Biochemical and hematological variables in COVID-19 positive patients

The coronavirus disease 2019 (COVID-19) pandemic has introduced attention to request for various diagnostic strategies, comparative validation of novel tests, quicker federal agency clearance, and quick manufacture of test kits to satisfy worldwide demand. Thus, this study was aimed to investigate biochemical and hematological variables in COVID-19 positive patients, so as to act early and improve patient outcomes. 34 patients with COVID-19 patients were diagnosed at Rifai General Hospital, Dhi Qar Health Directorate, during the period of (15 September 2020 to March 2021) in this study with two study group, as group one (i.e. the first week infection) and group two (i.e. the second week infection). The reagents kits for Random Blood Sugar (RBS) were used, and also urea, and creatinine measurements were done by spectrophotometry method (Biolabo/France), whereas D-dimer measurement was performed by)MAGLUMI 1000-China), Complete Blood Count measurement was conducted by XP-300™ Automated Hematology Analyzer System Device, USA. In this study, it was found that WBC had a significant difference (p-value 0.05) based on the comparison between the two groups, whereas RBS and creatinine had no significant difference (p-value>0.05) and urea and D-dimer had a significant difference (p-value 0.05) when compared between the two groups. The D-dimer and urea levels were significantly increased in the second group compared with the first group of the patients. Copyright © 2023 by SPC (Sami Publishing Company)

Laboratory characteristics among patients with COVID-19: a single-center experience from Khartoum, Sudan

Background: COVID19 is associated with a number of laboratory characteristics and changes with different levels of prognostic significance. We report changes in lab findings between severe and non-severe COVID-19 in patients that had molecular testing of nasopharyngeal swabs in Khartoum, Sudan Material(s) and Method(s): This was a descriptive cross-sectional study, conducted from Jan to May 2021. It included 66 preidentified COVID19 patients who attended the isolation center at Jabra Hospital in Khartoum the capital city of Sudan. Participants were enrolled for CBC, D-dimer and C-Reactive Protein testing. Among these participants, 21(31.8%) had severe COVID19 pneumonia.. Data were analysed using SPSS version 24, and the independent sample t-test was used to compare severe and non-sever cases. Result(s): The mean values for all cases showed a mild decrease in Hb (9.53+/-1.83 g/dl), MCHC (28.3+/-2.91 g/dl);lymphocytes % (19.8 +/-6.82);increased RDW-SD (50.1+/-5.70 fL), D-dimer (4.2+/-3.73 mug/ml) and CRP (107.2+/-61.21 mg/dl). There were significant d/span>differences in the laboratory findings between severe and non-severe COVID-19 cases in total WBCs (p value = .001), lymphocyte % (p value = .000), neutrophil % (p value=.038), RDW-SD (p value = .044), D-dimer (p value = .029) and CRP (p value = .044). Conclusion(s): The laboratory findings of CBC, D-dimer and CRP provide an essential contribution to predicti COVID-19 severity and prognosis.Copyright © 2023 Mohamed EAA et al.

Comparison of serum telomerase, CBC and insulin resistance and their relationship with physical fitness factors in active and sedentary elderly people under quarantine of coronavirus

The aim of this study was to compare serum telomerase, CBC and insulin resistance and their relationship with physical fitness factors in active and sedentary elderly people under quarantine of coronavirus. In this study, healthy men and women with a mean age of 61.43+/-6/07 in coronavirus pandemic conditions participated in this study voluntarily. Subjects were divided into three groups of physical activity: high, medium and low. The international Physical Activity Level Questionnaire (IPAQ) was used to assess the level of physical activity. Serum telomerase, CBC and insulin resistance were measured in different groups after measuring physical fitness factors. Results showed that BMI is higher in the sedentary group than the groups with moderate and high levels of physical activity;In addition, blood Hb and Hct levels were higher in the moderate physical activity group than in the sedentary group, but blood Plt levels were lower in the moderate physical activity group than in the sedentary group. Another result of the present study was the negative correlation of telomerase with BMI and the positive correlation of telomerase with Hb, Hct and RBC, although there was no correlation between telomerase and physical fitness factors. In addition, BMI was negatively correlated with fitness factors, glucose levels, insulin resistance and CBC. Physical fitness in the elderly people under quarantine of coronavirus has a positive relationship with some blood parameters but no correlation was observed between telomerase and insulin resistance with physical fitness.Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

Biochemical and hematological findings and risk factors associated with kidney impairment in patients with COVID-19.

