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Int J Lab Hematol ; 43 Suppl 1: 137-141, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1526369


INTRODUCTION: Eosinopenia has been observed during infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. This study evaluated the role of eosinopenia as a diagnostic and prognostic indicator in COVID-19 infection. METHODS: Information on 429 patients with confirmed COVID-19, admitted to Apollo Hospitals, Chennai, India between 04 June 2020 to 15 August 2020, was retrospectively collected through electronic records and analysed. RESULTS: 79.25% of the patients included in the study had eosinopenia on admission. The median eosinophil count in COVID-19-positive patients was 0.015 × 109 /L, and in negative patients, it was 0.249 × 109 /L. Eighteen per cent of the positive patients presented with 0 eosinophil count. Eosinopenia for early diagnosis of COVID-19 had a sensitivity of 80.68% and specificity of 100% with an accuracy of 85.24. Role of eosinopenia in prognostication of COVID-19 was found to be insignificant. There was no statistically significant difference between the median eosinophil counts in survivors and nonsurvivors. Eosinophil trends during the course of disease were found to be similar between survivors and nonsurvivors. CONCLUSIONS: Eosinopenia on admission is a reliable and convenient early diagnostic marker for COVID-19 infection, helping in early identification, triaging and isolation of the patients till nucleic acid test results are available. Role of eosinopenia as a prognostic indicator is insignificant.

COVID-19 Testing/methods , COVID-19/blood , Eosinophils , Leukocyte Count , Leukopenia/etiology , Area Under Curve , Biomarkers , COVID-19/diagnosis , COVID-19/mortality , Eosinophilia/blood , Eosinophilia/etiology , Humans , India , Leukopenia/blood , Prognosis , ROC Curve , Retrospective Studies , Selection Bias , Sensitivity and Specificity , Survival Analysis
Int J Lab Hematol ; 43(6): e303, 2021 12.
Article in English | MEDLINE | ID: covidwho-1223502
Diabetes Metab Syndr ; 15(1): 187-191, 2021.
Article in English | MEDLINE | ID: covidwho-987526


BACKGROUND AND AIMS: Renal involvement in Covid-19 infection is varied and can affect glomeruli, tubules, interstitium and can cause acute kidney injury (AKI). AKI is a strong predictor of mortality. Routine urinalysis gives an insight into the renal pathology of the patient. We studied the incidence of urinary abnormalities in hospitalised Covid-19 patients and analysed their impact on development of AKI and mortality. METHODS: Information on 110 hospitalised patients with confirmed Covid-19 was retrospectively collected and analysed. The demographic data such as age, gender, comorbid conditions such as diabetes mellitus, the need for dialysis and laboratory data such as urine for albumin, glucose, RBC and WBC, and serum creatinine were collected. The diagnosis of AKI was based on the KDIGO criteria. The outcomes studied were development of AKI and hospital mortality. RESULTS: Urine abnormalities were seen in 71% of the patients. Proteinuria in 58.2%, haematuria in 17.3%, pyuria in 8.2% of patients and concurrent proteinuria and haematuria was seen in 13.6% of patients. AKI was seen in 28.2% of patients and hospital mortality was 24.5%. AKI was strongly associated with mortality. Proteinuria and haematuria were good predictors of development of AKI, more strongly when they occurred concurrently (p < 0.01). CONCLUSION: Our results suggest that urine analysis is a simple test, which can be used to predict development of AKI and mortality and may be used for risk stratification of Covid-19 patients, especially in low resource settings.

Acute Kidney Injury/epidemiology , Acute Kidney Injury/urine , COVID-19/epidemiology , COVID-19/urine , Acute Kidney Injury/diagnosis , Adult , Aged , COVID-19/diagnosis , Female , Hospitalization/trends , Humans , India/epidemiology , Male , Middle Aged , Predictive Value of Tests , Proteinuria/diagnosis , Proteinuria/epidemiology , Proteinuria/urine , Retrospective Studies , Urinalysis/trends
Diabetes Metab Syndr ; 14(6): 2245-2249, 2020.
Article in English | MEDLINE | ID: covidwho-926257


BACKGROUND AND AIMS: COVID-19 is a multi-system disease, with coagulation abnormalities. D-dimer levels are increased in this disease. We aimed to determine the association of D-dimer levels and mortality and to establish its optimal cut off values in predicting mortality. Association of D-dimer levels with diabetes mellitus has also been established. METHODS: Information on 483 patients with confirmed COVID-19 was retrospectively collected and analyzed. The optimal D-dimer cutoff point and C-statistic of routine tests both on admission and during hospital stay were evaluated by receiver operator characteristic (ROC) curve. RESULTS: D-dimer elevation (≥0.50 µg/mL) was seen in 80.1% of the hospitalized patients. D-dimer level ≥2.01 µg/mL was a significant predictor of subsequent deaths (P < 0.01; HR, 3.165; 95% CI, 2.013-4.977). High D-dimer values (≥0.50 µg/mL) were observed in 72 of the 75 (96%) cases with a fatal outcome. Median D-dimer value among non-survivors was 6.34 µg/mL and among survivors it was 0.94 µg/mL. A higher proportion of fatal outcomes occurred in patients with underlying disease (89.0%), most prominent of which was diabetes mellitus (66%). The median D-dimer value was found to be significantly high in diabetic patients (1.68 µg/mL). CONCLUSIONS: Among the measured coagulation parameters, D-dimer during hospital stay had the highest C-index to predict in-hospital mortality in COVID-19 patients. D-dimer value ≥ 2.01 µg/mL can effectively predict in-hospital mortality in patients with COVID-19. A significant association of increased D-dimer level has been found with diabetes mellitus and elderly age.

COVID-19/blood , COVID-19/mortality , Fibrin Fibrinogen Degradation Products/metabolism , Adult , Aged , Biomarkers/blood , Female , Humans , Male , Middle Aged , Mortality/trends , Predictive Value of Tests , Retrospective Studies , Young Adult