Journal of Personalized Medicine

Research

14 pages, 948 KiB

Open AccessArticle

Biomarkers Linked with Dynamic Changes of Renal Function in Asymptomatic and Mildly Symptomatic COVID-19 Patients

by Ya-Chieh Chang, Ping-Huang Tsai, Yu-Ching Chou, Kuo-Cheng Lu, Feng-Yee Chang and Chia-Chao Wu

J. Pers. Med. 2021, 11(5), 432; https://doi.org/10.3390/jpm11050432 - 19 May 2021

Cited by 12 | Viewed by 2362

Abstract

The catastrophic coronavirus disease 2019 (COVID-19) pandemic is currently a critical global issue. One well-known complication of COVID-19 in severe cases is acute kidney injury, but no research has given a description of its impact on the kidney in patients with mild symptoms. [...] Read more.

The catastrophic coronavirus disease 2019 (COVID-19) pandemic is currently a critical global issue. One well-known complication of COVID-19 in severe cases is acute kidney injury, but no research has given a description of its impact on the kidney in patients with mild symptoms. We explore the renal function changes in mild COVID-19 patients. This retrospective, single-center study included 27 participants with laboratory-detected severe acute respiratory syndrome coronavirus two (SARS-CoV-2) infection who were admitted to the Tri-Service General Hospital from 4 February to 26 May 2020 and analyzed their clinical features, radiological findings, and laboratory data. Data collected upon admission and discharge showed a median estimated glomerular filtration rate (eGFR) of 106.7 mL/min/1.732 m² and 112.2 mL/min/1.732 m², respectively, with a p-value of 0.044. A correlation between renal function and the severity of infection was also found and was statistically significant upon admission. Patients with a lower lymphocyte count or higher C-reactive protein, neutrophil count, and neutrophil-to-lymphocyte ratio presented with a decreased eGFR during their early infection phase. The biomarkers (CRP and NLR) may be linked with dynamic changes of renal function in COVID-19 patients who are asymptomatic or have mild symptoms. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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15 pages, 3435 KiB

Open AccessArticle

SARS-CoV-2-Laden Respiratory Aerosol Deposition in the Lung Alveolar-Interstitial Region Is a Potential Risk Factor for Severe Disease: A Modeling Study

by Sabine Hofer, Norbert Hofstätter, Albert Duschl and Martin Himly

J. Pers. Med. 2021, 11(5), 431; https://doi.org/10.3390/jpm11050431 - 19 May 2021

Cited by 8 | Viewed by 15730

Abstract

COVID-19, predominantly a mild disease, is associated with more severe clinical manifestation upon pulmonary involvement. Virion-laden aerosols and droplets target different anatomical sites for deposition. Compared to droplets, aerosols more readily advance into the peripheral lung. We performed in silico modeling to confirm [...] Read more.

COVID-19, predominantly a mild disease, is associated with more severe clinical manifestation upon pulmonary involvement. Virion-laden aerosols and droplets target different anatomical sites for deposition. Compared to droplets, aerosols more readily advance into the peripheral lung. We performed in silico modeling to confirm the secondary pulmonary lobules as the primary site of disease initiation. By taking different anatomical aerosol origins into consideration and reflecting aerosols from exhalation maneuvers breathing and vocalization, the physicochemical properties of generated respiratory aerosol particles were defined upon conversion to droplet nuclei by evaporation at ambient air. To provide detailed, spatially-resolved information on particle deposition in the thoracic region of the lung, a top-down refinement approach was employed. Our study presents evidence for hot spots of aerosol deposition in lung generations beyond the terminal bronchiole, with a maximum in the secondary pulmonary lobules and a high preference to the lower lobes of both lungs. In vivo, initial chest CT anomalies, the ground glass opacities, resulting from partial alveolar filling and interstitial thickening in the secondary pulmonary lobules, are likewise localized in these lung generations, with the highest frequency in both lower lobes and in the early stage of disease. Hence, our results suggest a disease initiation right there upon inhalation of virion-laden respiratory aerosols, linking the aerosol transmission route to pathogenesis associated with higher disease burden and identifying aerosol transmission as a new independent risk factor for developing a pulmonary phase with a severe outcome. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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15 pages, 5567 KiB

Open AccessArticle

The Challenging Diagnosis of Pediatric Multisystem Inflammatory Syndrome Associated with Sars-Cov-2 Infection-Two Case Reports and Literature Review

by Marcela Daniela Ionescu, Roxana Taras, Bianca Dombici, Mihaela Balgradean, Elena Camelia Berghea and Alin Nicolescu

J. Pers. Med. 2021, 11(4), 318; https://doi.org/10.3390/jpm11040318 - 19 Apr 2021

Cited by 7 | Viewed by 3175

Abstract

Severe acute respiratory coronavirus 2 (SARS-CoV-2) is a novel coronavirus discovered in 2019 that caused the coronavirus disease 2019 (COVID19). During the last year, over 70 million people were infected and more than 1.5 million people died. Despite the tremendous number of people [...] Read more.