Background: COVID-19 is a new pandemic that has infected millions of people worldwide and caused a high morbidity and mortality rate. COVID-19 may have a harmful effect on organs, especially the kidneys. Aims: The main aim of our research is to study the association between the severity of COVID-19 disease and biochemical parameters related to kidney function and to investigate certain risk factors of COVID-19-associated kidney disease. Methods: A total of 174 individuals, 121 COVID-19 positive and 53 COVID-19 negative, were enrolled in this study. The relation between COVID-19 infection, severity, kidney function test, and hematological indicators were examined. Results: The most prominent symptoms among COVID-19 were fever (95% ) and fatigue (92%). Regarding biochemical parameters, median creatinine, MPV, and CRP were significantly higher in COVID-19 patients, whereas median eGFR, Na+, WBC, MCH, MCHC, and eosinophil percentages were significantly lower in this group. Severely infected patients were observed to have higher urea, creatinine, neutrophils, and NLR. However, median sodium, eGFR, hemoglobin, hematocrit, RBC, lymphocytes, and platelet count were significantly lower in the severe group. Urine examination of the severe group showed a significantly lower specific gravity, while urine pH, protein, and glucose were significantly higher. Conclusions: Our analysis indicates that COVID-19 infection affects kidney function, mainly creatinine level, urea, eGFR, Na+ and urine protein. Additionally, comorbidities such as older age (>65), hypertension, taking medications, and CRP (>33.55 mg/L) are considered risk factors that are more likely to contribute to kidney impairment in COVID-19 positive patients.

Retrospective Observational Study of Complete Blood Count (CBC) Parameters and ICU Mortality of COVID-19 Disease in Delta Variant and Omicron Variant in a Community-Based Hospital in New York City.

BACKGROUND: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is the official name of COVID-19, a respiratory infection that had the first case reported from the Hubei province of China on December 8, 2019. This virus is the main etiological agent behind the most dreaded pandemic of pneumonia that has spread to the entire world in a brief period and continues to pose a threat. The first wave corresponded with the period from February 2020 to June 2020, the Delta variant occurred around the middle of June 2021 and the Omicron wave was reported from December 2021 to February 2022. Objective: This study aims to compare the Delta and the Omicron variants of COVID-19 infection in a community-based hospital in New York City considering the comparison of ICU admissions in both variants. We aim to study the comparison of complete blood count (CBC) parameters and inflammatory markers of patients admitted to ICU stratified by two waves of COVID-19 infection. We aim to analyze the association of CBC parameters at admission and the discharge during ICU stay in both variants. We also aim to study the association of CBC parameters at admission and discharge with ICU mortality in both variants. METHODS: We conducted a retrospective observational study based on data from randomly selected hospitalized patients with COVID-19 in a community-based hospital in New York City during the Delta variant and the Omicron wave. A total of 211 patients COVID-19 positive from June to July 2021 (Delta variant) and 148 patients from December to February 2022 (Omicron wave) were included in the study. A comparison was done between the basic characteristics of patients with and without ICU admissions in both variants of COVID-19. We compared the relationship of different parameters of CBC (hemoglobin (Hgb), white blood count (WBC), lymphocytes, neutrophils, and platelets) on ICU admission and further analyzed any changes associated with ICU mortality. Logistic regression was performed to evaluate the relationship of different presenting CBCs on patients' disposition to ICU.  Result: A total of 211 patients (106 female) in the Delta wave (2021 variant) and 148 patients (80 female) in the Omicron wave (2022 variant) with an average ages of 60.9 ±18.10 (Delta variant) and 63.2 ± 19.10 (Omicron variant) were included in this study. There were 45 patients (21.3%) in the Delta wave and 42 patients (28.4%) in the Omicron wave were admitted to ICU. The average length of hospital stay was seven days in the Delta wave and nine days in the Omicron wave. No significant association was found between presenting cell count and ICU admission (p>0.05). Significant associations were found between different cell counts on admission and discharge and death in Delta waves except Hgb and platelets on admission. However, in the Omicron variant, a significant association was found only between WBC on admission and discharge, and Hgb and neutrophil on discharge with death in the univariate model. CONCLUSION:  Comparative study of different clinical parameters between the Delta and the Omicron variants of COVID-19 with the correlation of ICU stay and mortality can be used as a beneficial modality in assessing the outcome of the disease.

