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Sri Lankan Journal of Anaesthesiology ; 30(2):118-123, 2022.
Article in English | EMBASE | ID: covidwho-2066752

ABSTRACT

Background and aims:The ongoing Covid pandemic has burdened the medical system, more so due to the limited availability of ventilators. Our study aims at identifying the role of hematological markers in the risk stratification and the need for ventilator support among ICU admitted COVID-19 patients. Method(s): A single centre prospective study was conducted on 100 Covid positive patients admitted in the ICU to determine association between the haematological markers such as Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer with the need for oxygen therapy with or without invasive ventilatory support. Comparative analysis was performed between the 2 groups. Result(s): Neutrophilia, a mean of 76.7% among those ventilated and 71.6% among those non ventilated (p value 0.002;highly significant) and Lymphocytopenia (p value 0.004) with a mean of 14% and 18.6% respectively was noted. Hemoglobin levels were lower in ventilated (mean 11.6g/dl) as against those non ventilated (mean 12.58%) p value 0.046 which was significant. D-dimer was increased in COVID-19 patients;mean 5380 ng/ml in ventilated patients and mean 949ng/ml in those non ventilated (P < 0.001 highly significant). Elevated D-dimer and presence of diabetes correlated with increased chances of mechanical ventilation, while higher hemoglobin levels and associated COPD have a negative association with the need of mechanical ventilation. Conclusion(s): Hypercoagulability along with neutrophilia and lymphocytopenia can be used as positive associations for the need for invasive mechanical ventilation. Copyright © 2022, College of Anaesthesiologists of Sri Lanka. All rights reserved.

2.
Biomedicine ; 41(4):799-804, 2021.
Article in English | CAB Abstracts | ID: covidwho-1727543

ABSTRACT

Introduction and Aim: With the coronavirus disease 2019 (COVID-19) pandemic raging on, there is a need to identify clinical and laboratory predictors which predict progression towards severe and fatal forms of this illness. Our study aims to evaluate the ability of hematologic and biochemical biomarkers to discriminate between patients with and without severe or fatal forms of COVID-19. Materials and Methods: A retrospective study was conducted on 200 Covid positive patients;100 with mild disease and 100 with severe disease. Medical records were reviewed to collect demographic data and results of the following blood investigations were noted at admission: Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer. Comparative analysis was performed between the 2 groups.

3.
Journal of Clinical and Diagnostic Research ; 15(1):LC09-LC13, 2021.
Article in English | EMBASE | ID: covidwho-1257028

ABSTRACT

Introduction: Although the Coronavirus Disease-2019 (COVID-19) pandemic is creating a major global health crisis, the risk factors for mortality and the detailed clinical course of disease has not yet established. Aim: To determine association of the demographic data of COVID-19 patients with clinical profile and disease outcomes. Materials and Methods: The cross-sectional single-center study considered adults patients of both the gender from March to June 2020 with an estimated sample size of 2000 patients diagnosed with COVID-19 infection by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) technique. Necessary demographic and clinical data were collected and selected subjects were followed-up until discharge or death. Subjects were classified as those who survived (1839 patients) and succumbed (138 patients) to death. T-Test was used for comparing continuous variables and chi-square test for categorical data between the groups. Results: The study included 1977 patients with a male-To-female ratio of 1:0.62. Fever, dyspnea and cough were noted as the major symptoms prevalent among patients who succumbed to death when compared to those who survived (p-value <0.001). Statistically significant variables noted between the groups were age (survived mean age-42.74±15.15 years vs mean age 59.12±12.95 in those who succumbed to death, p-value <0.001), age groups (p-value <0.001), gender (p-value 0.042), haemoglobin, Total Leucocyte Count (TLC), neutrophil, lymphocytes, Neutrophil to Lymphocyte Ratio (NLR), Lactate Dehydrogenase (LDH), ferritin, all the comorbidity variables and the asymptomatic status. Variables identified as significant predictors of disease outcomes were Haemoglobin (Hb), TLC, neutrophils, lymphocytes, NLR, LDH and ferritin (p-value <0.001). Most of the subjects belonging to the mortality group required oxygen and other Intensive Care Unit (ICU) facilities when compared to the survival group (p-value <0.001). The mean days of viral clearance noted in COVID subjects was around 8.98±3.54 days. Conclusion: Hb, TLC, neutrophils, lymphocytes, NLR, LDH and ferritin are noted as significant predictors of COVID-19 outcome. Biochemical monitoring of COVID-19 patients helps in identifying critically ill patients early and can reduce mortality and improve the recovery.

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