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Article: Soluble urokinase plasminogen activator receptor (suPAR) in the emergency department: An update.

Velissaris, Dimitrios / Zareifopoulos, Nicholas / Karamouzos, Vasileios / Pierrakos, Charalampos / Karanikolas, Menelaos

Caspian journal of internal medicine

2022 Volume 13, Issue 4, Page(s) 650–665

Abstract: Background: The biomarker soluble urokinase plasminogen activator receptor (suPAR) is an indicator of inflammation which is increased in a variety of chronic and acute disease states. Its most promising application in the emergency setting is to aid in ... ...

Abstract	Background: The biomarker soluble urokinase plasminogen activator receptor (suPAR) is an indicator of inflammation which is increased in a variety of chronic and acute disease states. Its most promising application in the emergency setting is to aid in the prognostic stratification of patients by identifying those at high risk of deterioration. This is a narrative review of studies evaluating the use of suPAR. Methods: We conducted a Medline search for studies on the use of suPAR in patients acutely admitted to the emergency department. Results: 25 original studies were included in the review. suPAR as a marker of inflammation has been used alone or combined to other inflammatory biomarkers in the assessment of patients suffering from various acute and chronic diseases in an emergency setting. As it is non-specific, it may increase in infectious disease, malignancy or acute coronary syndromes among other conditions, but quantitative suPAR levels correlate with disease severity. It may be useful for the identification of high risk patients regardless of underlying pathology. Conclusion: As the ideal biomarker in the emergency setting has not been identified yet, suPAR may be a promising addition to the established biomarkers for the initial assessment of patients in this setting. Additional research is necessary to evaluate the usefulness of suPAR guided management algorithms.
Language	English
Publishing date	2022-11-16
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2971933-1
ISSN	2008-6172 ; 2008-6164
ISSN (online)	2008-6172
ISSN	2008-6164
DOI	10.22088/cjim.13.4.650
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Literature Review of Pathophysiology, Clinical Manifestations, Medications and Optimal Dosage, Outpatient, and Post-hospitalization Use of Anticoagulation in COVID-19 Patients.

Velissaris, Dimitrios / Michailides, Christos / Karalis, Iosif / Paraskevas, Themistoklis / Koniari, Ioanna / Pierrakos, Charalampos / Karamouzos, Vasileios

Anatolian journal of cardiology

2023 Volume 27, Issue 5, Page(s) 232–239

Abstract: Since severe acute respiratory syndrome coronavirus 2 led to a world pandemic, extensive research has been conducted to identify its characteristics and form an appropriate management plan. One recognized complication of COVID-19 is coagulation defects ... ...

Abstract	Since severe acute respiratory syndrome coronavirus 2 led to a world pandemic, extensive research has been conducted to identify its characteristics and form an appropriate management plan. One recognized complication of COVID-19 is coagulation defects that can lead to thromboembolic events. We have reviewed the literature to summarize and present the latest research about the pathophysiology, clinical manifestations, anticoagulation use and appropriate dose in COVID-19 patients, as well as the effect of anticoagulation in outpatient and post-hospital settings. The pathophysiology of coagulation abnormalities in COVID-19 is not fully understood yet, but multiple mechanisms appear to be involved, such as a direct viral attack, hyperinflammation, increased immune response, blood stasis, and endothelial injury. Clinical manifestations are mainly venous thromboembolism (deep vein thrombosis and pulmonary embolism), arterial thromboembolism, ischemic stroke, central venous sinus thrombosis, and central retinal vein occlusion. Anticoagulation is widely used in hospitalized patients with COVID-19, unless it is contraindicated. Heparinoid is the main anticoagulant used. However, the appropriate dosage is still debated as research is trying to find a balance between benefits and risks. In outpatients, it appears that anticoagulation has no benefit in contrast to post-hospitalization use, where benefit could be observed in severely affected patients. We concluded that thromboprophylaxis should be used in treating hospitalized COVID-19 patients, but the dosage is still a matter of debate. More research needs to be done on outpatient and post-hospitalized patients to derive accurate conclusions.
MeSH term(s)	Humans ; COVID-19/complications ; Anticoagulants/therapeutic use ; Outpatients ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/prevention & control ; Venous Thromboembolism/complications ; Blood Coagulation Disorders ; Hospitalization
Chemical Substances	Anticoagulants
Language	English
Publishing date	2023-04-28
Publishing country	Turkey
Document type	Journal Article ; Review
ZDB-ID	2278670-3
ISSN	2149-2271 ; 2149-2271
ISSN (online)	2149-2271
ISSN	2149-2271
DOI	10.14744/AnatolJCardiol.2023.3023
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Article ; Online: Soluble urokinase plasminogen activator receptor (suPAR) in the emergency department