Severe acute respiratory coronavirus 2 (SARS-CoV-2) is a novel coronavirus discovered in 2019 that caused the coronavirus disease 2019 (COVID19). During the last year, over 70 million people were infected and more than 1.5 million people died. Despite the tremendous number of people infected, children were less affected and presented milder forms of the disease. A short time after the pandemic was declared, a new hyperinflammatory syndrome resembling Kawasaki disease (KD) was described in children with confirmed or suspected SARS-CoV-2 infection named multisystem inflammatory syndrome in children (MIS-C). The incidence of MIS-C is low and it has a polymorphous clinical presentation, making the diagnosis difficult. Although the incidence is reduced, there is a high risk of cardiovascular complications. In order to raise awareness, we present the cases of two pediatric patients diagnosed with MIS-C in our clinic. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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15 pages, 2055 KiB

Open AccessFeature PaperArticle

Predictive Biomarkers of COVID-19 Severity in SARS-CoV-2 Infected Patients with Obesity and Metabolic Syndrome

by Carles Perpiñan, Laia Bertran, Ximena Terra, Carmen Aguilar, Miguel Lopez-Dupla, Ajla Alibalic, David Riesco, Javier Camaron, Francesco Perrone, Anna Rull, Laia Reverté, Elena Yeregui, Anna Marti, Francesc Vidal and Teresa Auguet

J. Pers. Med. 2021, 11(3), 227; https://doi.org/10.3390/jpm11030227 - 22 Mar 2021

Cited by 7 | Viewed by 4106

Abstract

In SARS-CoV-2-infected patients, obesity, hypertension, and diabetes are dangerous factors that may result in death. Priority in detection and specific therapies for these patients are necessary. We wanted to investigate the impact of obesity and metabolic syndrome (MS) on the clinical course of [...] Read more.

In SARS-CoV-2-infected patients, obesity, hypertension, and diabetes are dangerous factors that may result in death. Priority in detection and specific therapies for these patients are necessary. We wanted to investigate the impact of obesity and metabolic syndrome (MS) on the clinical course of COVID-19 and whether prognostic biomarkers described are useful to predict the evolution of COVID-19 in patients with obesity or MS. This prospective cohort study included 303 patients hospitalized for COVID-19. Participants were first classified according to the presence of obesity; then, they were classified according to the presence of MS. Clinical, radiologic, and analytical parameters were collected. We reported that patients with obesity presented moderate COVID-19 symptoms and pneumonia, bilateral pulmonary infiltrates, and needed tocilizumab more frequently. Meanwhile, patients with MS presented severe pneumonia and respiratory failure more frequently, they have a higher mortality rate, and they also showed higher creatinine and troponin levels. The main findings of this study are that IL-6 is a potential predictor of COVID-19 severity in patients with obesity, while troponin and LDH can be used as predictive biomarkers of COVID-19 severity in MS patients. Therefore, treatment for COVID-19 in patients with obesity or MS should probably be intensified and personalized. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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16 pages, 1412 KiB

Open AccessArticle

Prevention of Covid-19 Infection and Related Complications by Ozonized Oils

by Alberto Izzotti, Enzo Fracchia, William Au, Monica Colombo, Ulrich Pfeffer, Laura Emionite, Simone Pavan, Daniele Miotto, Paola Lova, Elena Grasselli, Emanuela Faelli, Ruggeri Piero, Micaela Tiso and Alessandra Pulliero

J. Pers. Med. 2021, 11(3), 226; https://doi.org/10.3390/jpm11030226 - 22 Mar 2021

Cited by 13 | Viewed by 2963

Abstract

Background: The COVID-19 pandemic continues to ravage the human population; therefore, multiple prevention and intervention protocols are being rapidly developed. The aim of our study was to develop a new chemo-prophylactic/-therapeutic strategy that effectively prevents COVID-19 and related complications. Methods: In in vitro [...] Read more.

