COVID-19 is a newly diagnosed entity that has been identified for about 6 months. With the US now being the prevalent nation affected, we aimed to identify factors that were relevant to survival and hematological events in COVID patients. Our group had primarily been assessing COVID-19 confirmed patients as per PCR at Ochsner Medical Center in Louisiana; we primarily studied patients who were admitted between January 2020 to May 2020. Our main events that are currently being studied include factors such as mortality, length of stay, and bleeding or thrombotic events. Secondary endpoints included factors such as influence on blood type and also amount of transfusions required by these patients.
Our overall analysis of 1773 patients yielded a number of 60 patients who were able to identify as having an active cancer diagnosis. This disproportionate number of patients may be related to factors such as reluctance to visit the hospital among cancer patients, a phenomenon noted similarly in Cardiology where the number of admissions for cardiac causes had declined suddenly during this pandemic timeline. Our half of our population was African American and included an even proportion of males and females. The age range of patients was between 35-93 years old.
The most common malignancies that were noted to co-occur with COVID-19 in our population seemed to be lung, prostate, and hematological malignancies. Although final analyses regarding mortality are to be completed, the proportion of patients who had died with a diagnosis of cancer was around 50% per collection of our current data. Twenty three out of 60 (38%) patients required blood transfusions. In comparison to other reports which had reported bleeding events and thrombotic events, our report had revealed a much less rate of bleeding events (5/60) and thrombotic events (5/60). We plan to repeat our analysis to assess for any confounders in identifying these events, as noted, since some earlier literature had reported between ¼ to ⅔ of patients having a thrombotic event.
Our analysis also looks at other descriptive variables such as use of anticoagulant and antiplatelet agents, absolute counts of neutrophils and lymphocytes, platelets, and coagulation markers. Also, our assessment includes a study in assessment of any delays noted in chemotherapy dates for these patients. Analysis of assessment of bleeding, thrombosis, and mortality for the entire patient group is currently in process.
Disclosures
No relevant conflicts of interest to declare.
Introduction:
Circulating micro-RNAs (miR) are reported in the pathophysiology of intracerebral hemorrhage. Previous reports suggested that miR-206, miR-486, miR-150 and miR-146a are associated with ICH outcomes. In this, study we explored the associated of miRNA expression with radiological predictors of outcome hematoma expansion (HE) and perihematomal edema volume (PHEV) and functional outcomes.
Methods:
Patients (n=96) with acute spontaneous ICH were consented and blood samples were collected within 48 hours of ICH onset. Plasma miR were used to screen 752 well-characterized miR using locked nucleic acid (LNA) probe-based real-time PCR (ver3.3.5). Cycle threshold data were obtained using the regression method and global mean normalization to a universally expressed miR-92a was applied. Significance levels were assessed using the Mann-Whitney’s U-test and the Welch’s t-test (GenEx). Demographic, clinical data and Modified Rankin Score (MRS) were collected with follow-up calls at 30, 90, and 365-days from ICH onset. Hematoma and perihematomal edema volumes were calculated based on the ABC/2 formula at presentation, 24hrs, and 96hrs from ICH onset. Spearman’s rank correlation was used to determine the association of miRNA expression with HE (>30% increase in volume) and PHEV at onset, 24hrs and 96hrs. Simple logistic regression was used to determine the odds of survival at 30-days and favorable outcome at 90- and 365-days, defined as MRS
<
3.
Results:
Overall, cohort mean age 60.2years (IQR 52-73), 57.1% were deep nuclei (thalamic and basal ganglia ICH), mean ICH vol. 38.4 (SD23.2). We observed a positive correlation with miR-206 and PHEV at 48-96hrs (rho 0.451, p=0.003). Expression of miR-206 was associated with a higher odds of survival at 30-days (OR 1.149 95% CI 1.016-1.299 p=0.0266) and a favorable outcome at 365-days (OR 1.135 95% CI 1.007-1.278 p=0.038). There was no association of miR-206 expression with HE. miR-486, miR-150, and miR-146a were not associated with radiological or functional outcomes.
Conclusion:
In our cohort, miR-206 was associated with PHEV at 96hrs, survival at 30days and favorable outcome at 1 year. Further studies are ongoing to further delineate the role of miR206 in ICH related biological mechanisms.
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