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  1. Article ; Online: Tidlig antibiotikabehandling til de rette pasientene.

    Holten, Aleksander Rygh / Skrede, Steinar

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2023  Volume 143, Issue 2

    Title translation Early antibiotic treatment for the right patients.
    Language Norwegian
    Publishing date 2023-01-30
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.22.0702
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  2. Article ; Online: Interleukin-6 in Critical Coronavirus Disease 2019, a Driver of Lung Inflammation of Systemic Origin?

    Aarskog, Nikolai Ravn / Aass, Hans Christian / Holter, Jan Cato / Rostrup, Morten / Holten, Aleksander Rygh

    Critical care explorations

    2021  Volume 3, Issue 10, Page(s) e0542

    Abstract: To examine whether interleukin-6 in critical coronavirus disease 2019 is higher in arterial than in central venous blood, as a sign of predominantly local pulmonal rather than systemic interleukin-6 production.: Design: Prospective cohort pilot study ... ...

    Abstract To examine whether interleukin-6 in critical coronavirus disease 2019 is higher in arterial than in central venous blood, as a sign of predominantly local pulmonal rather than systemic interleukin-6 production.
    Design: Prospective cohort pilot study with repeated weekly measurements of interleukin-6 in arterial and central venous blood. Respiratory function, assessed with Pao
    Setting: ICU at a university hospital.
    Subjects: Nine adult patients with critical coronavirus disease 2019, actively treated and receiving mechanical ventilation.
    Measurements and main results: No difference between arterial and central venous interleukin-6 was found. There was a significant negative relationship between interleukin-6 concentration and P/F ratio in both arterial (
    Conclusions: The absence of an arteriovenous interleukin-6 difference implies that interleukin-6 in critical coronavirus disease 2019 is mainly produced outside the lungs as part of a systemic inflammatory response syndrome and act as a driver of local inflammation and damage in the lungs.
    Language English
    Publishing date 2021-09-28
    Publishing country United States
    Document type Journal Article
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000000542
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Delirium is common in patients hospitalized with COVID-19.

    Watne, Leiv Otto / Tonby, Kristian / Holten, Aleksander Rygh / Olasveengen, Theresa Mariero / Romundstad, Luis Georg / Neerland, Bjørn Erik

    Internal and emergency medicine

    2021  Volume 16, Issue 7, Page(s) 1997–2000

    MeSH term(s) Aged ; Aged, 80 and over ; COVID-19/epidemiology ; Comorbidity ; Delirium/epidemiology ; Frailty/epidemiology ; Humans ; Inpatients/statistics & numerical data
    Language English
    Publishing date 2021-04-08
    Publishing country Italy
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-021-02715-x
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  4. Article ; Online: Serum ACE as a prognostic biomarker in COVID-19: a case series.

    Kolberg, Espen Skarstein / Wickstrøm, Kristin / Tonby, Kristian / Dyrhol-Riise, Anne Ma / Holten, Aleksander Rygh / Amundsen, Erik Koldberg

    APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

    2021  Volume 129, Issue 4, Page(s) 237–238

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Biomarkers/blood ; COVID-19/blood ; COVID-19/diagnosis ; COVID-19/veterinary ; Female ; Humans ; Male ; Middle Aged ; Peptidyl-Dipeptidase A/blood ; SARS-CoV-2/genetics ; SARS-CoV-2/physiology
    Chemical Substances Biomarkers ; Peptidyl-Dipeptidase A (EC 3.4.15.1)
    Language English
    Publishing date 2021-01-15
    Publishing country Denmark
    Document type Letter
    ZDB-ID 93340-5
    ISSN 1600-0463 ; 0903-4641
    ISSN (online) 1600-0463
    ISSN 0903-4641
    DOI 10.1111/apm.13108
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  5. Article ; Online: Predicting severe COVID-19 in the Emergency Department

    Holten, Aleksander Rygh / Nore, Kristin Grotle / Tveiten, Caroline Emilie Van Woensel Kooy / Olasveengen, Theresa Mariero / Tonby, Kristian

    Resuscitation Plus

    2020  Volume 4, Page(s) 100042

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2666-5204
    DOI 10.1016/j.resplu.2020.100042
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Escalated complement activation during hospitalization is associated with higher risk of 60-day mortality in SARS-CoV-2-infected patients.

