A novel coronavirus (severe acute respiratory syndrome coronavirus 2) causes a cluster of pneumonia cases in Wuhan, China. It spread rapidly and globally. CT imaging is helpful for the evaluation of the novel coronavirus disease 2019 (COVID-19) pneumonia. Infection control inside the CT suites is also important to prevent hospital-related transmission of COVID-19. We present our experience with infection control protocol for COVID-19 inside the CT suites.
Serum cholinesterase associated with COVID-19 pneumonia severity and mortality Dear Editor, Kunutsor and Laukkanen have written to this journal regarding elevated admission levels of markers of liver injury (alanine aminotransferase and aspartate aminotransferase, gammaglutamyltransferase, alkaline phosphatase and total bilirubin) may be associated with progression to severe disease or death in COVID-19. 1 On the other hand, serum cholinesterase plays an important role in the inflammatory response and may be associated with prognosis in sepsis. 2-4 We focused on the similarities between severe COVID-19 pneumonia and sepsis. We examined associations between cholinesterase levels on admission and the severity, and mortality of patients with COVID-19 pneumonia, as well as the interaction between cholinesterase and the previously reported factors of severity and mortality. We included patients who had tested positive for severe acute respiratory syndrome coronavirus 2 from February to May 2020 at
Background
Coronavirus disease 2019 (COVID-19) pneumonitis associated with severe respiratory failure is associated with high mortality. The pathogenesis of COVID-19 is associated with microembolism or microvascular endothelial injuries. Here, we report that syndecan-1 (SDC-1), a component of the endothelial glycocalyx, may be a biomarker of severity classification for COVID-19 related to endothelial injury.
Methods and analysis
We analyzed the data of COVID-19 patients for 1 year from February 2020 at Yokohama City University Hospital and Yokohama City University Medical Center Hospital. We selected COVID-19 patients who required admission care, including intensive care, and analyzed the classification of severe and critical COVID-19 retrospectively, using various clinical data and laboratory data with SDC-1 by ELISA.
Results
We analyzed clinical and laboratory data with SDC-1 in five severe COVID-19 and ten critical COVID-19 patients. In the two groups, their backgrounds were almost the same. In laboratory data, the LDH, CHE, and CRP levels showed significant differences in each group (P = 0.032, P < 0.0001, and P = 0.007, respectively) with no significant differences in coagulation-related factors (platelet, PT-INR, d-dimer, ISTH score; P = 0.200, 0.277, 0.655, and 0.36, respectively). For the clinical data, the SOFA score was significantly different from admission day to day 14 of admission (p < 0.0001). The SDC-1 levels of critical COVID-19 patients were significantly higher on admission day and all-time course compared with the levels of severe COVID-19 patients (P = 0.009 and P < 0.0001, respectively).
Conclusions
Temporal change of SDC-1 levels closely reflect the severity of COVID-19, therefore, SDC-1 may be a therapeutic target and a biomarker for the severity classification of Covid-19.
The coronavirus disease 2019 (COVID-19) pandemic has accelerated all over the world, and global health-care systems have become overwhelmed with potentially infectious patients seeking testing and care. It is essential to set up effective and useful zoning to prevent the spread of infection to and from medical staff or other patients with effective use of standard precautions with personal protective equipment (PPE). Methods: We repurposed a general ward into an acute care unit for severe COVID-19 patients taking into consideration airflow, the direction of movement of medical staff, and prevention of the spread of infection to medical staff and other patients. We checked the daily condition and body temperature of all medical staff for 60 days. Results: There was no evidence of COVID-19 infection in any medical staff or other patients during the period thanks to effective and useful zoning with PPE. Conclusion: Special wards and rooms should be set up for future protection of medical staff and other patients, and prevent the explosion of COVID-19 infection with effective and useful zoning with PPE.
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