Differential Leucocytes Count: An Independent Predictor of Clinical Outcomes in SARS-CoV-2 Patients

SARS-CoV-2 is a systemic infection that has a significant impact on the hemostasis and hematopoietic system. Lymphopenia may be considered a cardinal laboratory finding, with prognostic potential. The study aimed to determine the differential leukocyte count in SARS-CoV-2 among Sudanese patients, during the period from March to December 2020. A total of 787 subjects were enrolled 487 patients with COVID-19 and 300 healthy volunteers as a control group;their ages ranged from 29 to 89 years. 3 ml of EDTA venous blood samples were collected from each participant standard for CBC investigation and then analyzed by SPSS version 21 (Mean and Standard deviation). A significant association between leukocyte count among ICU, ER group, and control with (P. value 0.000), in addition, a significant association was revealed among mild group and control group in differential neutrophil count, differential lymphocyte count, and absolute neutrophil count (p. value 0.000), however non-significant in TWBC absolute mixed cell count, absolute lymphocyte count, and differential mixed cells count (value 0.7,0.2, 0.19) respectively. The study concluded that leukocytosis with neutrophilia and lymphopenia is associated with the severity of SARS-CoV-2 infection, and should be implicated as predict for a serious course of the disease as well as mortality.

Coagulation Dysfunctions: A Hallmarks for Thrombo-Inflammatory Risks in SARS-CoV-2 Hospitalized Patients

The relevance of coagulation malfunction in COVID-19 (severe coronavirus disease) is ambiguous. Current study aimed to assess the coagulation among SARS-CoV-2 hospitalized patients. A cross sectional study with qualitative approach was conducted among 300 patients who are already diagnosed as COVID 19 compared to 300 apparently healthy control group attended to Red Sea State during study period from April 2020 to April 2021. The Humaclot Due Plus1 coagulation analyser was used to estimate the prothrombin time (PT), activated partial prothrombin time (APTT), and international normalized ratio (INR) (Wiesbaden 1, Germany), adding 25 μL of plasma in cuvette. The study result showed that in COVID-19 patients D.dimer level is high (2000-10000 ng/mL) compared with control group (up to 500 ng/mL). COVID-19 infection cause high D. dimer level which can lead to thrombosis event or bleeding tendency. Abnormal coagulation results were revealed among SARS-CoV-2, with markedly elevated D. dimer.

Influence of COVID-19 on lymphocyte and platelet parameters among patients admitted to intensive care unit and emergency.

OBJECTIVE: The aim of the study was to detect the effect of COVID-19 on lymphocyte and platelet parameters among Sudanese patients admitted to Intensive Care unit (ICU) and emergency (ER). PATIENTS AND METHODS: This cross-sectional study was carried out on a total of 787 Sudanese individuals (487 confirmed COVID-19 cases and 300 apparently healthy individuals as controls, in duration between April 2020 to December 2020). Platelets (PLTs) and platelet indices, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) and platelet larger cell ratio (PLCR) were investigated as part of the complete blood count (CBC) for the case and control group. Also, the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were calculated, and the results were statistically analyzed by SPSS version 21. RESULTS: The severity of the disease was also affected by the patient's age: 262 COVID-19 cases admitted to ICU were over 50 years old, compared to only four patients in the mild group. Regarding hematological parameters, the absolute lymphocyte count, PLTs, MPV, PDW, and P-LCR were significantly different between cases and control groups (p-values = 0.000, 0.002, 0.000, 0.000, and 0.000, respectively). PLR and NLR levels were found to be significantly higher as disease severity increased; p-values = 0.000 and 0.000, respectively. The study also demonstrated that lymphopenia was associated with severe COVID-19 infection (in 93% of ICU patients, 59.9% of ER, and 9% of the mild group), while thrombocytopenia was detected only among 30.8% of ICU patients. CONCLUSIONS: Lymphopenia and thrombocytopenia are associated with severe COVID-19 infection. NLR and PLR were markedly increased with COVID-19.

