DTI, fMRI, VBM, PWI, ASL), preprints, and case reports were excluded. The National Heart, Lung, and Blood Institute and PRISMA Extension tools were used for quality assurance. Results: A total of 7 citations out of 167 were included. The total sample size was 451 patients (average age 51 ± 8 years; 67% female). Five studies followed a single recovering cohort, while two studies compared findings between two severity groups. The MRI findings were perivascular spaces (47%), microbleeds (27%) and white matter lesions (10%). All the studies agreed that PCC manifestations are not associated with specific MRI findings. Conclusion: The results of the included studies are heterogeneous due to the low agreement on the types of MRI abnormalities in PCC. Our findings indicate that the routine brain MRI protocol has little value for long COVID diagnostics. Full article
(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)
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