Hemograms and serial hemogram-derived ratios in survivors and non-survivors of COVID-19 in Campinas, Brazil

Introduction The hemogram and hemogram-derivative ratios (HDRs) are becoming markers of the severity and mortality of COVID-19. We evaluated the hemograms and serial weekly HDRs [neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), neutrophil-platelet ratio (NPR) and systemic immune-inflammatory index (SII)] in the survivors and non-survivors of COVID-19. Methods We retrospectively reviewed the medical notes and serial hemograms of real-time reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 adults hospitalized from April 2020 to March 2021 from the time of diagnosis to the 3rd week of diagnosis. Results Of the 320 adults, 257 (80.3%) were survivors and had a lower mean age than the non-survivors (57.73 vs. 64.65 years, p < 0.001). At diagnosis, the non-survivors had lower hematocrit (p = 0.021), and lymphocyte (p = 0.002) and basophil (p = 0.049) counts and the hematocrit showed a p-value (Is this what you meant???) of 0.021); higher NLR (p < 0.001), PLR (p = 0.047), NPR (p = 0.022) and SII (p = 0.022). Using general linear models, the survivors and non-survivors showed significant variations with weekly lymphocyte count (p < 0.001), neutrophil count (p = 0.005), NLR (p = 0.009), MLR (p = 0.010) and PLR (p = 0.035). All HDRs remained higher in the non-survivors in the 2nd week and 3rd week of diagnosis and the HDRs were higher in the intubated patients than in the non-intubated patients. The NLR and SII were more efficient predictors of mortality in COVID-19 patients. Conclusions This study shows that serial lymphocyte and neutrophil counts, NLR, PLR, MLR, NPR and SII could serve as good and easily accessible markers of severity and predictors of outcomes in COVID-19 patients and should be used for the monitoring of treatment response.

Changes in blood counts, serum lactate dehydrogenase activity and haptoglobin level in malaria infected subjects in Nnewi, Anambra state, Nigeria

Background: Malaria is a mosquito-borne public health problem which alters the blood counts, haptoglobin level and serum lactate dehydrogenase (sLDH) activity of the infected individuals. Some of the alterations are associated risk factors in malaria pathology. This study aims at elucidating changes in blood counts, sLDH activity and haptoglobin level in malaria infected subjects seen in a Tertiary Health Institution in Nnewi, as search for associated risk factors in malaria pathology.Methods: This cross sectional study enrolled 270 age matched subjects between 18-65 years. The test group (200) who tested positive to P. falciparium was placed into two groups based on their parasite counts with cut-off of  ≥1000 parasites x 109/L. Group one (100) had counts above the cut-off and group two (100) below. The control (70) was aparasitemic. The demographic data were noted and 4mls of blood drawn. 2mls in K3EDTA was for FBC testing using Mythic 22 hematology analyzer, and remaining dispensed into plain tubes was for sLDH assay by kinetic method and haptoglobin by ELISA technique.Results: The HCT, Hb, RBC and Platelet count of test were progressively significantly lowered (p=0.001) compared to control, with an intra-significant difference among the 3 groups (p<0.05), also the parameters were found to have an inverse significant relationship (p=0.001) to the parasite counts. This trend was also seen with haptoglobin while reverse was the case with LDH activity which rather increased significantly (p = 0.000) at opposite direction as parasite density increases.Conclusions: This study show that the degree of intravascular haemolysis is directly influenced by the parasite density, this portends that high endemicity and perennial parasiteamia in the study area could cause chronic anaemia and thrombocytopenia in the population studied.