Background: The COVID-19 pandemic continues to ravage the human population; therefore, multiple prevention and intervention protocols are being rapidly developed. The aim of our study was to develop a new chemo-prophylactic/-therapeutic strategy that effectively prevents COVID-19 and related complications. Methods: In in vitro studies, COVID-19 infection-sensitive cells were incubated with human oropharyngeal fluids containing high SARS-CoV-2 loads. Levels of infection were determined via intra-cellular virus loads using quantitative PCR (qPCR). Efficacies for infection prevention were determined using several antiviral treatments: lipid-encapsulated ozonized oil (HOO), water-soluble HOO (HOOws), UV, and hydrogen peroxide. In in vivo studies, safety and efficacy of HOO in fighting COVID-19 infection was evaluated in human subjects. Results: HOO in combination with HOOws was the only treatment able to fully neutralize SARS-CoV-2 as well as its capacity to penetrate and reproduce inside sensitive cells. Accordingly, the feasibility of using HOO/HOOws was tested in vivo. Analysis of expired gas in healthy subjects indicates that HOO administration increases oxygen availability in the lung. For our human studies, HOO/HOOws was administered to 52 cancer patients and 21 healthy subjects at high risk for COVID-19 infection, and all of them showed clinical safety. None of them developed COVID-19 infection, although an incidence of at least 11 cases was expected. Efficacy of HOO/HOOws was tested in four COVID-19 patients obtaining recovery and qPCR negativization in less than 10 days. Conclusions: Based on our experience, the HOO/HOOws treatment can be administered at standard doses (three pills per day) for chemo-prophylactic purposes to healthy subjects for COVID-19 prevention and at high doses (up to eight pills per day) for therapeutic purposes to infected patients. This combined prevention strategy can provide a novel protocol to fight the COVID-19 pandemic. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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10 pages, 241 KiB

Open AccessArticle

Alterations of Left Ventricular Function Persisting during Post-Acute COVID-19 in Subjects without Previously Diagnosed Cardiovascular Pathology

by Mariana Tudoran, Cristina Tudoran, Voichita Elena Lazureanu, Adelina Raluca Marinescu, Gheorghe Nicusor Pop, Alexandru Silvius Pescariu, Alexandra Enache and Talida Georgiana Cut

J. Pers. Med. 2021, 11(3), 225; https://doi.org/10.3390/jpm11030225 - 22 Mar 2021

Cited by 26 | Viewed by 3336

Abstract

(1) Background: Coronavirus infection (Covid-19) has emerged as a severe medical condition, associated with high pulmonary morbidity and often with cardiovascular (CV) complications. This study aims to evidence the persistence of left ventricular (LV) systolic function (LV-SF) alterations and diastolic dysfunction (DD) in [...] Read more.

(1) Background: Coronavirus infection (Covid-19) has emerged as a severe medical condition, associated with high pulmonary morbidity and often with cardiovascular (CV) complications. This study aims to evidence the persistence of left ventricular (LV) systolic function (LV-SF) alterations and diastolic dysfunction (DD) in COVID-19 patients without history of cardiovascular (CV) diseases by transthoracic echocardiography (TTE). (2) Methods: 125 patients, aged under 55 years, hospitalized during the first outbreak of Covid-19 for moderate pneumonia, underwent a comprehensive cardiologic examination and TTE at 6–10 weeks after discharge. Their initial in-hospital laboratory data and thorax computer tomography (TCT) were accessed from the electronic database of the hospital. (3) Results: with TTE, we documented alterations of LV-SF and DD in 8.8% of patients and in 16.8% only patterns of DD, statistically correlated with the initial levels of creatin-kinase (CK-MB) and inflammatory factors. Multivariate regression analysis evidenced that CK-MB levels, age, and body mass index (BMI) are responsible for 65% of LV-SF decrease. (4) Conclusions: Alterations of LV-SF and DD are frequent in post-acute COVID-19 infection and are responsible for the persistence of symptoms. Elevated myocardial necrosis markers during the acute phase seem to predict subsequent alteration of cardiac performance. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

11 pages, 792 KiB

Open AccessArticle

White Blood Cells and Severe COVID-19: A Mendelian Randomization Study

by Yitang Sun, Jingqi Zhou and Kaixiong Ye

J. Pers. Med. 2021, 11(3), 195; https://doi.org/10.3390/jpm11030195 - 12 Mar 2021

Cited by 40 | Viewed by 5761

Abstract

Increasing evidence shows that white blood cells are associated with the risk of coronavirus disease 2019 (COVID-19), but the direction and causality of this association are not clear. To evaluate the causal associations between various white blood cell traits and the COVID-19 susceptibility [...] Read more.