Dimitrios Velissaris / Nicholas Zareifopoulos / Vasileios Karamouzos / Charalampos Pierrakos / Menelaos Karanikolas

Caspian Journal of Internal Medicine, Vol 13, Iss 4, Pp 650-

An update

2022 Volume 665

Abstract	Background: The biomarker soluble urokinase plasminogen activator receptor (suPAR) is an indicator of inflammation which is increased in a variety of chronic and acute disease states. Its most promising application in the emergency setting is to aid in the prognostic stratification of patients by identifying those at high risk of deterioration. This is a narrative review of studies evaluating the use of suPAR Methods: We conducted a Medline search for studies on the use of suPAR in patients acutely admitted to the emergency department. Results: 25 original studies were included in the review. suPAR as a marker of inflammation has been used alone or combined to other inflammatory biomarkers in the assessment of patients suffering from various acute and chronic diseases in an emergency setting. As it is non-specific, it may increase in infectious disease, malignancy or acute coronary syndromes among other conditions, but quantitative suPAR levels correlate with disease severity. It may be useful for the identification of high risk patients regardless of underlying pathology. Conclusion: As the ideal biomarker in the emergency setting has not been identified yet, suPAR may be a promising addition to the established biomarkers for the initial assessment of patients in this setting. Additional research is necessary to evaluate the usefulness of suPAR guided management algorithms.
Keywords	supar ; biomarker ; emergency department ; mortaliti ; infection ; sepsis ; Internal medicine ; RC31-1245
Subject code	610
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	Babol University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: High flow nasal cannula oxygen therapy in adults with COVID-19 respiratory failure. A case report.

Karamouzos, Vasileios / Fligou, Fotini / Gogos, Charalambos / Velissaris, Dimitrios

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

2020 Volume 90, Issue 2

Abstract: The novel corona virus (SARS-CoV-2) continuous to spread around the globe causing high mortality, tremendous stress on healthcare systems and an unprecedented disruption of everyday life with unpredictable socioeconomic ramifications. The diseaseis ... ...

Abstract	The novel corona virus (SARS-CoV-2) continuous to spread around the globe causing high mortality, tremendous stress on healthcare systems and an unprecedented disruption of everyday life with unpredictable socioeconomic ramifications. The diseaseis typically affecting the respiratory system and some patients will develop refractory hypoxemic respiratory insufficiency requiring mechanical ventilation. The role of non-invasive ventilation (NIV), high flow nasal cannula (HFNC) or continuous positive airway pressure devices (C-PAP) in the treatment of the 2019 corona virus disease (COVID-19) is not yet clear. We hereby report a case of a 44-year-old COVID-19 positive male patient suffering from hypoxic respiratory failure that was successfully treated with high flow nasal cannula oxygen therapy in a negative pressure intensive care room. Although specific criteria for the use of high flow nasal canula devices COVID-19 are not available at this time, clinicians could use this non-invasive modality as analternative method of respiratory support in selected patients presenting with respiratory failure.
MeSH term(s)	Adult ; COVID-19 ; Cannula ; Coronavirus Infections/complications ; Critical Care ; Humans ; Male ; Noninvasive Ventilation/instrumentation ; Oxygen Inhalation Therapy/instrumentation ; Pandemics ; Pneumonia, Viral/complications ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-06-09
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	1160940-0
ISSN	1122-0643 ; 1120-0391
ISSN	1122-0643 ; 1120-0391
DOI	10.4081/monaldi.2020.1323
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Article ; Online: Continuous positive airway pressure in the treatment of COVID-19 patients with respiratory failure. A report of six cases with excellent outcome.

