Coagulation and platelet profiles of COVID-19 patients admitted to a COVID Referral Center from March 2020 to December 2022

Objective@#This study aimed to determine the demographic profiles of admitted COVID-19 patients, the association of coagulation and platelet tests on COVID-19 severity and compare the coagulation and platelet profile across the spectrum of the disease in terms of severity among adult COVID-19 patients admitted to the Philippine General Hospital from March 2020 to December 2022. @*@#Methodology. Medical records of a sample of adult COVID-19 patients admitted to the emergency room of the Philippine General Hospital from March 2020 to December 2022 were reviewed. The demographics, initial COVID-19 diagnosis and initial coagulation and platelet test results were gathered and tabulated. Comparison of the initial coagulation and initial platelet results were made per disease category. @*Results@#Three hundred eighty-five (385) patients were included; 194 were males, and 191 were females. The mean age of all patients was 56.18 years old. There was a total of 30 patients classified as mild and 105 patients are under moderate category. 141 patients were classified as severe, whereas 109 patients were classified as critical. Platelet count test and Activated Partial Thromboplastin Time (APTT) were mostly normal in all disease categories. Prothrombin time was normal in a majority of patients from the mild and severe categories. INR and D-dimer were all elevated mostly in all disease categories.@*Conclusion@#Platelet counts and APTT were mostly normal in all disease categories. Prothrombin time and D-dimer had a significant association with disease severity. Platelet count, APTT and INR did not show significant association with disease severity. Prothrombin time, APTT, INR and D-dimer means had significant differences versus disease categories.

Baseline complete blood count and cell population data as prognostic markers for in-hospital mortality among COVID-19 patients admitted at the Philippine General Hospital from March 2020 to January 2022

INTRODUCTION@#Complete blood count (CBC) and cell population data (CPD) are hematologic parameters used in several clinical scenarios including infection and neoplastic processes. In the setting of COVID-19 infection, there is relative paucity of data in their use as possible prognostic markers.@*OBJECTIVE@#We aim to evaluate the utility of the baseline CBC and CPD as prognostic markers for in-hospital mortality among COVID-19 patients admitted in Philippine General Hospital from March 2020 to January 2022.@*METHODOLOGY@#This is a case-control study. Expired patients served as cases, and recovered patients served as controls. Data from eligible patients including age, sex, admitting COVID diagnosis with severity, final disposition, baseline CBC and CPD results were collected from the hospital medical records and hematology section of the Department of Laboratories. Statistical analyses were done to determine the prognostic value of these parameters for in-hospital mortality.@*RESULTS@#Among the different CBC and CPD parameters, the study shows total white blood cell (WBC) count, absolute neutrophil count (ANC), absolute eosinophil count (AEC), and neutrophil-lymphocyte ratio (NLR) were statistically significant predictors for in-hospital mortality. For total WBC count, at a cut off 9.9 x 10 9 /L, the sensitivity and specificity is 70.9% and 66.2%, respectively. For ANC, at a cut off of 7.3 x 10 9 /L, the specificity is 76.4% and the specificity is 68.2%. At a cut off of 7.62, the NLR shows a sensitivity of 76.4% and specificity of 70.1%. For AEC, at a cut off of 0.006 x 10 9 /L, the sensitivity is 53.3% and the specificity is 87.3%. AEC predicts towards the direction of survival rather than to the direction of in-hospital mortality.@*CONCLUSION@#The total WBC count, ANC, and NLR were statistically significant predictors for in-hospital mortality, while AEC predicts towards the direction of survival. The sensitivities and specificities of the cut off for these parameters were less than ideal. Correlation with clinical and other laboratory parameters is still recommended. For future studies, the authors recommend monitoring CBC and CPD parameters at different time points during the patients’ hospital course.

Glomangiopericytoma: A rare sinonasal neoplasm

@#Glomangiopericytoma is a rare neoplasm of the nasal and paranasal sinuses comprising less than 1% of all tumors of the said region. We report of a 59-year-old hypertensive male who presented with epistaxis. CT scan findings showed a mass in the right nasal cavity with extension into the ethmoid and sphenoid sinuses. Histopathologic diagnosis was glomangiopericytoma confirmed with immunohistochemistry studies. Prognosis is favorable with complete resection of tumor and long-term monitoring.

Disseminated double-hit lymphoma in a young adult

@#High-grade B-cell lymphoma with MYC and BCL2 and-or BCL6 rearrangements, also called double-hit lymphoma, is an aggressive mature B-cell lymphoma that carries both MYC and BCL2 and/or BCL6 translocations. This can present as a diagnostic challenge since clinical characteristics, morphology and immunophenotype are not accurate indicators of underlying genetic aberrations in this type of lymphoma. We report a case of a 25-year-old male who presented with a one-year history of cough, gradually increasing abdominal girth and jaundice. Definitive diagnosis was made post-mortem with additional ancillary studies using immunohistochemistry staining and fluorescent in-situ hybridization studies.

The diagnostic accuracy of hematologic parameters, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio, in malignant and benign epithelial neoplasms of the ovary in Philippine General Hospital Service Patients

Background and Objectives@#Early detection of ovarian neoplasms confer a better outcome and prognosis for patients. Although newer diagnostic modalities have been recently developed, the availability and accessibility of complete blood count parameters specifically, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) make it a convenient and cost-effective marker to aid as a pre-operative predictor of epithelial ovarian neoplasms. We aim to determine the significance and relationship of preoperative NLR and PLR in predicting a diagnosis of malignant surface epithelial ovarian tumor.@*Methodology@#We gathered surgical pathology reports and complete blood count parameters of service patients with benign and malignant surface epithelial ovarian neoplasms. Diagnostic accuracy of NLR and PLR was determined by using receiver operating curve (ROC) plots. Optimal cutoff points were set using the Youden index.@*Results@#We have included 351 cases of ovarian surface epithelial neoplasms, 209 of which were benign and 142 of which were malignant. The ROC curve for PLR had an area under curve (AUC) of 0.6629 [0.6043, 0.7215]. The optimal cut-off point of was set at 195.99 with the maximal Youden index of 0.295 [9.193, 0.396]. The corresponding sensitivity of this test to determine malignancy at this point was 56.5% [47.8, 64.6] while the specificity was at 73.2% [66.7, 79.1]. The ROC curve for NLR had an AUC of 0.6616 [0.6051, 0.7180]. The optimal cut-off point of was set at 2.60 with the maximal Youden index of 0.316 [0.219, 0.413]. The corresponding sensitivity of this test to determine malignancy at this point was 76.1% [68.2, 82.8] while the specificity was at 55.5% [48.5, 62.4].@*Conclusion@#The utility of CBC parameters such as PLR and NLR are cost-effective tools which may have some diagnostic value but, they cannot be used as a stand-alone predictor of malignancy and must be correlated with other clinical, laboratory and radiologic studies.