Increasing evidence shows that white blood cells are associated with the risk of coronavirus disease 2019 (COVID-19), but the direction and causality of this association are not clear. To evaluate the causal associations between various white blood cell traits and the COVID-19 susceptibility and severity, we conducted two-sample bidirectional Mendelian Randomization (MR) analyses with summary statistics from the largest and most recent genome-wide association studies. Our MR results indicated causal protective effects of higher basophil count, basophil percentage of white blood cells, and myeloid white blood cell count on severe COVID-19, with odds ratios (OR) per standard deviation increment of 0.75 (95% CI: 0.60–0.95), 0.70 (95% CI: 0.54–0.92), and 0.85 (95% CI: 0.73–0.98), respectively. Neither COVID-19 severity nor susceptibility was associated with white blood cell traits in our reverse MR results. Genetically predicted high basophil count, basophil percentage of white blood cells, and myeloid white blood cell count are associated with a lower risk of developing severe COVID-19. Individuals with a lower genetic capacity for basophils are likely at risk, while enhancing the production of basophils may be an effective therapeutic strategy. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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11 pages, 235 KiB

Open AccessFeature PaperArticle

Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea

by Tak Kyu Oh, In-Ae Song and Young-Tae Jeon

J. Pers. Med. 2021, 11(2), 116; https://doi.org/10.3390/jpm11020116 - 10 Feb 2021

Cited by 24 | Viewed by 3489

Abstract

We aimed to investigate whether statin therapy is associated with the incidence of coronavirus disease 2019 (COVID-19) among the South Korean population. In addition, we examined whether statin therapy affects hospital mortality among COVID-19 patients. The National Health Insurance Service (NHIS)-COVID-19 database in [...] Read more.

We aimed to investigate whether statin therapy is associated with the incidence of coronavirus disease 2019 (COVID-19) among the South Korean population. In addition, we examined whether statin therapy affects hospital mortality among COVID-19 patients. The National Health Insurance Service (NHIS)-COVID-19 database in South Korea was used for data extraction for this population-based cohort study. A total of 122,040 adult individuals, with 22,633 (18.5%) in the statin therapy group and 101,697 (91.5%) in the control group, were included in the analysis. Among them, 7780 (6.4%) individuals were diagnosed with COVID-19 and hospital mortality occurred in 251 (3.2%) COVID-19 cases. After propensity score matching, logistic regression analysis showed that the odds of developing COVID-19 were 35% lower in the statin therapy group than in the control group (odds ratio: 0.65, 95% confidence interval: 0.60 to 0.71; p < 0.001). Regarding hospital mortality among COVID-19 patients, the multivariable model indicated that there were no differences between the statin therapy and control groups (odds ratio: 0.74, 95% confidence interval: 0.52 to 1.05; p = 0.094). Statin therapy may have potential benefits for the prevention of COVID-19 in South Korea. However, we found that statin therapy does not affect the hospital mortality of patients who are diagnosed with COVID-19. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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18 pages, 982 KiB

Open AccessFeature PaperArticle

A Predictive Model and Risk Factors for Case Fatality of COVID-19

by Melchor Álvarez-Mon, Miguel A. Ortega, Óscar Gasulla, Jordi Fortuny-Profitós, Ferran A. Mazaira-Font, Pablo Saurina, Jorge Monserrat, María N. Plana, Daniel Troncoso, José Sanz Moreno, Benjamin Muñoz, Alberto Arranz, Jose F. Varona, Alejandro Lopez-Escobar and Angel Asúnsolo-del Barco

J. Pers. Med. 2021, 11(1), 36; https://doi.org/10.3390/jpm11010036 - 8 Jan 2021

Cited by 18 | Viewed by 6040

Abstract

This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience [...] Read more.

This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February–June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Príncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (<5%), medium-risk level (5–20%), and high-risk level (>20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU–death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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11 pages, 2100 KiB

Open AccessArticle

Blood Biomarkers for Assessing Headaches in Healthcare Workers after Wearing Biological Personal Protective Equipment in a COVID-19 Field Hospital

by Francisco Martín-Rodríguez, Raúl López-Izquierdo, Raquel M. Portillo Rubiales, Laura N. Fadrique Millán, Virginia Carbajosa Rodríguez, Ancor Sanz-García, Guillermo Ortega Rabbione, Begoña Polonio-López, Miguel Ángel Castro Villamor and José L. Martín-Conty

J. Pers. Med. 2021, 11(1), 27; https://doi.org/10.3390/jpm11010027 - 4 Jan 2021

Cited by 4 | Viewed by 2970

Abstract

The coronavirus disease 2019 (COVID-19) has led to a pandemic, which among other things, has highlighted biosafety as a key cornerstone in the management of disease transmission. The aim of this work was to analyze the role played by different blood biomarkers in [...] Read more.