AKI in kuwait: Incidence, causes, management, and outcomes-a prospective observational study

Background: Little is known about AKI epidemiology, causes, management and outcome in Kuwait. We report that. Methods: Demographics, comorbidities, treatment and 4 weeks outcome data for nephrology referrals for AKI in 7 public hospitals from 1/Jan-30/Apr/2021 prospectively collected and analyzed Results: Total number of AKI referrals was 1298, that is 3.3% of hospital admissions. Community acquired cases were 12.5%. Males were 57%, mean age 64 (52% > 65), and Kuwaiti citizens 65%. DM affected 71%, HTN 74%, and cardiac disease 36% of patients. Mean baseline eGFR before AKI was 62. Baseline eGFR < 60 seen in 52%, and those compared to patients with eGFR > 60, had mean baseline eGFR of 35 (vs 90), were older (68 vs 60 with 61% above age 65 vs 41%), 81% had DM (vs 60%), 85% had HTN (vs 63%), 46% had cardiac disease (vs 24%). Cause of AKI was pre-renal / ischemic ATN in 87%, COVID-19 related in 8%, contrast-associated in 6%, drug-induced AIN in 5% of cases. Many had more than one possible cause. Sepsis was most common precipitating factor seen in 67% then volume depletion in 50%. Many had more than one factor. IV fluids used in 73% (less in lower eGFR group), IV diuretics in 46% (more in lower eGFR group), IV vasopressors in 40% (less in lower eGFR group) and steroids in 33%. KRT needed in 33%, more in patients who used diuretics or vasopressors. Volume overload and electrolytes / acid-base disorders were most common indication (75% and 79% respectively). CKRT was modality of choice in 85%, however, in 52% of CKRT, conventional HD not used due to lack of dialysate source in some sites. At 30 days, mean eGFR was 42%, with complete recovery in 34%, and 38% failed to recover at all. Death occurred in 31%, 55% had baseline eGFR > 60, and 50% of deaths occurred while still on KRT. Non-survivors were older and had higher use of vasopressors. AKI associated mortality in 25% of total hospital mortality and in 31% of ICU / CCU mortality. Conclusions: AKI is common. Most cases hospital-acquired. Use of resources (medications, critical care, KRT) and rates of mortality are high. Kuwaiti citizens represent 1/3 of the population and 2/3 of AKI cases and almost 70% of deaths.

Covid-19 infection in hemodialysis population

BACKGROUND AND AIMS: A third novel coronavirus leading to severe respiratory infection (coronavirus disease 2019, COVID-19) was first identified in Wuhan, China in December 2019;1 as of January 2021, more than 90 million person infected and more than 2,000,000 died worldwide. 2 Hemodialysis (HD) patients are at risk of COVID-19 infection but reported infection rates are variable. 1We report results of prospectively collected data on HD patients who contracted COVID-19 infection in Kuwait. METHOD: Demographics, comorbidities, and mortality data for HD patients who got infected with COVID-19 in Kuwait from 1/March/2020 to 31/July/2020 were collected and analyzed. RESULTS: Kuwait population during that same period was 4,600,000 (63% Males and 37%Females). 3 Total number of HD patients was 2000 (representing only 0.04% of the total population with 52% Males and 48% Females). Total number of COVID-19 cases confirmed by PCR from nasopharyngeal swab was 66,957. Total number of infected HD patients was 141 (representing 7% of the total HD population and 0.2% of the total number of people infected with COVID-19 in Kuwait). All COVID-19 positive cases were treated for free in ministry of health hospitals Mean age for HD patients with COVID-19 was 57 (54 for males and 62 for males). DM was present in 70%, HTN in 95%, CV disease in 61%, respiratory illness in 20.5%, and ICU admission was required for 31 patients (22%), with 80% requiring intubation and assisted ventilation. Conventional HD was switched to CRRT in 61 patients (43%). Steroids were used for 23%, convalescent plasma in 1 patient, lopinavir/ritonavir in 7 patients, tocilizumab in 3 patients. Total number of mortality due to covid-19 infection in Kuwait was 447 (0.7% of the total cases). 4 Total mortality in HD population during that period for any reason was 100 (5% of the total HD population), however, total mortality due to COVID-19 infection was 30% of the total mortality in the HD population (and 7% of the total COVID-19 related mortality in the country). Patients who died were older with mean age of 63 vs 56 for survivors and had respiratory illness more frequently (27% vs 18%) and 60% were males. Of those who were switched to CRRT, 21 of 61 (34%) died. Of the 31 HD patients admitted to ICU, 19 (61%) died. CONCLUSION: Despite the fact the HD population represents only a small fraction of the total population, they represent a sizable proportion of the total COVID-19 positive cases and a significant percentage of the total COVID-19 related mortality. This study highlights the increased susceptibility of HD population to COVID-19 infection, which is associated with high rate of mortality, although lower than mortality rates reported in Europe and the united states. 5,6.