Complete blood count derived inflammation indexes predict outcome in COVID-19 patients: a study in Indonesia.

INTRODUCTION: Inflammation plays a vital role in the pathophysiology of COVID-19. Complete blood count (CBC) is a routine test performed on patients. It provides information regarding the inflammatory process and can be used as a predictor of outcome. This study aimed to explore the correlation between different complete blood count (CBC)-derived inflammation indexes at hospital admission, such as neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte × platelet ratio (NLPR), aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII), to in-hospital mortality in confirmed COVID-19 patients. METHODOLOGY: A retrospective observational study was performed at Ulin Referral Hospital of South Kalimantan with 445 COVID-19 patients from April to November 2020. The patients were divided into two groups, non-survivor and survivor. A receiver operating characteristic (ROC) curve was used to determine the cut-off values. Bivariate analysis was performed using the Chi Square test, the risk ratio was calculated, and logistics regression was determined. RESULTS: Increase of NLR, dNLR, PLR, MLR, NLPR, MLR, AISI, SIRI, and SII from cut-off values were significantly correlated with patient survival outcome. The cut off values were 6.90, 4.10, 295, 0.42, 0.037, 1,422, 1.80, and 2,504 respectively. NLPR was dominant in predicting in-hospital mortality (OR: 6.668, p = 0.000) with a 28.1% sensitivity and 95.9% specificity. CONCLUSIONS: CBC-derived inflammation indexes were associated with the survival outcome of confirmed COVID-19 patients and NLPR was a dominant variable.

Leukocyte differential and cell population data in the evaluation of SARS-CoV-2 and other infections

Background: Cell population data (CPD) are reported as part of leukocyte differentials by Mindray BC 6800Plus analyzer, give information of the size (Neu Z, Lym Z, Mon Z) nucleic acid content (Neu Y, Lym Y, Mon Y) and internal structure (Neu X, Lym X, Mon X) of leukocytes. We evaluated the potential utility of the leukocyte differential and CPD as laboratory indicators for the detection of coronavirus disease 2019 (COVID-19) in patients when admitted to the Emergency Department. Methods: A total of 672 patients with suspected infection were recruited at admission to the Hospital. The study group included 237 (151 COVID-19, 33 other virus, 53 bacterial infections). We applied the unsupervised K-means clustering method and principal component analysis (PCA). A validation group of 435 patients, 268 COVID-19 and 167 non-COVID-19 was used to verify the reliability of our model. Results: The COVID-19 cases presented the typical neutrophilia and lymphopenia, high Mon Z, and intermediate values of Neu X and Neu Y. The study group was classified into two clusters. This model was applied to the validation set;PCA analysis showed that almost 45.71% of the data variability could be explained by the two clusters. Cluster 1 had higher neutrophil counts, Neutrophil Lymphocyte ratio, Neu X, Neu Y and Mon Z, and Cluster 2, higher lymphocyte counts (P<0.05). Cluster 1 which included 91.4% of the COVID-19 patients and 60.5% of non-COVID-19 patients were assigned to Cluster 2, notably 100% of other viral infections. Conclusions: Leukocyte count (WBC) differential and CPD seem reliable parameters for the initial evaluation of patients with fever of unknown origin. By means of K analysis, the patients can be classified into distinct groups according to the etiology of the infection. © Journal of Laboratory and Precision Medicine. All rights reserved.