    Barratt-Due, Andreas / Pettersen, Kristin / Børresdatter-Dahl, Tuva / Holter, Jan Cato / Grønli, Renathe H / Dyrhol-Riise, Anne Ma / Lerum, Tøri Vigeland / Holten, Aleksander Rygh / Tonby, Kristian / Trøseid, Marius / Skjønsberg, Ole H / Granerud, Beathe Kiland / Heggelund, Lars / Kildal, Anders Benjamin / Schjalm, Camilla / Aaløkken, Trond Mogens / Aukrust, Pål / Ueland, Thor / Mollnes, Tom Eirik /
    Halvorsen, Bente

    Journal of internal medicine

    2024  

    Abstract: Background: The complement system, an upstream recognition system of innate immunity, is activated upon SARS-CoV-2 infection. To gain a deeper understanding of the extent and duration of this activation, we investigated complement activation profiles ... ...

    Abstract Background: The complement system, an upstream recognition system of innate immunity, is activated upon SARS-CoV-2 infection. To gain a deeper understanding of the extent and duration of this activation, we investigated complement activation profiles during the acute phase of COVID-19, its persistence post-recovery and dynamic changes in relation to disease severity.
    Methods: Serial blood samples were obtained from two cohorts of hospitalized COVID-19 patients (n = 457). Systemic complement activation products reflecting classical/lectin (C4d), alternative (C3bBbP), common (C3bc) and terminal pathway (TCC and C5a) were measured during hospitalization (admission, days 3-5 and days 7-10), at 3 months and after 1 year. Levels of activation and temporal profiles during hospitalization were related to disease severity defined as respiratory failure (PO
    Findings: During hospitalization, TCC, C4d, C3bc, C3bBbP and C5a were significantly elevated compared to healthy controls. Severely ill patients had significantly higher levels of TCC and C4d (p < 0.001), compared to patients with moderate COVID-19. Escalated levels of TCC and C4d during hospitalization were associated with a higher risk of 60-day mortality (p < 0.001), and C4d levels were additionally associated with chest CT changes at 3 months (p < 0.001). At 3 months and 1 year, we observed consistently elevated levels of most complement activation products compared to controls.
    Conclusion: Hospitalized COVID-19 patients display prominent and long-lasting systemic complement activation. Optimal targeting of the system may be achieved through enhanced risk stratification and closer monitoring of in-hospital changes of complement activation products.
    Language English
    Publishing date 2024-03-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 96274-0
    ISSN 1365-2796 ; 0954-6820
    ISSN (online) 1365-2796
    ISSN 0954-6820
    DOI 10.1111/joim.13783
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  7. Article ; Online: Predicting severe COVID-19 in the Emergency Department.

    Holten, Aleksander Rygh / Nore, Kristin Grotle / Tveiten, Caroline Emilie Van Woensel Kooy / Olasveengen, Theresa Mariero / Tonby, Kristian

    Resuscitation plus

    2020  Volume 4, Page(s) 100042

    Abstract: Background: COVID-19 may lead to severe disease, requiring intensive care treatment and challenging the capacity of health care systems. The aim of this study was to compare the ability of commonly used scoring systems for sepsis and pneumonia to ... ...