Impact of blood group in dengue: a study

Background: Dengue can result in high mortality. Several studies have shown an association of blood groups with the severity of dengue. In our study we attempt to associate the prevalence of blood groups with the known hematological prognosticators and thus derive its impact on the severity of dengue. We aim to study the patterns and prevalence of different ABO blood groups in dengue fever.Methods: A total of 100 serologically proven dengue cases over a month’s period in November 2016 were recruited for our study. Their relevant hematological data (obtained by automated haematology analyser and peripheral smears) and blood grouping results were recorded and analyzed.Results: The age range was 5 months to 65 years with a slight male predominance. Analysis of the blood group patterns showed prevalence of O group (42%) followed by A and B group (27% each). B group was more prevalent in children (34%) and females (31%) with dengue.The patients with B group showed increased derangement in hematological parameters namely higher number of cases with B group showed rise in haematocrit (59%), an increased number of cases with leucopenia (56%), higher proportion of cases with lymphocytosis (45%) and severe thrombocytopenia (74%) when compared to the other blood groups.Conclusions: Our study shows that blood groups can impact severity of dengue and that B group is a risk factor for severity hence, such individuals warrant close supervision especially in the presence of other risk factors.

Effects of Body Mass Index (BMI) on complete blood count parameters

Background: Anemia is considered by Worl Health Organization (WHO) as a global health problem. It can be affected by the body mass index of an individual since increasing weight can result in low-grade systemic inflammation and elevation of hepcidin which results in seguestratiion of iron inside a variety of cells including macrophages, hepatocytes and enteroytes and this would lead to the development of what is known as anemia of inflammation. In this study, we aimed to evaluate the effects of BI on complete blood count parameters. Patients and methods: In this crosssectional, retrospective study: the data of 200 overweight and obese male patients aged (18-60 years) were collected. They were grouped according to BMI into everweight and obese: different CBC parameters were noted. Inter group comparison was applied regarding different blood parameters and the relations eith BMI were calculated. Results: The prevalence of anemia was 16%. An extremely significant difference was found in mean white blood cells count in relation to different BMI gropups (p=0.001). A positive linear correlation was found between BMI with RDW, WBS, and platelets. Conclusions: There were effects of increasing BMI on WBC, RDW and platelets (AU)

Evaluation of criteria of manual blood smear review following automated complete blood counts in a large university hospital

Abstract Background: There is great interest in reducing the number of automated complete blood counts requiring manual blood smear reviews without sacrificing the quality of patient care. This study was aimed at evaluating and establishing appropriate screening criteria for manual blood smear reviews to improve the performance in a hematology laboratory. Method: A total of 1977 consecutive samples from the daily workload were used to evaluate four sets of screening criteria for manual blood smear reviews to identify samples with positive smear findings. Three sets of screening criteria were arbitrarily proposed in this study: Group 1 (narrow ranges), Group 2 (intermediate ranges), and Group 3 (wide limits) and one set (Group 4) was adapted from the International Society for Laboratory Hematology. All samples were run on Sysmex hematology analyzers and were investigated using manual blood smear reviews. Diagnostic accuracy and agreement were performed for each set of screening criteria, including an investigation of microscopic review rate and efficiency. Results: The microscopic review rates for Groups 1, 2, 3 and 4 were 73.85%, 54.52%, 46.33% and 46.38%, respectively; the false-negative rates were 0.50%, 1.97%, 2.73% and 3.95%, respectively. The efficiency and negative predictive values of Group 3 were 73.04% and 4.91%, respectively. Conclusions: Group 3 had the best relationship between safety (false-negative rate: ≤3%) and efficiency to estimate the limits of automation in performing complete blood counts. This study strengthens the importance of establishing screening criteria for manual blood smear reviews, which account for the different contexts in which hematological determinations are performed. Each laboratory should optimize the screening criteria for manual blood smear reviews in order to maximize their efficiency and safety.

