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

Outcome of Haematological and Haemostatic Indices in Hospitalized Yellow Fever Patients at the Centre for Communicable Disease Control and Research (CCDCR) Federal Medical Centre, Asaba, Delta State, Nigeria

Study Design:Retrospective observational study.Place and Duration of Study:Centre for Communicable Disease Control and Research (CCDCR), Federal Medical Centre Asaba, Nigeria, between August and December 2020.Methodology:Descriptive data was collected from the records of fifty-six (56) patients aged 16 –65 years who were hospitalized and treated at the CCDCR FMC Asaba, within the months of August to December, 2020 and 56 non-Yellow Fever subjects as control subjects. The patients’ samples were previously collected and analyzed for haematological parameters (neutrophil, eosinophil, basophil, lymphocytes, monocytes, platelet count, mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC), using an automated haematology analyzer. Data collected was analyzed using SPSS version 25 and P values less than .05were considered statistically significant. Results:There were higher levels of total white blood cell count, eosinophil and MCH in hospitalized yellow fever patients when compared with the control group (P < 0.05). On the other hand, there was a lower level in platelet count of hospitalized yellow fever patients when compared with non-yellow fever control subjects (P < 0.05). There was no significant difference in other haematological indices assayed which appeared normal (P > 0.05).Conclusion:In conclusion, it can be inferred that yellow fever can be associated with several haematological derangements which this study has succeeded to lay bare. Understanding these characteristics aids in planning therapy, management of patients as well as monitoring outcome.

Toxicity of the Hydroethanolic Leaves Extract of Duranta erecta L. in Rat Models

Background and Objectives:Duranta erectais used in folklore medicine for the treatment of myriad of diseases in Africa. The study was carried out to evaluate the safety of hydroethanolic leaves extract of D. erectain experimental rats in order to ascertain its potential toxic effects. Materials and Methods:The acute toxicity study was performed by fixed dose method at 5000 mg/kg. In the subacute study performed on both male and female rats, group I (control) received 1 mL of freshly distilled water, groups II, III, IV were treated with 100, 250 and 500 mg/kg of freshly prepared extract respectively for 28 days. At the end of the study, haematological and biochemical parameters were determined. Internal organs (kidney, liver, lung, heart, spleen, stomach, testes and uterus) were weighed.Results:50% lethal dose (LD50) of the extract was determined to be >5 g/kg body weight. The subacute toxicity assessment resulted in overall body weight increase, a change in relative organ weight of the liver, lung, stomach, and changes in the haematological indices such as HCT%, LYM%, RDW-SD/fL, MCHC, MCV/fL, P-LCR% and biochemical parameters namely ALT, AST, LDH and creatinine of the tested group relative to the normal. The positive activity of the extract on liver enzymes and LDH is an indication of its good hepatoprotective potential.Conclusion:The results affirmed that the extract is safe but could cause kidney problems when used for a prolonged period

Haematological Indices and Predisposing Factors Associated with Tuberculosis at Federal Medical Center Owerri, Imo State, Nigeria

Introduction:Tuberculosis(TB)is a chronic infectious disease caused by bacterium “Mycobacterium tuberculosis”.It is a systemic infection and has deleterious effect on both circulatory and respiratory systems, and thrives more in a society with little knowledge of its predisposing factors.Aim of the Study:This study was carried out to identify the predisposing factors of tuberculosis and itseffects on haematological indices of thepositivepatients at the Federal Medical Center, Owerri, Imo state, Nigeria.Materials and Methods:The blood samples wereanalyzed manuallyfor the indices whilepredisposing factors of Tuberculosis were obtained with the aid of a structured self-administered questionnair,these were administered simultaneously while the blood samples were been collected.Results and Discussion: Results were considered to be statistically signifificant (P<0.05), (OR>1).Simple frequencies were also computed. Theresults revealed that Haemoglobin(P=0.001); Erythrocyte sedimentation rate(P=0.020); Neutrophils(P=0.002); Eosinophils(P=0.000); Monocytes(P=0.000); Platelets(P=0.001) of the Tuberculosis positive patients when compared with the controls, showed, statistically (P<0.05) significant haematological abnormalities. History of Tuberculosis in family(Odd ratio=9.3) and Alcoholism(OR=6.0) were significant predisposing factors of Tuberculosis. Other predisposing factors; smoking habits(OR=2.7), Educationalstatus(OR=2.2), marital status(OR=1.3) were also associated with Tuberculosis infection, while employment status(OR=1.0) and socio-economic status(OR=0.1) were not.Tuberculosis infection in this study adversely affected Haemoglobin, Platelets, Erythrocyte sedimentation rate, Neutrophil, Eosinophil and Monocyte values, while family history of Tuberculosis and Alcoholism were significantly associated with the infection.Conclusion: Quarrantine of Tuberculosis patients and creating more awareness on the predisposing factors of tuberculosis will help towards preventing, reducing and eliminating the disease

The Effect of Hydroxyurea Therapy on Adverse Clinical Events and Haematological Indices in Paediatric Patients with Sickle Cell Anaemia / Efecto de la Terapia con Hidroxiurea en los Eventos Clínicos Adversos y los Indices Haematológicos de Pacientes Paediátricos con Aanemia de Células Falciformes

