ABSTRACT
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.
ABSTRACT
Background: Cancer is one of the leading causes of death due to noncommunicable diseases worldwide. Despite increasing public awareness and availability of sophisticated imaging techniques, some cancers evade clinical diagnosis and/or are incidentally encountered at autopsies, often with dissemination. Aims: The present study evaluated the disseminated epithelial cancers at autopsy. Materials and Methods: This is a retrospective observational 5-year autopsy analysis of disseminated epithelial cancers performed at a tertiary-care hospital. The cases were categorized as (1) clinically diagnosed malignancy, known primary; (2) clinically diagnosed malignancy, unknown primary; and (3) clinically undiagnosed malignancy. Statistical Analysis: Nil. Results: Dissemination was identified in 66 (57.9%) of the 114 patients with epithelial malignancies. There were 29 patients (43.9%) in category 1, 26 patients (39.4%) in category 2, and 11 patients (16.7%) in category 3, majority of whom were women (38 patients, 57.6%). When all categories were considered together, lung and colorectal carcinomas were the commonest cancers seen in 13 (19.7%) and 8 (12.1%) patients, respectively, in both men and women. Majority of the patients (43 cases, 65.2%) had symptoms produced by metastases, which were the sole manifestations in 13 patients (19.7%). Lungs and liver were the common metastatic sites. Conclusions: Cancerous dissemination continues to be a major cause of morbidity and mortality even after considerable improvements in the surgical or nonsurgical treatment modalities. An autopsy study can provide important clinical insights in retrospect.