Peripheral blood morphology and hemogram in COVID-19 patients correlates with disease severity: Insights from a Tertiary Care Center

Context: Coronavirus Disease 2019 (COVID-19) has profound hematopoietic manifestations reflected in complete blood count (CBC) parameters and peripheral blood morphology. Aims: We aimed to evaluate CBC and peripheral blood morphology in COVID-19 patients and correlated them with severity, progression, and mortality. Settings and Design: Prospective observational study. Methods and Materials: Baseline and sequential blood samples were collected in 197 hospitalized COVID-19 patients, and CBC and morphology were assessed and compared with severity, progression, and survival. Statistical Analysis Used: Independent samples t-test for parametric continuous and Chi-Square and Fisher Exact for categorical variables. Results: Of the 197 patients, 84 (42.6%) were non-severe and 113 (57.4%) severe. The severe group displayed higher mean Total leukocyte count (TLC) (mean 11,772/μL SD 5445 vs. mean 7872/μL SD 3789, P < 0.0001), neutrophils (mean 81.2% SD 17.01 vs. mean 59.8% SD 14.55, P < 0.0001), and Red Cell Distribution Width-Standard Deviation (RDW-SD) (mean 30.04 SD 17.1 vs. mean 16.95 SD 6.63, P < 0.0001) with lymphopenia (mean 12.86% SD 15.41 vs. mean 30.64% SD 13.23, P < 0.0001) and monocytopenia (mean 4.62% SD 3.56 vs. mean 7.23% SD 3.06, P < 0.0001). The severe group had significantly more pseudo Pelger-Huet (62.8% (71/113) vs. 22.9% (14/61), P < 0.0001), abnormal nuclear projections (27.4% (31/113) vs. 3.3% (2/61), P < 0.0001), elongated nucleoplasm (17.7% (20/113) vs. 3.3% (2/61), P = 0.0073), shift to left (100% (113/113) vs. 21.3% (13/61), P < 0.0001), prominent granules (100% (113/113) vs. 85.2% (52/61), P < 0.0001), cytoplasmic vacuolations (100% (113/113) vs. 50.8% (31/61), P < 0.0001), ring (8.3% (3/113) vs. 4.9% (3/61), P = 0.0117), fetoid (15.04% (17/113) vs. 1.6% (1/61), P = 0.039), and nucleolated forms (53.9% (61/113) vs. 21.3% (13/61), P < 0.0001) with red cell agglutination (8.8% (10/113) vs. 0% (0/61), P = 0.0154) than non-severe patients. The non-severe group showed lympho-plasmacytoid (98.4% (60/61) vs. 37.2% (42/113), P < 0.0001), monocytoid (96.7% (59/61) vs. 25.7% (29/113), P < 0.0001), apoptotic (100% (61/61) vs. 17.6% (20/113), P < 0.0001), and nucleolated lymphocytes (78.7% (48/61) vs. 5.3% (6/113), P < 0.0001) with prominent granules (80.3% (49/61) vs. 12.4% (14/113), P < 0.0001), cytoplasmic vacuolations (83.6% (51/61) vs. 30.1% (34/113), P < 0.0001), and plasma cells (45.9% (28/61) vs. 19.5% (22/113), P = 0.0004). The progressors (9/84) had baseline leukocytosis (TLC mean 15,889/cu mm SD 4163.96 vs. mean 6940.27/cu mm SD 2381.59, P < 0.0001) and lymphopenia (lymphocyte% mean 18.11% SD 10.75 vs. mean 32.1% SD 12.75, P = 0.0022) with elevated RDW-SD (P = 0.032) at 7 th to 10 th day of illness. The 14 non-survivors had significant thrombocytopenia (mean 63.35 × 10 3 /μL SD 30.72 vs. mean 230.77 × 10 3 /μL SD 98.77, P < 0.0001) with lymphocytes nadir at day 9 without recovery versus day 7 to 8 nadir before recovery in survivors. Conclusions: The peripheral blood morphological features are distinct in severe and non-severe COVID-19 patients and baseline leukocytosis, lymphopenia, and elevated RDW-SD at day 7 of illness are useful indicators of disease progression. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow.