Hematological parameters in children with Down syndrome / Parâmetros hematológicos em crianças com síndrome de Down

Introduction: There are few studies that investigated whether Down syndrome (DS) interferes with references values for complete blood counts (CBC) test in children with the syndrome. Objective: This study aimed to analyze the results of CBC performed in children with DS. Patients and methods: Data from CBC of DS children were included; at the time of examination they were aged between 2 and 10 years and had no clinical signs and/or symptoms of infectious disease. The hematological parameters analyzed were: total number of erythrocytes (RBC), hemoglobin (Hb) concentration, hematological indices, platelet count, and total number of leucocytes. Additionally, we compared the collected parameters according to gender and age of the children studied. Results: A total of 203 CBC (100 girls and 103 boys) were evaluated. In general, no significant differences were observed in studied parameters between the values found in samples of DS children and the values described in the literature as a reference for children in this age group. No difference in the prevalence of anemia was observed in relation to gender (p = 0.33), 14/103 (13.6%) boys, and 11/100 (11%) girls had anemia. However, the Hb and hematological indices values found in boys was significantly lower than in girls (p < 0.001). Conclusion: This investigation is the first one in Brazil to present and analyze the CBC results of DS children, reporting that their hematological indices are within the expected range for children without DS. Additionally, it was found that 12.3% of them had anemia. .

Introdução: São escassos os estudos que investigaram se a síndrome de Down (SD) interfere nos valores de referência para a avaliação do hemograma em crianças com a síndrome. Objetivos: Analisar os resultados dos hemogramas realizados em crianças com SD. Casuística e métodos: Foram incluídos os dados retirados dos hemogramas realizados em crianças com SD que, no momento do exame, tinham idade entre 2 e 10 anos e não apresentavam no exame clínico sinais e/ou sintomas de doença infecciosa. Os parâmetros hematológicos analisados foram número total de eritrócitos, concentração de hemoglobina (Hb), índices hematimétricos e número total de plaquetas e de leucócitos. Adicionalmente, foram comparados os parâmetros coletados em relação ao gênero e à idade das crianças estudadas. Resultados: No total, foram avaliados 203 hemogramas (100 meninas e 103 meninos). De maneira geral, comparando-se os valores encontrados nas amostras das crianças com SD e os valores já descritos na literatura como sendo de referência para crianças nessa faixa etária, não foram observadas diferenças significativas nos parâmetros estudados. Não se observou diferença na prevalência de anemia em relação aos gêneros (p = 0,33), sendo 14/103 (13,6%) meninos e 11/100 (11%) meninas com anemia. No entanto, na comparação entre os gêneros, observou-se que os meninos apresentaram Hb e índices hematimétricos significativamente menores que as meninas (p < 0,001). Conclusão: Esta investigação é pioneira no Brasil ao apresentar e analisar os resultados dos hemogramas das crianças com SD, relatando que seus índices hematológicos encontram-se dentro do esperado para crianças sem a SD. Adicionalmente, foi possível verificar que 12,3% delas apresentavam anemia. .

Analysis of the routine blood counts and blood biochemical parameters and hemorheology in the rats with congenital cataract / 中国比较医学杂志

Objective To measure the range of routine blood counts and blood biochemical parameters ,to analyze hemorheology of the rats with congenital cataract .Methods Blood samples were taken from 90 rats with congenital cataract weight about 185 ~211 g.Routine blood analysis was performed and blood biochemical and hemorheology paramenters were determind using an automatic blood biochemical and hemorheology analyzer .Results There were no significant difference ( P >0.05 ) between the cataract rats and the normal rats in Blood test results; but there were significant difference between the microphthalmos cataract rats and the normal same -sex rats ( P <0.01 or P <0.05 ) . The biochemical results is the cataract rats and the normal rats were different significantly in ALB group ( P <0.01 or P<0.05), and the female microphthalmos cataract rats compared with the control rats had significant difference in Ure (P<0.01) , the female cataract rats ompared with the normal rats were very significant difference in Cr group ( P <0.05 or P <0.01).The erythrocyte counts of the male cataract rats and male microphthalmos cataract rats were significantly lower than that in the female ones, respectively(P <0.05, P <0.01).The platelet counts of the male cataract rats and the male microphthalmos cataract rats were significantly higher than that in the female ones , respectively(P <0.01), and the creatinine of the male cataract rats and the male microphthalmos cataract rats were significantly lower then that in the female ones, respectively(P <0.01).There were no significant difference in every group on hemorheology .Conclusions There were significant differences in some blood indexes between the congenital cataract rats and the normal rats .These data may become useful reference for biomedical researcher in this field .