Velissaris, Dimitrios / Aretha, Diamanto / Tsiotsios, Konstantinos / Gogos, Charalambos / Karamouzos, Vasileios

Advances in respiratory medicine

2021 Volume 89, Issue 2, Page(s) 197–202

Abstract: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently considered a significant threat to global health and global economy. This new rapidly spreading virus causes enormous stress to ... ...

Abstract	Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently considered a significant threat to global health and global economy. This new rapidly spreading virus causes enormous stress to healthcare systems as large number of patients present with respiratory failure, needing intubation and mechanical ventilation. While the industry is racing to meet the rising demand for ventilators, all the alternative respiratory support modalities are employed to save lives in hospitals around the globe. We hereby report 6 patients who were diagnosed with SARS-CoV-2 and treated with continuous positive airway pressure in a negative pressure isolated room in a tertiary center in western Greece. The rapid progression of mild flu-like symptoms to respiratory failure in all patients was controlled with the use of continuous positive airway pressure making this strategy a reasonable alternative to respiratory failure due to SARS-CoV-2 as it may avert intubation and mechanical ventilation.
MeSH term(s)	Aged ; COVID-19/complications ; COVID-19/therapy ; Continuous Positive Airway Pressure/methods ; Female ; Greece ; Humans ; Male ; Middle Aged ; Oxygen Inhalation Therapy/methods ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2021-04-19
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2893877-X
ISSN	2543-6031 ; 2451-4934
ISSN (online)	2543-6031
ISSN	2451-4934
DOI	10.5603/ARM.a2020.0181
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Article ; Online: The Role of High Flow Nasal Oxygen in the Management of Severe COVID-19: A Systematic Review.

Paraskevas, Themistoklis / Oikonomou, Eleousa / Lagadinou, Maria / Karamouzos, Vasileios / Zareifopoulos, Nikolaos / Spyropoulou, Despoina / Velissaris, Dimitrios

Acta medica portuguesa

2022 Volume 35, Issue 6, Page(s) 476–483

Abstract: Introduction: Oxygen therapy remains the cornerstone for managing patients with severe SARS-CoV-2 infection and several modalities of non-invasive ventilation are used worldwide. High-flow oxygen via nasal canula is one therapeutic option which may in ... ...

Abstract	Introduction: Oxygen therapy remains the cornerstone for managing patients with severe SARS-CoV-2 infection and several modalities of non-invasive ventilation are used worldwide. High-flow oxygen via nasal canula is one therapeutic option which may in certain cases prevent the need of mechanical ventilation. The aim of this review is to summarize the current evidence on the use of high-flow nasal oxygen in patients with severe SARS-CoV-2 infection. Material and methods: We conducted a systematic literature search of the databases PubMed and Cochrane Library until April 2021 using the following search terms: "high flow oxygen and COVID-19" and "high flow nasal and COVID-19". Results: Twenty-three articles were included in this review, in four of which prone positioning was used as an adjunctive measure. Most of the articles were cohort studies or case series. High-flow nasal oxygen therapy was associated with a reduced need for invasive ventilation compared to conventional oxygen therapy and led to an improvement in secondary clinical outcomes such as length of stay. The efficacy of high-flow nasal oxygen therapy was comparable to that of other non-invasive ventilation options, but its tolerability is likely higher. Failure of this modality was associated with increased mortality. Conclusion: High flow nasal oxygen is an established option for respiratory support in COVID-19 patients. Further investigation is required to quantify its efficacy and utility in preventing the requirement of invasive ventilation.
MeSH term(s)	Humans ; COVID-19/therapy ; Oxygen/therapeutic use ; SARS-CoV-2 ; Respiratory Insufficiency/drug therapy ; Noninvasive Ventilation ; Oxygen Inhalation Therapy
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-01-14
Publishing country	Portugal
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	603078-6
ISSN	1646-0758 ; 0870-399X
ISSN (online)	1646-0758
ISSN	0870-399X
DOI	10.20344/amp.16686
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Article ; Online: N-acetylcysteine efficacy in patients hospitalized with COVID-19 pneumonia: a systematic review and meta-analysis.