An inexpensive and rapid diagnostic method for detection of SARS-CoV-2 RNA by loop-mediated isothermal amplification (LAMP).

SARS-CoV-2 is a public pandemic health concern globally. Nasopharyngeal and oropharyngeal swab samples are used for Covid-19 viral detection. Sample collection procedure was tedious and uncomfortable and unsuitable for biochemical and CBC analysis in swab samples. Biochemistry and CBC tests are key determinant in management of Covid-19 patients. We developed a LAMP test to detect viral RNA in blood samples. LAMP is required four specific primers targeting the internal transcribed S-region and loop primers for viral RNA amplification. RNA was extracted from blood samples by TRIzol method. LAMP reaction was performed at 60 °C for 1 hour and amplicons were visualized in HNB dye. No cross-reactivity was seen with HBV, HCV, and HIV infected sample. Out of 40 blood samples, 33 samples were positive for LAMP and Q-PCR analysis, one sample was positive for LAMP and negative for Q-PCR, two samples were negative for LAMP but positive for Q-PCR, and four blood samples were negative for LAMP and Q-PCR. LAMP method has an accuracy of 92.50%, with sensitivity and specificity of 94.28% and 80%, respectively. Thus, LAMP diagnostic test has proved reliable, fast, inexpensive and can be useful for detection where the limited resources available.•LAMP method is a potential tool for detection of SARS-CoV-2.•Blood samples are the key determinant for routine diagnostics as well as molecular diagnostics.•LAMP assay is an appropriate diagnostics method which offers greater simplicity, low cost, sensitivity, and specificity than other methods in molecular diagnostics.

Post Covid 19 Care: Suggestive Tests and Scans

The COVID 19 virus can leave long-lasting, lingering side effects even after the viral load has depleted. Most of the people they get better within few weeks. But in some people, especially those who got critically ill, needed to stay in the ICU, be put on a ventilator, or have other types of breathing support, in them the virus can impact many vital organs of the body, either directly or sometimes very badly hamper immune response. So, special precautions, some tests and scans might be worth taking it. Our study adds some novelty about the identification of effective biomarkers of progressive disease, and which might be helpful for diagnosis, prevention of complications, and effective therapy. Copyright © The Authors.

Impact of dexamethasone and tocilizumab on hematological parameters in COVID-19 patients with chronic disease.

Background and aim: The most effective way to control severity and mortality rate of the novel coronavirus disease (COVID-19) is through sensitive diagnostic approaches and an appropriate treatment protocol. We aimed to identify the effect of adding corticosteroid and Tocilizumab to a standard treatment protocol in treating COVID-19 patients with chronic disease through hematological and lab biomarkers. Materials and methods: This study was performed retrospectively on 68 COVID-19 patients with chronic disease who were treated by different therapeutic protocols. The patients were categorized into four groups: control group represented the patients' lab results at admission before treatment protocols were applied; group 1 included patients treated with anticoagulants, Hydroxychloroquine, and antibiotics; group 2 comprised patients treated with Dexamethasone; and group 3 included patients treated with Dexamethasone and Tocilizumab. Results: The WBC and neutrophil counts were increased significantly in group 3 upon the treatment when they were compared with patients in group 1 (p = 0.004 and p = 0.001, respectively). The comparison of C-reactive Protein (CRP) level at admission was higher in group 3 than in group 1 with p = 0.030. After 10 days of treatment, CRP level was decreased in all groups, but in group 3 it was statistically significant (p = 0.002). Conclusion: The study paves the way into the effectiveness of combining Dexamethasone with Tocilizumab in treatment COVID-19 patients with chronic diseases.