ABSTRACT Objective: The aim of this study was to determine the effect of hydroxyurea on adverse clinical events and haematological indices in paediatric patients with sickle cell anaemia. Method: This study compared the same cohort of patients before and after hydroxyurea therapy, monitoring the rate of adverse events, pre- and post-treatment and haematological indices. Results: Of the 40 patients, the incidence rate of painful crises post-treatment was 80% lower than pre-treatment. Post-treatment incidence rates of painful crises managed at home, requiring emergency department care or requiring admission to the ward were also lower - 79%, 81% and 84%, respectively. There was no significant difference in the incidence of other clinical events. The haemoglobin concentration increased within the first month and plateaued while the mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC) continued to increase until six months before plateauing out. The white blood cell count (WBC) and absolute neutrophil count (ANC) decreased over the first month before levels stabilized. The reticulocyte percentage and the absolute reticulocyte count (ARC) decreased over the first three months before plateauing while the platelet count remained stable. Conclusion: Hydroxyurea significantly reduced the incidence of painful crises. There were significant increases in haemoglobin, MCV and MCHC with decreases in WBC, ANC, ARC, and reticulocyte percentage while the platelet count remained relatively stable.

RESUMEN Objetivo: El objetivo de este estudio fue determinar el efecto de la hidroxiurea sobre los eventos clínicos adversos y los índices hematológicos en pacientes pediátricos con anemia falciforme. Método: Este estudio comparó una misma cohorte de pacientes antes y después del tratamiento con hidroxiurea, monitoreando la tasa de eventos adversos, el tratamiento previo y posterior, y los índices hematológicos. Resultados: En los 40 pacientes, la tasa de incidencia de postratamiento de crisis dolorosas fue 80% inferior a la del pretratamiento. Las tasas de incidencia de postratamientos de crisis dolorosas que fueron tratadas en el hogar, atendidas en el departamento de emergencias, o requirieron ingreso hospitalario, fueron también menores -79%, 81%y 84%, respectivamente. No hubo diferencias significativas en la incidencia de otros eventos clínicos. La concentración de hemoglobina aumentó en el primer mes y se estabilizó, mientras que el volumen corpuscular medio (VCM) y la concentración de hemoglobina corpuscular media (CHCM) continuaron aumentando hasta seis meses antes de estabilizarse. nivelarse. El conteo de glóbulos blancos (CGB) y el conteo absoluto de neutrófilos (CAN) disminuyeron durante el primer mes antes de que los niveles se estabilizaran. El porcentaje de reticulocitos y el conteo absoluto de reticulocitos (CAR) disminuyeron durante los primeros tres meses antes de estabilizarse, mientras que el conteo de plateletas permaneció estable. Conclusión: La hidroxiurea redujo significativamente la incidencia de crisis dolorosas. Hubo aumentos significativos de hemoglobina, VCM y CHCM con disminuciones de CGB, CAN, CAR, y porcentaje de reticulocitos mientras que el conteo plaquetario permaneció relativamente estable.

Haematological Indices and Absolute CD4 Counts of Apparently Healthy Population in Ondo State, Nigeria.

Aims: This study was designed and conducted to establish the normal values of various haematological indices and CD4 absolute count for apparently healthy adult in Ondo State, and to compare these values with those obtained for other populations in both tropical and western countries. Study Design: Cross sectional study. Place and Duration of Study: Department of Haematology and the global HIV/AIDS Initiative Nigeria (GHAIN), Federal Medical Centre (FMC), Owo. Nigeria between July 2013 and June 2014. Methodology: Haematological indices and absolute CD4 count were determined in four hundred and eighty one (481) apparently healthy individuals whose ages ranged between 20–50 years, were randomly recruited into this study from the Haematology department, Federal Medical Centre, Owo. Results: The mean blood levels of HCT, RBC, HB and MONO were significantly lower in female subjects compared with male subjects. Also, the mean blood levels of HCT, RBC and HGB were significantly lower while the mean blood level of Retics and ESR were significantly higher with decrease in age group. The comparative values for males and females in this study were also compared with previous established baseline values in Nigeria, Kenya and US. Conclusion: This study was able to establish normal reference values for hematological indices and CD4 counts in apparently normal adults in Ondo State, Nigeria. This range could be useful as a basis for making some clinical decisions and also in enrolling HIV patients into the ART program when absolute CD4 counts are considered.

Comparative Effects of Aqueous Garlic (Allium sativum) and Onion (Allium cepa) Extracts on Some Haematological and Lipid Indices of Rats.

The relationship between some haematological and lipid indices were studied and compared in white albino rats using aqueous garlic (Allium sativum) and onion (Allium cepa) extracts. The effect of garlic and onion extracts were each tested with 0.5, 1.0, and 1.5 mg/kg body wt. concentrations for 28 days. Biochemical parameters were assayed using standard methods. The extracts significantly (P<0.05) lowered the serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein-cholesterol (LDL) but increased the high density lipoprotein cholesterol (HDL) concentration when compared between the control and the test groups though there were no significant differences (P>0.05) when the effects of the extracts were compared at 0.5, 1.0, and 1.5 mg/kg body wt. equal treatments. The results show that there was no significant difference between the effects of the extracts on the haematological indices. The total cholesterol and triacylglycerols concentrations positively correlated to the haematological indices. The results collectively indicate that the extracts have hypolipidaemic effects which were not significant to each other. The results also show that though the extract lowered the TC and TG concentration, they indicated a direct relationship to the haematological indices.