Hematological and other Laboratory Parameter Changes in COVID-19 Patients

Background: World Health Organization (WHO) declared Coronavirus disease of 2019 (COVID-19) as a pandemic in March 2020. The disease showed a wide range of severity ranging from being asymptomatic to causing high mortality. Various laboratory parameters were investigated, which could be used as biomarkers to determine the severity of the disease. The objective of the present study was to analyze hematological, coagulation, and immunological markers in mild, moderate, severe, and critical cases of COVID-19 patients and their relation to the outcome. Materials and methods: A retrospective observational study of 1,000 COVID-19-positive hospitalized patients was conducted. Cases were classified into mild, moderate, severe, and critical groups using WHO guidelines. Along with demographic data, hematological, coagulation, and inflammatory parameters were analyzed and correlated with severity and survival. Result: Out of the total 1,000 cases, there were 510 cases in mild, 232 in moderate, 201 in severe, and 57 in the critical category. Increase in total white blood cell count, absolute neutrophil count (ANC), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and inflammatory parameters like C-reactive protein (CRP), serum ferritin, lactate dehydrogenase (LDH), interleukin-6 (IL-6), and decrease in absolute lymphocyte count (ALC) showed significant difference with disease severity and survival. Conclusion: These are important biomarkers to predict the prognosis and outcome of COVID-19 patients. As these markers are easily available, they could be used to categorize the patients at an early stage for optimum management.

Sudden, unexpected and natural death in young adults of age between 18 and 35 years: A clinicopathological study.

Context: To identify various causes, risk factors, age and sex distribution associated with sudden and unexpected natural deaths (SUNDs) in young adults of age between 18 and 35 years. Materials and Methods: Retrospective analysis of autopsy reports and medical records of all SUNDs that occurred instantaneously or within 24 hours of onset of symptoms in young adults, between 2001 and 2009. Result: Of the total 6453 deaths autopsied during 2001-2009, 64 (0.99%) were SUNDs in young adults, chiefly in males between 30 and 35 years of age. Non-cardiac causes significantly predominated (73.4%) over cardiac causes (7.8%). Most of the SUND cases were due to preventable causes, including infections (54.6% cases), cerebrovascular accidents (9.37%) and ischemic cardiac causes (6.25%). Sudden adult death syndrome (SADS) accounted for 18.75% deaths. Conclusion: SUND in young adults is preventable. A meticulous post-mortem examination with special attention to the conduction system of heart and detailed toxicological analysis can pinpoint the cause of death in SADS.

Alagille syndrome.

Syndromic paucity of bile ducts or "Alagille syndrome" is characterized by peculiar facies, chronic cholestasis, posterior embryotoxon, butterfly-like vertebral arch defects and peripheral pulmonary artery hypoplasia or stenosis. We present a two-year-old female child with the 'partial' or 'incomplete' Alagille syndrome. The child had three of the five major features of the syndrome. A brief review of literature of the syndrome is presented.