The coronavirus disease 2019 (COVID-19) has led to a pandemic, which among other things, has highlighted biosafety as a key cornerstone in the management of disease transmission. The aim of this work was to analyze the role played by different blood biomarkers in predicting the appearance of headaches in healthcare workers wearing personal protective equipment (PPE) in a COVID-19 treatment unit. A prospective cohort study of 38 healthcare workers was performed during April 2020. Blood analysis, performed just before the start of a 4 hour shift, was carried out on all volunteers equipped with PPE. At the end of their shifts and after decontamination, they were asked if they had suffered from headache in order to obtain a binary outcome. The baseline creatinine value reflected a specific odds ratio of 241.36 (95% CI: 2.50–23,295.43; p = 0.019) and an area under the curve (AUC) value of 0.737 (95%CI: 0.57–0.90; p < 0.01). Blood creatinine is a good candidate for predicting the appearance of a de novo headache in healthcare workers after wearing PPE for four hours in a COVID-19 unit. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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Review

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11 pages, 1080 KiB

Open AccessReview

COVID-19 Infection during Pregnancy: Risk of Vertical Transmission, Fetal, and Neonatal Outcomes

by Marwa Saadaoui, Manoj Kumar and Souhaila Al Khodor

J. Pers. Med. 2021, 11(6), 483; https://doi.org/10.3390/jpm11060483 - 28 May 2021

Cited by 26 | Viewed by 10657

Abstract

The COVID-19 pandemic is a worldwide, critical public health challenge and is considered one of the most communicable diseases that the world had faced so far. Response and symptoms associated with COVID-19 vary between the different cases recorded, but it is amply described [...] Read more.

The COVID-19 pandemic is a worldwide, critical public health challenge and is considered one of the most communicable diseases that the world had faced so far. Response and symptoms associated with COVID-19 vary between the different cases recorded, but it is amply described that symptoms become more aggressive in subjects with a weaker immune system. This includes older subjects, patients with chronic diseases, patients with immunosuppression treatment, and pregnant women. Pregnant women are receiving more attention not only because of their altered physiological and immunological function but also for the potential risk of viral vertical transmission to the fetus or infant. However, very limited data about the impact of maternal infection during pregnancy, such as the possibility of vertical transmission in utero, during birth, or via breastfeeding, is available. Moreover, the impact of infection on the newborn in the short and long term remains poorly understood. Therefore, it is vital to collect and analyze data from pregnant women infected with COVID-19 to understand the viral pathophysiology during pregnancy and its effects on the offspring. In this article, we review the current knowledge about pre-and post-natal COVID-19 infection, and we discuss whether vertical transmission takes place in pregnant women infected with the virus and what are the current recommendations that pregnant women should follow in order to be protected from the virus. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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Other

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6 pages, 4712 KiB

Open AccessCase Report

Spontaneous Rectal Perforation in a Patient with SARS–CoV-2 Infection

by Mauro Giuffrè, Alessandro Marco Bozzato, Stefano Di Bella, Alessandro Agostino Occhipinti, Paola Martingano, Marco Francesco Maria Cavallaro, Roberto Luzzati, Fabio Monica, Maria Assunta Cova and Lory Saveria Crocè

J. Pers. Med. 2020, 10(4), 157; https://doi.org/10.3390/jpm10040157 - 8 Oct 2020

Cited by 23 | Viewed by 3612

Abstract

Coronavirus disease 2019 (COVID-19) is mostly perceived as a respiratory disease. However, there is increasing evidence of patients showing gastrointestinal symptoms, with increasing rates of presentation according to the severity of the disease. In a few cases, the abdominal involvement of COVID-19 resulted [...] Read more.

Coronavirus disease 2019 (COVID-19) is mostly perceived as a respiratory disease. However, there is increasing evidence of patients showing gastrointestinal symptoms, with increasing rates of presentation according to the severity of the disease. In a few cases, the abdominal involvement of COVID-19 resulted in spontaneous bowel perforation. Here, we present in detail the first case of rectal perforation in a patient with COVID-19. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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