Search

Background: COVID-19 severity has been linked to an increased production of inflammatory mediators called "cytokine storm". Available data is mainly restricted to the first international outbreak and reports highly variable results. This study compares demographic and clinical features of patients with COVID-19 from Córdoba, Argentina, during the first two waves of the pandemic and analyzes association between comorbidities and disease outcome with the "cytokine storm", offering added value to the field., Methods: We investigated serum concentration of thirteen soluble mediators, including cytokines and chemokines, in hospitalized patients with moderate and severe COVID-19, without previous rheumatic and autoimmune diseases, from the central region of Argentina during the first and second infection waves. Samples from healthy controls were also assayed. Clinical and biochemical parameters were collected., Results: Comparison between the two first COVID-19 waves in Argentina highlighted that patients recruited during the second wave were younger and showed less concurrent comorbidities than those from the first outbreak. We also recognized particularities in the signatures of systemic cytokines and chemokines in patients from both infection waves. We determined that concurrent pre-existing comorbidities did not have contribution to serum concentration of systemic cytokines and chemokines in COVID-19 patients. We also identified immunological and biochemical parameters associated to inflammation which can be used as prognostic markers. Thus, IL-6 concentration, C reactive protein level and platelet count allowed to discriminate between death and discharge in patients hospitalized with severe COVID-19 only during the first but not the second wave., Conclusions: Our data provide information that deepens our understanding of COVID-19 pathogenesis linking demographic features of a COVID-19 cohort with cytokines and chemokines systemic concentration, presence of comorbidities and different disease outcomes. Altogether, our findings provide information not only at local level by delineating inflammatory/anti-inflammatory response of patients but also at international level addressing the impact of comorbidities and the infection wave in the variability of cytokine and chemokine production upon SARS-CoV-2 infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Almada, Angiolini, Dho, Dutto, Gazzoni, Manzone-Rodríguez, Marín, Ponce, Arroyo, Quiróz, Iribarren, Cerbán, Morón, Amezcua Vesely, Cervi, Chiapello, Fozzatti, Icely, Maccioni, Montes, Motrán, Rodríguez-Galán, Stempin, Viano, Mena, Bertone, Abiega, Escudero, Kahn, Caeiro, Maletto, Acosta Rodríguez, Gruppi and Sotomayor.)

Introduction: COVID-19 disease is an acute viral pneumonia caused by SARS-CoV-2. Its main means of transmission is from person to person through respiratory droplets. It presents as a febrile condition with respiratory symptoms and high transmissibility rate. There is no vaccine, so the clinical suspicion and immediate isolation of the patient are essential, Objective: The purpose of this work is to report the first confirmed case of COVID-19 disease in Córdoba (Argentina), highlighting telemedicine as a novel form of outpatient management., Methodology: We describe the first confirmed case of COVID-19 disease in Córdoba (Argentina), which presented in a patient without comorbidities in good clinical condition, and therefore ambulatory management using telemedicine was decided, which was satisfactory., Results: Outpatient management using telemedicine turned out to be optimal, avoiding the use of beds and the transmission of the virus within the hospital through management at home., Conclusion: Outpatient management of selected patients avoids virus transmission within the hospital and saturation of beds. Telemedicine is an effective and novel strategy for this situation., (Universidad Nacional de Córdoba)