Valor predictivo del hemograma en la sepsis neonatal / Predictive value of the complete blood count (CBC) in neonatal sepsis

Objetivo: Realizar un análisis del hemograma, herramienta de diagnóstico accesible en los hospitales públicos y valorar su utilidad en la sepsis neonatal. Metodología: Estudio de pruebas diagnósticas, desarrollado en el Hospital General Pediátrico Niños de Acosta Ñu, del 1 de enero del 2008 al 31 de diciembre de 2009. Resultados: Desde enero del 2008 a diciembre del 2009 ingresaron 209 RN en Urgencias y Terapia Intensiva Pediátrica del HGP. Tuvieron hemocultivo positivo 30 pacientes ingresados al estudio. Presentaron leucopenia 13 % (4/30) en el grupo de sepsis vs 10% (4/40) en el grupo control, leucocitosis 23% (7/30) en el grupo sepsis vs 35 % (14/40) en el grupo control. La leucopenia tuvo una S = 13% E= 90% VPP 50% y VPN 58%. El CP+ de 3 y CP- de 0,96. Solo 13 % presento neutropenia 4/30 del grupo sepsis y 12,5% (5/40) del grupo control, neutrofilia (>17500) se observo en el 41 %, (13/30) grupo sepsis y 40% (16/40) del grupo control. Considerando la S,E VPP,VPN y CP para cada uno de los puntos de cortes, se tuvo, para neutropenia S 13%, E 87%, VPP 44% VPN 57%; CP+ 1;CP- 1. Neutrofilia S 43 %, E 80 %; VPP 44% VPN 58% CP+ 2; CP- 0,71. Las plaquetas también fueron analizadas, se encontró plaquetopenia (<150000) en el 20 %, (11/30) en el grupo sepsis, y frente a 7,5% (3/40) en el grupo control). Las plaquetas en promedio en el grupo con sepsis fue 200.000±139.897 vs grupo control 340.825± 15.0417 (p= 0,0002) Para la plaquetopenia la S 36%, E de 92 %; VPP 78%; VPN 66%; CP+ 4,5 y CP- de 0,6. El análisis de los verdaderos positivos y los falsos positivos con la curva ROC mostró un área bajo la curva para los leucocitos de 0,50 (IC95% 0,36 - 0,65), para los neutrófilos 0,57 (IC 95% 0,43 - 0,71) y para las plaquetas 0,76 (IC 95% 0,64 - 0,88)...

Introduction: Diagnosis of neonatal sepsis remains a challenge. There is no single laboratory test to confirm diagnosis. In recent years the usefulness of various markers has been investigated, but always in conjunction with blood count values (white count, neutrophils etc.). Objective: The purpose of this study is to analyze the complete blood count, a diagnostic tool available in almost all public hospitals, and assess its usefulness in neonatal sepsis. Methodology: A study of diagnostic tests performed at the Niños of Acosta Nu General Pediatric Hospital between January 1, 2008 and December 31, 2009. We analyzed the medical records of newborns clinically diagnosed with sepsis and confirmed by two positive blood cultures. The CBC taken was analyzed as an auxiliary method of diagnosis. Results: 209 newborns were admitted through the hospital’s emergency or pediatric multidisciplinary intensive care units. A study group was formed of the 30 patients with positive blood cultures and a control group from 40 patients with no suspected infection. In the sepsis group leucopenia was shown in 13% (4/30) vs. 10% (4/40) in the control group while leukocytosis was seen in 23% (7/30) of the sepsis group vs. 35% (14/40) in the control group. For leukopenia sensitivity was 13%, specificity 90%, positive predictive value (PPV) 50%, and negative predictive value (NPV) 58%. The positive probability ratio was 3 and negative probability ratio 0.96. In the sepsis group, only 13% (4/30) presented neutropenia vs. 12.5% (5/40) in the control group; neutrophilia (>17500) was observed in 41% (13/30) of the sepsis group and 40% (16/40) of the control group, while in regard to the cutoff points, for neutropenia sensitivity was 13%, specificity 87%, PPV 44%, NPV 57%, positive probability ratio 1, and negative probability ratio 1, while for neutrophilia sensitivity was43%, specificity 80%, PPV 44%, NPV 58% positive probability ratio 2, and negative probability ratio 0.71...

