Lower Blood pH as a High Predisposing Factor for a Fatal Outcome in Critically Ill COVID-19 Patients at Intensive Care Unit: a Multivariable Analysis

Kieninger, Martin; Sinning, Annemarie; Vadász, Timea; Gruber, Michael; Gronwald, Wolfram; Zeman, Florian; Lunz, Dirk; Dienemann, Thomas; Schmid, Stephan; Graf, Bernhard M.; Lubnow, Matthias; Müller, Thomas; Holzmann, Thomas; Salzberger, Bernd; Kieninger, Bärbel

doi:10.21203/rs.3.rs-685940/v1

2021

DOI: 10.21203/rs.3.rs-685940/v1

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Lower Blood pH as a High Predisposing Factor for a Fatal Outcome in Critically Ill COVID-19 Patients at Intensive Care Unit: a Multivariable Analysis

Martin Kieninger

Annemarie Sinning

Timea Vadász

et al.

Abstract: Background: Data of critically ill COVID-19 patients are being evaluated worldwide, not only to understand the various aspects of this disease and to refine treatment strategies but also to improve clinical decision-making. For the last aspect in particular, predictors of a lethal course of disease would be highly relevant.Methods:In this retrospective cohort study, we analyzed the first 59 adult critically ill Covid-19 patients treated in one of the intensive care units of the University Medical Center Regens… Show more

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Cited by 4 publications

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Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study

et al. 2023

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Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is among the top global health crises. As confirmed by the Vietnam Ministry of Health on 25th January 2023, Vietnam had a cumulative total of more than 11.52 million COVID-19 patients, including 10.61 million recoveries and 43,186 deaths. Objectives: This study aimed to describe the clinical and subclinical characteristics, treatment progress, and outcomes of 310 cases of SARS-CoV-2 infection. Methods: A total of 310 patients with medical records of SARS-CoV-2 were admitted to Can Tho City Hospital of Tuberculosis and Lung Diseases, Can Tho city, Vietnam, between July 2021 and December 2021. Demographic and clinical data, including laboratory examinations, of all the patients were collected and analyzed. Results: The median duration of hospital stay was 16.4 ± 5.3 days. There were 243 (78.4%) patients with clinical symptoms of COVID-19 and 67 (21.6%) patients without clinical symptoms. The common symptoms included cough (71.6% of 310 patients), fever (35.4%), shortness of breath (22.6%), sore throat (21.4%), loss of smell/taste (15.6%), and diarrhea (14.4%). Regarding treatment outcomes, 92.3% of the patients were discharged from the hospital, 1.9% of the patients suffered a more severe illness and were transferred to a higher-level hospital, and 5.8% of the patients died. The RT-PCR results were negative in 55.2% of the patients, and 37.1% of the patients had positive RT-PCR results with Ct values of >30 on the discharge/transfer day. Multivariate logistic regression analyses showed that comorbidity and decreased blood pH were statistically significantly related to the treatment outcomes of the patients with COVID-19 (p < 0.05). Conclusions: This study provides useful information (i.e., the clinical characteristics and treatment outcomes) on the COVID-19 pandemic in Vietnam during its biggest outbreak; the information may be used for reference and for making improvements in the handling of future health crises.

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Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study

et al. 2023

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Salivary Metabolomic Analysis Reveals Amino Acid Metabolism Shift in SARS-CoV-2 Virus Activity and Post-Infection Condition

et al. 2023

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The SARS-CoV-2 virus primarily infects salivary glands suggesting a change in the saliva metabolite profile; this shift may be used as a monitoring instrument during SARS-CoV-2 infection. The present study aims to determine the salivary metabolomic profile of patients with and post-SARS-CoV-19 infection. Patients were without (PCR−), with SARS-CoV-2 (PCR+), or post-SARS-CoV-2 infection. Unstimulated whole saliva was collected, and the 1H spectra were acquired in a 500 MHz Bruker nuclear magnetic resonance spectrometer at 25 °C. They were subjected to multivariate analysis using principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA), as well as univariate analysis through t-tests (SPSS 20.0, IL, USA), with a significance level of p < 0.05. A distinction was found when comparing PCR− subjects to those with SARS-CoV-2 infection. When comparing the three groups, the PLS-DA cross-validation presented satisfactory accuracy (ACC = 0.69, R2 = 0.39, Q2 = 0.08). Seventeen metabolites were found in different proportions among the groups. The results suggested the downregulation of major amino acid levels, such as alanine, glutamine, histidine, leucine, lysine, phenylalanine, and proline in the PCR+ group compared to the PCR− ones. In addition, acetate, valerate, and capronic acid were higher in PCR− patients than in PCR+. Sucrose and butyrate were higher in post-SARS-CoV-2 infection compared to PCR−. In general, a reduction in amino acids was observed in subjects with and post-SARS-CoV-2 disease. The salivary metabolomic strategy NMR-based was able to differentiate between non-infected individuals and those with acute and post-SARS-CoV-19 infection.

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Temporal Dynamics of Serum Perforin and Granzyme during the Acute Phase of SARS-CoV-2 Infection

et al. 2023

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Background: As many SARS-CoV-2 infections are asymptomatic, it could be useful to be able to determine how much time has passed since infection. We explored the changes in the temporal levels of T cell-related proteins (including perforin and granzymes) in the sera of patients with SARS-CoV-2 infection using a commercially available assay. Methods: This study enrolled 36 patients infected with SARS-CoV-2 and 20 healthy control participants. Blood samples were collected at three different times based on the number of days since symptom onset (early phase: 1–5 days, mid-phase: 6–10 days, late phase: 11–18 days). We assessed the temporal changes in the serum levels of perforin and granzymes in patients with SARS-CoV-2 infection by comparing the results with those obtained in the healthy control group. Results: We identified a significantly low level of perforin in the early phase of SARS-CoV-2 infection (p < 0.01), which was restored to normal during the mid- and late phases of the infection. However, there was no difference in the temporal change in the level of granzymes in SARS-CoV-2-infected patients compared to the healthy control group. Conclusions: This finding suggests that SARS-CoV-2 infection paralyzed the perforin expression in the early period immediately after infection. Thus, serum perforin is a potential marker for identifying the acute phase of SARS-CoV-2 infection.

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Lower Blood pH as a High Predisposing Factor for a Fatal Outcome in Critically Ill COVID-19 Patients at Intensive Care Unit: a Multivariable Analysis

Cited by 4 publications

References 9 publications

Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study

Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study

Salivary Metabolomic Analysis Reveals Amino Acid Metabolism Shift in SARS-CoV-2 Virus Activity and Post-Infection Condition

Temporal Dynamics of Serum Perforin and Granzyme during the Acute Phase of SARS-CoV-2 Infection

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