    Abstract Background: COVID-19 may lead to severe disease, requiring intensive care treatment and challenging the capacity of health care systems. The aim of this study was to compare the ability of commonly used scoring systems for sepsis and pneumonia to predict severe COVID-19 in the emergency department.
    Methods: Prospective, observational, single centre study in a secondary/tertiary care hospital in Oslo, Norway. Patients were assessed upon hospital admission using the following scoring systems; quick Sequential Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome criteria (SIRS), National Early Warning Score 2 (NEWS2), CURB-65 and Pneumonia Severity index (PSI). The ratio of arterial oxygen tension to inspiratory oxygen fraction (P/F-ratio) was also calculated. The area under the receiver operating characteristics curve (AUROC) for each scoring system was calculated, along with sensitivity and specificity for the most commonly used cut-offs. Severe disease was defined as death or treatment in ICU within 14 days.
    Results: 38 of 175 study participants developed severe disease, 13 (7%) died and 29 (17%) had a stay at an intensive care unit (ICU). NEWS2 displayed an AUROC of 0.80 (95% confidence interval 0.72-0.88), CURB-65 0.75 (0.65-0.84), PSI 0.75 (0.65-0.84), SIRS 0.70 (0.61-0.80) and qSOFA 0.70 (0.61-0.79). NEWS2 was significantly better than SIRS and qSOFA in predicating severe disease, and with a cut-off of5 points, had a sensitivity and specificity of 82% and 60%, respectively.
    Conclusion: NEWS2 predicted severe COVID-19 disease more accurately than SIRS and qSOFA, but not significantly better than CURB65 and PSI. NEWS2 may be a useful screening tool in evaluating COVID-19 patients during hospital admission.
    Trial registration: : ClinicalTrials.gov Identifier: NCT04345536. (https://clinicaltrials.gov/ct2/show/NCT04345536).
    Language English
    Publishing date 2020-10-21
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-5204
    ISSN (online) 2666-5204
    DOI 10.1016/j.resplu.2020.100042
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  8. Article ; Online: Structured evaluation on arrival of patients with sepsis and initiation of antibiotics.

    Trydal, Elisabet / Martinsen, Anders B / Beisland, Frode / Jacobsen, Dag / Holten, Aleksander Rygh

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2019  Volume 139, Issue 9

    Abstract: Background: In 2017, Acute Admissions at Oslo University Hospital, Ullevål, introduced a specific protocol for evaluating patients with suspected sepsis on arrival. Patients with suspected sepsis, and all those who fulfilled at least two of three ... ...

    Title translation Strukturert mottak av sepsispasienter og oppstart av antibiotika.
    Abstract Background: In 2017, Acute Admissions at Oslo University Hospital, Ullevål, introduced a specific protocol for evaluating patients with suspected sepsis on arrival. Patients with suspected sepsis, and all those who fulfilled at least two of three criteria in the Quick Sequential Organ Failure Assessment (qSOFA) screening tool, were to undergo a structured evaluation by a dedicated sepsis team. We have examined whether this initiative improved compliance with national recommendations to initiate antibiotics within one hour in cases of sepsis.
    Material and method: Adult patients with suspected sepsis who underwent a structured team evaluation on arrival in Acute Admissions in the period 15 May to 15 November 2017 were included. A retrospective review was used to determine whether or not those included did in fact have sepsis.
    Results: Antibiotics were administered for suspected sepsis following 216 structured evaluations in Acute Admissions (172 by sepsis teams and 44 by general medical teams). In all, 175 (81 %) patients received antibiotics within one hour of arrival in Acute Admissions. Median time from arrival to initiation of antibiotics was 35 minutes. Use of qSOFA alone captured 80 (71 %) of the 112 patients who were subsequently classified as having sepsis.
    Interpretation: Following the introduction of a structured evaluation for patients with suspected sepsis, antibiotic treatment was generally initiated within one hour.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/therapeutic use ; Emergency Service, Hospital ; Female ; Hospitals, University ; Humans ; Male ; Middle Aged ; Norway/epidemiology ; Organ Dysfunction Scores ; Patient Admission ; Prospective Studies ; Retrospective Studies ; Sepsis/classification ; Sepsis/diagnosis ; Sepsis/drug therapy ; Sepsis/mortality ; Time-to-Treatment
    Chemical Substances Anti-Bacterial Agents
    Language Norwegian
    Publishing date 2019-05-27
    Publishing country Norway
    Document type Journal Article ; Observational Study
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.18.0216
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: CXCL16 associates with adverse outcome and cardiac involvement in hospitalized patients with Covid-19.