Does soy increase blood counts in myelodysplastic syndromes? / Será que a soja aumenta as contagens sanguíneas em síndrome mielodisplásica?

Myelodysplastic syndromes (MDS) are a group of clonal stem cell diseases characterized by ineffective hematopoiesis, bone marrow hyperproliferation, cytopenias in peripheral blood and risk of transformation into acute leukemia. We decided to investigate the effects of a soy concentrate on MDS patients based on the follow-up results of a 61 year-old Japanese female patient who was diagnosed with MDS and refractory cytopenia with multilineage dysplasia in 2003 (hemoglobin = 11g/dL; white blood cells count = 2,500/uL and platelets = 25,000/uL; marrow with mild dysplasia and normal karyotype; paroxysmal nocturnal hemoglobinuria was excluded). She started using soy as a dietary supplementation in May 2004 and presented a gradual increment in blood counts, achieving normalization approximately eight months afterwards. Among the soy components, the main compounds with anti-carcinogenic activity are the isoflavones (genistein and daidzein). Based on these lines of evidence, we proposed to administer daily a standard soy concentrate to 14 MDS out-patients for a minimum period of three months and maximum of 12 months, in an attempt to evaluate prospectively the possible increase in hemoglobin, neutrophils and platelet counts. A historical control group was used to compare results. The use of a soy concentrate in a standardized manner was associated with an increase in neutrophil and/or platelet counts in some cases, but spontaneous increments were also observed in historical controls. This preliminary study does not allow establishing a relation between soy supplementation and blood cell count increase.

As síndromes mielodisplásicas (SMD) são um grupo das doenças clonais de células-tronco caracterizado por hematopoese ineficaz, hiperproliferação de medula óssea, citopenias no sangue periférico e risco de transformação para leucemia aguda. Decidimos investigar os efeitos de um concentrado de soja em pacientes com SMD com base no fato de termos o seguimento de uma paciente japonesa, de 61 anos de idade, que foi diagnosticada em 2003 com SMD, citopenia refratária com displasia subtipo multilinhagens (hemoglobina = 11 g/dL; contagem de glóbulos brancos = 2.500/uL e plaquetas = 25.000/uL; medula com displasia leve e cariótipo normal; hemoglobinúria paroxística excluída), e que começou a usar a soja como suplemento alimentar em maio de 2004, apresentando gradual aumento da contagem das células sanguíneas, atingindo a normalização cerca de oito meses depois. Entre os componentes da soja, os principais compostos com propriedades anticarcinogênese são as isoflavonas (Ge nisteína e daidzeína). Com base nessas linhas de evidência, foi proposto oferecer diariamente um concentrado de soja padrão, por um período mínimo de três meses e máximo de doze meses, a 14 pacientes ambulatoriais, na tentativa de avaliar, prospectivamente, o possível aumento de hemoglobina, neutrófilos e plaquetas. Um grupo controle histórico foi utilizado para comparar os resultados. O uso de um concentrado de soja de forma padronizada foi associado ao aumento na contagem de neutrófilos e/ou de plaquetas em alguns casos, mas aumentos espontâneos também foram observados em controles históricos. Este estudo preliminar não permite estabelecer relação entre o uso de soja e o aumento na contagem sanguínea.