Haematological indices and coagulation profile as predictors of disease severity and associations with clinical outcome among COVID­19 patients in Lagos, Nigeria

Background: This study aims to evaluate the use of haematological indices and coagulation profiles as possible low cost predictors of disease severity and their associations with clinical outcomes in COVID 19 hospitalized patients in Nigeria. Materials and Methods: We carried out a hospital based descriptive 3 month observational longitudinal study of 58 COVID 19 positive adult patients admitted at the Lagos University Teaching Hospital, Lagos, Nigeria. We used a structured questionnaire to obtain the participants' relevant sociodemographic and clinical data, including disease severity. Basic haematologic indices, their derivatives, and coagulation profile were obtained from patients' blood samples. Receiver Operating Characteristic (ROC) analysis was used to compare these laboratory based values with disease severity. A P < 0.05 was considered statistically significant. Results: The mean age of the patients was 54.4 ± 14.8 years. More than half of the participants were males (55.2%, n = 32) and most had at least one comorbidity (79.3%, n = 46). Significantly higher absolute neutrophil count (ANC), neutrophil­lymphocyte ratio (NLR), systemic immune inflammation index (SII), lower absolute lymphocyte count (ALC) and lymphocyte­monocyte ratio (LMR) were associated with severe disease (P< 0.05). Patients' hemoglobin concentration (P= 0.04), packed cell volume (P< 0.001), and mean cell hemoglobin concentration (P= 0.03) were also significantly associated with outcome. Receiver operating characteristic (ROC) analysis of disease severity was significant for the ANC, ALC, NLR, LMR, and SII. The coagulation profile did not show any significant associations with disease severity and outcomes in this study. Conclusion: Our findings identified haematological indices as possible low cost predictors of disease severity in COVID 19 in Nigeria

Use of exchange blood transfusion in the management of severe COVID-19 infection in pregnancy: experience from Lagos, Nigeria

Coronavirus disease 2019 (COVID-19) presents with symptoms that may be mild or severe. The individual with the severe form of the disease usually presents with a constellation of respiratory symptoms typical of acute respiratory distress syndrome. In this report, we present our experience of the successful management of an oxygen-dependent pregnant woman with severe COVID-19 infection who had 2 sessions of partial exchange blood transfusion. We discussed the principles that informed this intervention and the need to adopt this novel approach in the care of severe COVID-19 infection.