    Gregersen, Ida / Ueland, Thor / Holter, Jan Cato / Olsen, Maria Belland / Michelsen, Annika E / Murphy, Sarah L / Tveita, Anders Aune / Henriksen, Katerina Nezvalova / Hoel, Hedda / Nordberg, Lena Bugge / Holten, Aleksander Rygh / Edvardsen, Thor / Yang, Kuan / Heggelund, Lars / Trøseid, Marius / Müller, Fredrik / Kildal, Anders Benjamin / Dyrhol-Riise, Anne Ma / Barratt-Due, Andreas /
    Dahl, Tuva B / Aukrust, Pål / Halvorsen, Bente

    The Journal of infection

    2022  Volume 85, Issue 6, Page(s) 702–769

    MeSH term(s) Humans ; COVID-19 ; SARS-CoV-2 ; Chemokine CXCL16
    Chemical Substances CXCL16 protein, human ; Chemokine CXCL16
    Language English
    Publishing date 2022-10-08
    Publishing country England
    Document type Letter
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2022.09.029
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    Zs.A 1501: Show issues Location:
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  10. Article: Predicting severe COVID-19 in the Emergency Department

    Holten, Aleksander Rygh Grotle Nore Kristin Tveiten Caroline Emilie Van Woensel Kooy Olasveengen Theresa Mariero Tonby Kristian

    Resuscitation Plus

    Abstract: Background COVID-19 may lead to severe disease, requiring intensive care treatment and challenging the capacity of health care systems The aim of this study was to compare the ability of commonly used scoring systems for sepsis and pneumonia to predict ... ...

    Abstract Background COVID-19 may lead to severe disease, requiring intensive care treatment and challenging the capacity of health care systems The aim of this study was to compare the ability of commonly used scoring systems for sepsis and pneumonia to predict severe COVID-19 in the emergency department Methods Prospective, observational, single centre study in a secondary/tertiary care hospital in Oslo, Norway Patients were assessed upon hospital admission using the following scoring systems;quick Sequential Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome criteria (SIRS), National Early Warning Score 2 (NEWS2), CURB-65 and Pneumonia Severity index (PSI) The ratio of arterial oxygen tension to inspiratory oxygen fraction (P/F-ratio) was also calculated The area under the receiver operating characteristics curve (AUROC) for each scoring system was calculated, along with sensitivity and specificity for the most commonly used cut-offs Severe disease was defined as death or treatment in ICU within 14 days Results 38 of 175 study participants developed severe disease, 13 (7 %) died and 29 (17 %) had a stay at an intensive care unit (ICU) NEWS2 displayed an AUROC of 0 80 (95 % confidence interval 0 72-0 88), CURB-65 0 75 (0 65-0 84), PSI 0 75 (0 65-0 84), SIRS 0 70 (0 61 – 0 80) and qSOFA 0 70 (0 61-0 79) NEWS2 was significantly better than SIRS and qSOFA in predicating severe disease, and with a cut-off of5 points, had a sensitivity and specificity of 82 % and 60 %, respectively Conclusion NEWS2 predicted severe COVID-19 disease more accurately than SIRS and qSOFA, but not significantly better than CURB65 and PSI NEWS2 may be a useful screening tool in evaluating COVID-19 patients during hospital admission Trial registration : ClinicalTrials gov Identifier: NCT04345536 (https://clinicaltrials gov/ct2/show/NCT04345536)
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #885428
    Database COVID19

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