Paraskevas, Themistoklis / Kantanis, Anastasios / Karalis, Iosif / Michailides, Christos / Karamouzos, Vasileios / Koniari, Ioanna / Pierrakos, Charalampos / Velissaris, Dimitrios

Romanian journal of internal medicine = Revue roumaine de medecine interne

2023 Volume 61, Issue 1, Page(s) 41–52

Abstract: Background: N-acetylcysteine (NAC) is a mucolytic agents with anti-inflammatory properties that has been suggested as an adjunctive therapy in patients with COVID-19 pneumonia.: Objectives: We conducted a systematic review and meta-analysis to ... ...

Abstract	Background: N-acetylcysteine (NAC) is a mucolytic agents with anti-inflammatory properties that has been suggested as an adjunctive therapy in patients with COVID-19 pneumonia. Objectives: We conducted a systematic review and meta-analysis to evaluate available evidence on the possible beneficial effects of NAC on SARS-CoV-2 infection. Methods: In September 2022, we conducted a comprehensive search on Pubmed/Medline and Embase on randomized controlled trials (RCTs) and observational studies on NAC in patients with COVID-19 pneumonia. Study selection, data extraction and risk of bias assessment was performed by two independent authors. RCTs and observational studies were analyzed separately. Results: We included 3 RCTs and 5 non-randomized studies on the efficacy of NAC in patients with COVID-19, enrolling 315 and 20826 patients respectively. Regarding in-hospital mortality, the summary effect of all RCTs was OR: 0.85 (95% CI: 0.43 to 1.67, I Conclusion: The certainty of evidence in the included studies was very low, thus recommendations for clinical practice cannot be yet made. For all hard clinical outcomes point estimates in RCTs are close to the line of no effect, while observational studies have a high degree of heterogeneity with some of them suggesting favorable results in patients receiving NAC. More research is warranted to insure that NAC is both effective and safe in patients with COVID-19 pneumonia.
MeSH term(s)	Humans ; COVID-19 ; Acetylcysteine/therapeutic use ; SARS-CoV-2 ; Hospitalization
Chemical Substances	Acetylcysteine (WYQ7N0BPYC)
Language	English
Publishing date	2023-03-16
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2015966-3
ISSN	2501-062X ; 0035-3973 ; 1582-3296
ISSN (online)	2501-062X
ISSN	0035-3973 ; 1582-3296
DOI	10.2478/rjim-2023-0001
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Article ; Online: N-acetylcysteine efficacy in patients hospitalized with COVID-19 pneumonia

Paraskevas Themistoklis / Kantanis Anastasios / Karalis Iosif / Michailides Christos / Karamouzos Vasileios / Koniari Ioanna / Pierrakos Charalampos / Velissaris Dimitrios

Romanian Journal of Internal Medicine, Vol 61, Iss 1, Pp 41-

a systematic review and meta-analysis

2023 Volume 52

Abstract: Background: N-acetylcysteine (NAC) is a mucolytic agents with anti-inflammatory properties that has been suggested as an adjunctive therapy in patients with COVID-19 pneumonia. Objectives: We conducted a systematic review and meta-analysis to evaluate ... ...