In Silico Studies of Some Isoflavonoids as Potential Candidates against COVID-19 Targeting Human ACE2 (hACE2) and Viral Main Protease (Mpro).

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the "COVID-19" disease that has been declared by WHO as a global emergency. The pandemic, which emerged in China and widespread all over the world, has no specific treatment till now. The reported antiviral activities of isoflavonoids encouraged us to find out its in silico anti-SARS-CoV-2 activity. In this work, molecular docking studies were carried out to investigate the interaction of fifty-nine isoflavonoids against hACE2 and viral Mpro. Several other in silico studies including physicochemical properties, ADMET and toxicity have been preceded. The results revealed that the examined isoflavonoids bound perfectly the hACE-2 with free binding energies ranging from -24.02 to -39.33 kcal mol-1, compared to the co-crystallized ligand (-21.39 kcal mol-1). Furthermore, such compounds bound the Mpro with unique binding modes showing free binding energies ranging from -32.19 to -50.79 kcal mol-1, comparing to the co-crystallized ligand (binding energy = -62.84 kcal mol-1). Compounds 33 and 56 showed the most acceptable affinities against hACE2. Compounds 30 and 53 showed the best docking results against Mpro. In silico ADMET studies suggest that most compounds possess drug-likeness properties.

Benzothiazole moieties and their derivatives as antimicrobial and antiviral agents: A mini-review

Heterocyclic chemistry has provided an inexhaustible source of pharmaceutical molecules. Heterocyclic compounds such as benzothiazole moieties and its derivatives area substantial class of compounds in pharmaceutical chemistry and exhibited therapeutic capabilities, such as antitumor, anticancer, antioxidant, antidiabetic, antiviral, antimicrobial, antimalarial, anthelmintic and other activities. Besides, some antibiotics such as penicillin and cephalosporin have heterocyclic moiety. The growing prevalence of multi-drug resistant pathogens represents serious global concern,which requires the development of new antimicrobial drugs. Moreover, the emergence of pandemic SARS-CoV-2 causing Covid-19 disease and all these health dilemmas urge the scientific community to examine the possible antimicrobial and antiviral capacities of some bioactive benzothiazole derivatives against these severe causative agents.This mini-review highlights some recent scientific literature on different benzothiazole molecules and their derivatives. It turns out that, there are numerous synthesized benzothiazole derivatives which exhibited different mode of actions against microorganisms or viruses and accordingly suggested them as an active candidate in the discovery of new antimicrobial or antiviral agents for clinical development. The recommended bioactive benzothiazole derivatives mentioned in the current study are mainly Schiff bases, azo dyes and metal complexes benzothiazole derivatives;the starting material for most of these derivatives are 2-aminobenzothiazole although careful pharmaceutical studies should be conducted to ensure the safety and efficacy of these bioactive synthesized molecules as an antimicrobial or antiviral drug in the future.