Laboratory markers included in the Corona Score can identify false negative results on COVID-19 RT-PCR in the emergency room

After December 2019 outbreak in China, the novel Coronavirus infection (COVID-19) has very quickly overflowed worldwide. Infection causes a clinical syndrome encompassing a wide range of clinical features, from asymptomatic or oligosymptomatic course to acute respiratory distress and death. In a very recent work we preliminarily observed that several laboratory tests have been shown as characteristically altered in COVID-19. We aimed to use the Corona score, a validated point-based algorithm to predict the likelihood of COVID-19 infection in patients presenting at the Emergency rooms. This approach combines chest images-relative score and several laboratory parameters to classify emergency room patients. Corona score accuracy was satisfactory, increasing the detection of positive patients’ rate

Elevations of inflammatory markers PTX3 and sST2 after resuscitation from cardiac arrest are associated with multiple organ dysfunction syndrome and early death

BACKGROUND: A systemic inflammatory response is observed after cardiopulmonary resuscitation. We investigated two novel inflammatory markers, pentraxin 3 (PTX3) and soluble suppression of tumorigenicity 2 (sST2), in comparison with the classic high-sensitivity C-reactive protein (hsCRP), for prediction of early multiple organ dysfunction syndrome (MODS), early death, and long-term outcome after out-of-hospital cardiac arrest. METHODS: PTX3, sST2, and hsCRP were assayed at ICU admission and 48 h later in 278 patients. MODS was defined as the 24 h non-neurological Sequential Organ Failure Assessment (SOFA) score 6512. Intensive care unit (ICU) death and 12-month Cerebral Performance Category (CPC) were evaluated. RESULTS: In total, 82% of patients survived to ICU discharge and 48% had favorable neurological outcome at 1 year (CPC 1 or 2). At ICU admission, median plasma levels of hsCRP (2.8 mg/L) were normal, while levels of PTX3 (19.1 ng/mL) and sST2 (117 ng/mL) were markedly elevated. PTX3 and sST2 were higher in patients who developed MODS (p<0.0001). Admission levels of PTX3 and sST2 were also higher in patients who died in ICU and in those with an unfavorable 12-month neurological outcome (p<0.01). Admission levels of PTX3 and sST2 were independently associated with subsequent MODS [OR: 1.717 (1.221-2.414) and 1.340, (1.001-1.792), respectively] and with ICU death [OR: 1.536 (1.078-2.187) and 1.452 (1.064-1.981), respectively]. At 48 h, only sST2 and hsCRP were independently associated with ICU death. CONCLUSIONS: Higher plasma levels of PTX3 and sST2, but not of hsCRP, at ICU admission were associated with higher risk of MODS and early death

Long pentraxin 3 as a marker of COVID-19 severity: evidences and perspectives

Several laboratory tests are characteristically altered in Coronavirus Disease 2019 (COVID-19), but are not totally accurate in predicting the disease outcome. The long pentraxin 3 (PTX3) is quickly released directly at inflammation sites by many immune cell types. Previous studies have shown that PTX3 correlated with disease severity in various inflammatory conditions. Our study investigated the use of PTX3 as a potential marker of COVID-19 severity and compared its performance in detecting a more severe form of the disease with that of routine laboratory parameters. Stored serum samples of RT-PCR confirmed COVID-19 cases that had been obtained at hospital admission were retrospectively analysed. Intensive care unit (ICU) stay was considered a surrogate endpoint of severe COVID-19. Pentraxin 3 was measured by a commercial enzyme-linked immunosorbent assay. A total of 96 patients were recruited from May 1st, 2020 to June 30th, 2020; 75/96 were transferred to ICU. Pentraxin 3 was higher in ICU vs non-ICU patients (35.86 vs 10.61 ng/mL, P 18 ng/mL yielded a sensitivity of 96% and a specificity of 100% in identifying patients requiring ICU. High values of PTX3 predict a more severe COVID-19

Pentraxin 3 Plasma Levels and Disease Activity in Systemic Lupus Erythematosus

SLE is an autoimmune disorder that involves polyclonal autoimmunity against multiple autoantigens. PTX3, a marker of the acute-phase inflammatory response, plays an important role in innate immunity and in modulation of the adaptive immune response. Our study tried to resolve some rather controversial aspects of the use of PTX3 as a biomarker of disease activity in SLE patients. We demonstrated that plasma PTX3 concentration of the SLE patients was significantly higher than the healthy control groups and reflected disease activity. ROC curve analysis was used to determine best cut-off point (2.8 ng/mL) with a good sensitivity and specificity. In patients with SLE, PTX3 concentrations were correlated with SLEDAI. Trend to remission (TTR) curve was created by plotting PTX3 levels and SLEDAI and we applied the curve as a model for the analysis of two patients with different follow-up. PTX3 plasma levels declined significantly and this decline occurred parallel to the clinical improvement with a complete remission of disease. In patients who experienced a clinical relapse, an increase in PTX3 levels followed the lupus flare. The proposal of PTX3 cut-off associated with TTR and monitoring of PTX3 plasma levels could be an innovative approach to follow-up of SLE patients

Habitat selection of the threatened northern lapwing (Vanellus vanellus) breeding in an intensive agroecosystem

Land use changes induced by agricultural intensification and wetland reclamation are negatively impacting farmland biodiversity. In this context, information on habitat selection of wildlife can be fundamental to developing effective conservation actions targeting biodiversity conservation, shedding light on fine-scale species-habitat relationships. We studied nesting and foraging habitat selection in a declining shorebird, the northern lapwing ( Vanellus vanellus ), in the intensive agroecosystem of the Po Plain, Italy. Out of 67 nests we found, 94% were in wetlands and summer crops, wetlands being the only habitat actively selected. The likelihood that a pair of lapwings nested in a cropland patch was inversely proportional to plant height and ground cover, which likely explains why summer crops were more favourable than winter and hay crops to the species nest settlement. Tracking data showed that GPS tagged lapwings ( n = 14) stayed close (207 ± 153 m) to their nests throughout the entire breeding period, and they selected the same habitat types for foraging as for nesting. Home ranges averged 56 ha (range = 3–161 ha), and were on average larger than previously reported from elsewhere, probably because the overall low quality of the habitat in the Po Plain. Home ranges of lapwings breeding in croplands were larger and significantly more cohesive than those of birds breeding in wetlands, suggesting a need to explore larger areas to find suitable foraging patches. The dual nesting and feeding strategy highlighted the crucial importance of both wetlands and, unexpectedly, summer crops for this species of conservation concern. To provide suitable habitat for breeding lapwings, restored wetlands must be well managed and attention should be given to intrafield heterogeneity, possibly increasing bare ground patches

Diagnostic accuracy of a new commercially available HCV-antigen test

Nowadays the diagnosis of HCV infection is based on the detection of anti-HCV antibodies (HCV-Ab) subsequently confirmed by a RIBA test and HCV-RNA test.A new chemiluminescence assay is now available allowing the detection of HCV antigen (HCV-Ag) (HCV-Ag,Abbott, USA®).The aim of the study was to investigate the diagnostic performances of this new test.We performed on 63 selected serum samples the following analyses: HCV-Ab , HCV-Ag, RIBA test and HCV-RNA . For HCV-Ag vs HCV-RNA we found specificity of 95% and sensitivity of 100%. Our study has highlighted the diagnostic accuracy of HCV-Ag test. This test does not require special equipments to be performed, so its strong specificity suggests its possible role in a rapid and low-cost new diagnostic protocol, particularly in a population with low incidence of HCV infection