ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) is an infectioncaused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Since there is activation of both inflammatory and thrombotic pathways in this disease, indices derived from routinelymeasured blood parameters, whose role is established in severe sepsis,are being evaluated worldwide as potential prognostic markers.Aims &Objectives: In this study we aimed to evaluate the role ofAbsolute Neutrophil count (ANC), Absolute Lymphocyte Count(ALC), Mean platelet volume (MPV), platelet distribution width(PDW), Plateletcrit (PCT), Platelet-large cell ratio(P-LCR), Neutrophil Platelet ratio (NPR) and Platelet Lymphocyte ratio (PLR) inpredicting survival amongst patients admitted with COVID-19infection.Materials &Methods: We conducted a retrospective chart review ofall moderate to severely ill adult patients admitted with COVID-19pneumonia admitted at All India Institute of Medical Sciences,Bhopal, a tertiary care hospital in Central India from April 2020-November 2020. Information about their demography, clinical features, laboratory investigations and in-hospital survival were collectedfrom charts.Result: The study included 1331 patients, out of these 1181 weresurvivors (389 females;792 males) and 150 were non survivors (35females;115 males). Amongst the various parameters studied ANC,NPR and PCT were found to be significantly lower amongst thesurvivors as compared to the non survivors whereas ALC was significantly higher amongst the survivors.Conclusions: The results of the current study showed that ANC,ALC, NPR and PCT can be used as useful cost-effective prognosticmarkers in patients with COVID-19 infection.
ABSTRACT
To meet the unprecedented requirement of diagnostic testing for SARS-CoV-2, a large number of diagnostic kits were authorized by concerned authorities for diagnostic use within a short period of time during the initial phases of the ongoing pandemic. We undertook this study to evaluate the inter-test agreement and other key operational features of 5 such commercial kits that have been extensively used in India for routine diagnostic testing for COVID-19. The five commercial kits were evaluated, using a panel of positive and negative respiratory samples, considering the kit provided by National Institute of Virology, Indian Council of Medical Research (2019-nCoV Kit) as the reference. The positive panel comprised of individuals who fulfilled the 3 criteria of being clinically symptomatic, having history of contact with diagnosed cases and testing positive in the reference kit. The negative panel included both healthy and disease controls, the latter being drawn from individuals diagnosed with other respiratory viral infections. The same protocol of sample collection, same RNA extraction kit and same RT-PCR instrument were used for all the kits. Clinical samples were collected from a panel of 92 cases and 60 control patients, who fulfilled our inclusion criteria. The control group included equal number of healthy individuals and patients infected with other respiratory viruses (n = 30, in each group). We observed varying sensitivity and specificity among the evaluated kits, with LabGun COVID-19 RT-PCR kit showing the highest sensitivity and specificity (94% and 100% respectively), followed by TaqPath COVID-19 Combo and Allplex 2019-nCoV assays. The extent of inter-test agreement was not associated with viral loads of the samples. Poor correlation was observed between Ct values of the same genes amplified using different kits. Our findings reveal the presence of wide heterogeneity and sub-optimal inter-test agreement in the diagnostic performance of the evaluated kits and hint at the need of adopting stringent standards for fulfilling the quality assurance requirements of the COVID-19 diagnostic process.