Objectives Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a novel coronavirus that causes COVID-19. This disease is associated with leukocytosis with lymphopenia, neutrophilia, and elevated levels of d-dimer, and C-reactive protein, ferritin, procalcitonin, and lactate dehydrogenase. The aim of this study was to describe the clinical and analytical characteristics of hospitalized patients with SARS-CoV-2 infection and to identify prognostic factors of disease progression. Methods Patients were categorized into two groups based on COVID-19 severity. Study variables included demographic data, medical history, length of hospital stay, course of pneumonia, drug therapy, and analytical parameters. A descriptive and multivariate analysis was performed to identify prognostic factors for disease severity. Results The study population included 197 patients, of whom 127 had mild disease and 70 had severe COVID-19. Statistically significant differences were observed in most analytical parameters. The parameters included in the multivariate analysis were advanced age and elevated levels of leukocytes, CRP, GGT, and PCT at admission as prognostic factors for disease severity. Conclusions The prognostic factors for the severity of SARS-CoV-2 infection identified in this study (age, leukocytes, CRP, GGT, and PCT) will help predict the course of the disease at an early stage.

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AbstractObjectivesGaucher disease (GD) is the most common inherited lysosomal storage disease, caused by mutations in acid β-glucosidase (GBA) gene. This study aimed to identify mutations in Andalusia patients with GD and their genotype-phenotype correlation.MethodsDescriptive observational study. University Hospital Virgen del Rocio patients diagnosed from GD from 1999 to 2019 were included. Demographic and clinical data, β-glucocerebrosidase activity, variants pathogenic in GBA gene and biomarkers for monitoring treatment were collected from digital medical record.ResultsTwenty-six patients with aged between 1 day and 52 years were studied. A total of six mutations described as pathogenic and one mutation not described above [c.937T>C (p.Tyr313His)] were identified in the GBA gene, four patients were homozygotes and 22 compound heterozygotes. Twenty-four patients were diagnosed in non-neuropathic form (type 1) and two cases presented neurological involvement (type 2 or 3). The most common variant was c.1226A>G (p.Asn409Ser), which was detected in 24 patients, followed by c.1448T>C (p.Leu483Pro) variant, identified in 13 patients. The c.1448T>C (p.Leu483Pro) mutation has been presented in the most severe phenotypes with neurological involvement associated with type 2 and 3 GD, while c.1226A>G (p.Asn409Ser) mutation has not been associated with neurological alterations. Splenomegaly and bone disease were the most frequent clinical manifestations, and thrombocytopenia was the most common hematological disorder.ConclusionsThe c.1226A>G (p.Asn409Ser) and c.1448T>C (p.Leu483Pro) mutations were the most common. The c.937T>C (p.Tyr313His) was identified as a novel mutation. The c.1448T>C (p.Leu483Pro) mutation was associated with neurological alterations and c.1226A>G (p.Asn409Ser) mutation has not been associated it.

La meningitis bacteriana es una patología grave que requiere de un diagnóstico preciso y precoz. El aumento de leucocitos, con predominio de polimorfonucleares, la proteinorraquia y la hipoglucorraquia orientan hacía una etiología bacteriana, aunque no siempre se correlacionan con el diagnóstico definitivo. El objetivo de este estudio fue evaluar la utilidad del lactato en líquido cefalorraquídeo como biomarcador de meningitis bacteriana. Este es un estudio observacional y prospectivo en el que se analizaron 706 líquidos cefalorraquídeos de pacientes atendidos en el Hospital Universitario Virgen de Valme (Sevilla, España) durante 20 meses. De los líquidos analizados, en 21 casos se diagnosticó meningitis bacteriana, en 31 la meningitis bacteriana fue compatible y en 654 casos se descartó esta infección. El punto de corte óptimo del lactato en líquido cefalorraquídeo fue de 3,0 mmol/L, con una sensibilidad de 68%, una especificidad de 98%, un valor predictivo positivo de 79% y un valor predictivo negativo de 97%. La concentración de lactato, la concentración de proteínas y el número de leucocitos en líquido cefalorraquídeo fue significativamente mayor en los pacientes con meningitis bacteriana confirmada. El alto valor predictivo negativo del lactato es especialmente útil para descartar meningitis bacteriana en pacientes enfermos. El lactato es el biomarcador con mejor rendimiento diagnóstico de todos los analizados, por lo que recomendamos su inclusión en el perfil bioquímico del líquido cefalorraquídeo.

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