ABSTRACT
We highlighted the role of D-dimers, platelet count and LDH (lactate dehydrogenase) as primary biomarkers in diagnosing the COVID-19-associated coagulopathy (CAC) in severe and critical cases. 141 COVID-19 patients of severe and critical categories, were enrolled from an epicenter tertiary care hospital. The mean values of platelets were found normal, whereas, the mean values of LDH were found elevated in both severe and critical cases. There was no patient with low value of LDH in both groups. 87% patients were having high values of LDH in severe cases, whereas, 98% patients were having high values of LDH in critical cases. Majority patients were having normal value of platelet counts. 43% critically infected patients were having raised D-dimers, whereas, 38% raised D-dimers were found in severely infected patients. According to t-test, severe and critical cases were not found significantly different in platelet counts and LDH values. In developing countries, LDH along with platelet count and D-dimers can make a cost effective trio for an earliest detection of COVID-19-associated coagulopathy (CAC). Regular monitoring of these biomarkers can prompt early detection and timely management of CAC.
ABSTRACT
BACKGROUND: Disasters are events that disrupt the daily functioning of a community or society, and may increase long-term risk of adverse cardiometabolic outcomes, including cardiovascular disease, obesity and diabetes. The objective of this study was to conduct a systematic review to determine the impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course. DESIGN: A systematic search was conducted in May 2020 using two electronic databases, EMBASE and Medline. All studies were screened in duplicate at title and abstract, and full-text level. Studies were eligible for inclusion if they assessed the association between a population-level or community disaster and cardiometabolic outcomes ≥1 month following the disaster. There were no restrictions on age, year of publication, country or population. Data were extracted on study characteristics, exposure (eg, type of disaster, region, year), cardiometabolic outcomes and measures of effect. Study quality was evaluated using the Joanna Briggs Institute critical appraisal tools. RESULTS: A total of 58 studies were included, with 24 studies reporting the effects of exposure to disaster during pregnancy/childhood and 34 studies reporting the effects of exposure during adulthood. Studies included exposure to natural (n=35; 60%) and human-made (n=23; 40%) disasters, with only three (5%) of these studies evaluating previous pandemics. Most studies reported increased cardiometabolic risk, including increased cardiovascular disease incidence or mortality, diabetes and obesity, but not all. Few studies evaluated the biological mechanisms or high-risk subgroups that may be at a greater risk of negative health outcomes following disasters. CONCLUSIONS: The findings from this study suggest that the burden of disasters extend beyond the known direct harm, and attention is needed on the detrimental indirect long-term effects on cardiometabolic health. Given the current COVID-19 pandemic, these findings may inform public health prevention strategies to mitigate the impact of future cardiometabolic risk. PROSPERO REGISTRATION NUMBER: CRD42020186074.