Abstract	Background: N-acetylcysteine (NAC) is a mucolytic agents with anti-inflammatory properties that has been suggested as an adjunctive therapy in patients with COVID-19 pneumonia. Objectives: We conducted a systematic review and meta-analysis to evaluate available evidence on the possible beneficial effects of NAC on SARS-CoV-2 infection.
Keywords	antioxidants ; oxidative stress ; covid-19 ; n-acetylcysteine ; critical care ; Internal medicine ; RC31-1245
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Sciendo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: High flow nasal cannula oxygen therapy in adults with COVID-19 respiratory failure. A case report

Vasileios Karamouzos / Fotini Fligou / Charalambos Gogos / Dimitrios Velissaris

Monaldi Archives for Chest Disease, Vol 90, Iss

2020 Volume 2

Abstract	The novel corona virus (SARS-CoV-2) continuous to spread around the globe causing high mortality, tremendous stress on healthcare systems and an unprecedented disruption of everyday life with unpredictable socioeconomic ramifications. The diseaseis typically affecting the respiratory system and some patients will develop refractory hypoxemic respiratory insufficiency requiring mechanical ventilation. The role of non-invasive ventilation (NIV), high flow nasal cannula (HFNC) or continuous positive airway pressure devices (C-PAP) in the treatment of the 2019 corona virus disease (COVID-19) is not yet clear. We hereby report a case of a 44-year-old COVID-19 positive male patient suffering from hypoxic respiratory failure that was successfully treated with high flow nasal cannula oxygen therapy in a negative pressure intensive care room. Although specific criteria for the use of high flow nasal canula devices COVID-19 are not available at this time, clinicians could use this non-invasive modality as analternative method of respiratory support in selected patients presenting with respiratory failure.
Keywords	SARS-CoV-2 ; COVID-19 ; high flow nasal cannula ; Medicine ; R ; covid19
Subject code	610
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	PAGEPress Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Role of High Flow Nasal Oxygen in the Management of Severe COVID-19

Themistoklis Paraskevas / Eleousa Oikonomou / Maria Lagadinou / Vasileios Karamouzos / Nikolaos Zareifopoulos / Despoina Spyropoulou / Dimitrios Velissaris

Acta Médica Portuguesa, Vol 35, Iss 6, Pp 476-

A Systematic Review

2022 Volume 483

Abstract	Introduction: Oxygen therapy remains the cornerstone for managing patients with severe SARS-CoV-2 infection and several modalities of non-invasive ventilation are used worldwide. High-flow oxygen via nasal canula is one therapeutic option which may in certain cases prevent the need of mechanical ventilation. The aim of this review is to summarize the current evidence on the use of high-flow nasal oxygen in patients with severe SARS-CoV-2 infection. Material and Methods: We conducted a systematic literature search of the databases PubMed and Cochrane Library until April 2021 using the following search terms: “high flow oxygen and COVID-19” and “high flow nasal and COVID-19’’. Results: Twenty-three articles were included in this review, in four of which prone positioning was used as an adjunctive measure. Most of the articles were cohort studies or case series. High-flow nasal oxygen therapy was associated with a reduced need for invasive ventilation compared to conventional oxygen therapy and led to an improvement in secondary clinical outcomes such as length of stay. The efficacy of high-flow nasal oxygen therapy was comparable to that of other non-invasive ventilation options, but its tolerability is likely higher. Failure of this modality was associated with increased mortality. Conclusion: High flow nasal oxygen is an established option for respiratory support in COVID-19 patients. Further investigation is required to quantify its efficacy and utility in preventing the requirement of invasive ventilation.
Keywords	cannula ; covid-19 ; critical care ; noninvasive ventilation ; oxygen/therapeutic use ; respiration ; artificial ; respiratory distress ; syndrome ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Ordem dos Médicos
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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