Antecedentes y objetivo: La forma más eficaz de controlar la gravedad y la tasa de mortalidad de la enfermedad del nuevo coronavirus (COVID-19) es mediante enfoques de diagnóstico sensibles y un protocolo de tratamiento adecuado. Nuestro objetivo fue identificar el efecto de agregar corticosteroides y tocilizumab a un protocolo de tratamiento estándar en el tratamiento de pacientes con COVID-19 con enfermedad crónica a través de biomarcadores hematológicos y de laboratorio. Materiales y métodos: Este estudio se realizó de forma retrospectiva en 68 pacientes COVID-19 con enfermedad crónica que fueron tratados por diferentes protocolos terapéuticos. Los pacientes se clasificaron en cuatro grupos: el grupo de control representaba los resultados de laboratorio de los pacientes en el momento de la admisión antes de que se aplicaran los protocolos de tratamiento; el grupo 1 incluyó a pacientes tratados con anticoagulantes, hidroxicloroquina y antibióticos; el grupo 2 estaba compuesto por pacientes tratados con dexametasona; y el grupo 3 incluyó a pacientes tratados con dexametasona y tocilizumab. Resultados: Los recuentos de glóbulos blancos y neutrófilos aumentaron significativamente en el grupo 3 tras el tratamiento cuando se compararon con los pacientes del grupo 1 (p = 0,004 y p = 0,001, respectivamente). La comparación del nivel de proteína C reactiva (CRP) al ingreso fue mayor en el grupo 3 que en el grupo 1, con p = 0,030. Después de 10 días de tratamiento, el nivel de CRP disminuyó en todos los grupos, pero en el grupo 3 fue estadísticamente significativo (p = 0,002). Conclusión: El estudio allana el camino hacia la eficacia de la combinación de dexametasona con tocilizumab en el tratamiento de pacientes con COVID-19 con enfermedades crónicas.

Comparison of Clinical Features, Complete Blood Count Parameters, and Outcomes between Two Distinct Waves of COVID-19: A Monocentric Report from Italy.

BACKGROUND: Since the beginning of the SARS-CoV-2 pandemic, the ability to predict the trajectory of the disease has represented a major challenge for clinicians. There is recent evidence that complete blood cell count (CBC)-derived inflammation indexes have predictive value in COVID-19. We aimed to describe any changes in the clinical features, CBC-derived ratios, and outcomes of patients admitted to our hospital across two temporally distinct waves. METHODS: We retrospectively assessed and compared the clinical characteristics and blood cell count values of patients hospitalized during the second and fourth waves of COVID-19, and explored any outcome differences in terms of the level of respiratory support required and transfer to intensive care. RESULTS: We observed that fourth-wave patients were older, less male-predominant, and carried more comorbidities compared to the second-wave patients but, nevertheless, experienced more favorable outcomes. A strong internal correlation was documented for both waves between outcomes and CBC-derived ratios, with the fourth-wave cases displaying lower admission values of the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation index (SII). No significant differences were found for lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). CONCLUSIONS: We observed that both admission values of CBC-derived indexes and adverse respiratory outcomes decreased from the second to the fourth wave of COVID-19. These data represent a contribution to the existing knowledge on the role of CBC-derived indexes as a potential tool to help clinicians to quickly differentiate in-hospital patients at increased risk of serious illness and death.

To Investigate The Importance Of The CBC, Derived Parameters, And Morphology Of Peripheral Blood Cells In Covid-19 Patients

Aim: To investigate the importance of the CBC, derived parameters, and morphology of peripheral blood cells in Covid-19 patients. Material and methods: According to their symptoms, patients were classified as asymptomatic, mild, or moderate-severe. This research included all paediatric and adult patients who had two CBC samples available (one at admission and another during discharge) throughout their hospital stay. Those who were already undergoing therapy for their cancer, haematological illness, liver disease, or chronic lung disease were not allowed to participate. Results: Patients' ages varied from 8 to 71. The patients' average age was 36.15±14.58 years. Sixty percent of research participants were male, making up a sex ratio of 1.5:1. (M: F). The average white blood cell count was 6.87±3.51 x109/L, the average red blood cell count was 4.61±0.88 x106/microL, and the average haemoglobin level was 12.80±2.15 g/dl upon admission. The average absolute neutrophil count was 3.81±3.46x109/L, the average absolute lymphocyte count was 2.31±1.40x109/L, the average absolute monocyte count was 0.38±0.31x109/L, and the average absolute eosinophil count was 0.15±0.18x109/L. Overall, the average number of platelets per microliter of blood was 149.21± 80.25. Neutrophil to lymphocyte ratio (NLR) at admission was 3.806;platelet to lymphocyte ratio (PLR) was 116.32±13.1;lymphocyte to monocyte ratio (LMR) was 8.91±5.25, and derivative neutrophil to lymphocyte ratio (d-NLR) was 2.61±1.36. Twenty (40%) of the patients were asymptomatic at admission, while 44% had mild symptoms, and 16% required oxygen and ventilator support due to moderate to severe symptoms. The RT-PCR test was positive for all of the patients examined. There was a noteworthy shift in both the mean WBC and mean platelet counts after the follow-up evaluation. No correlation was seen between clinical state on admission and any of the other CBC measures (p>0.05). Conclusion: The significance of CBC values and morphological inspection of the peripheral blood smear at baseline and subsequent assessment is highlighted in the research. [ FROM AUTHOR]

Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio as a Severity Marker in Moderate to Severe COVID-19 Patients

The world is facing COVID-19 pandemic which has created havoc amongst the mankind. It has created huge burden on health care facilities. The COVID-19 disease is caused by a newly emerged mutant of corona virus that is SARS-CoV-2. The virus is highly contagious and infects through respiratory route. It invades the respiratory tract mainly lungs causing coronavirus pneumonia. Patients usually present with fever, non-productive cough, breathlessness, myalgia, fatigue. In severe cases, disease can rapidly progress to ARDS (Acute Respiratory Distress Syndrome), septic shock, MODS (Multi-Organ Dysfunction Syndrome). Death may occur due to the complications. Furthermore, early diagnosis of severe cases and early interventions help in decreasing the burden on intensive healthcare facilities. HRCT scans are being used to assess the disease severity and CT score were calculated which was graded as mild, moderate and severe with score 0-8, 9-15 and 16-25 respectively. But this is highly expensive for general population of a developing country like India. Interleukins, D-dimer, ferritin, pro-calcitonin tests have also been used to assess the severity but again they pose a financial constraint for the population. So we needed a basic investigation which could let us assess the severity of disease and prognosis of the patient early for effective and early management of the patient. This might help provide better intensive care management for the patients at early stage and decrease the morbidity and mortality in COVID-19 patients. We have tried to unfold the CBC as prognostic marker for COVID-19 patients.

The Prevalence of Anemia and Hematological Findings in COVID-19 Patients in Saudi Arabia

Objectives: The aim of this study was to estimate the prevalence of anemia among COVID-19 patients in Saudi Arabia and evaluate their hematological parameters. Materials and Methods: A descriptive, cross-sectional, hospital-based study was conducted between February 2021 to March 2021, data collection covered the period between September 2020 to March 2021. All the patients were hospitalized for confirmed COVID-19. Results: A total of 6048 COVID-19 patients included in our study, 2358 (48.9%) were anemic, 3666 (60.61%) were normal HGB level, and only 24 (0.49%) were having polycythemia. Hemoglobin level ranged from 5 g/dL to 18 g/dL with a median (interquartile range) of 11.8 g/dL (8.9 to 13.1) g/dL. The median for male (interquartile range) was for anemic patient’s 9.8 g/dL (8.5 to 11.4) g/dL, normal 14 g/dL (13.5 to 14.8) g/dL, and polycythemia 17.4 g/dL (17.2 to 17.7) g/dL. The median for female (interquartile range) was for anemic patient’s 9.1 g/dL (8.2 to 10.2) g/dL, normal 13.5 g/ dL (12.5 to 14.5) g/dL, and polycythemia 17 g/dL (16.82 to 17.2) g/dL. Hematological parameters detected are indicative of severe complications in anemic patients compared to non-anemic patients. Conclusion: Our findings were consistent with other studies that reported poor outcomes of anemia in COVID-19 patients. © 2022, Association of Pharmaceutical Teachers of India. All rights reserved.

The Cost-Effectiveness of Requesting a Complete Blood Count (CBC) in the Management of COVID-19 in Saudi Arabia.

BACKGROUND: Since the beginning of the COVID-19 pandemic, studies have attempted to determine the value of the different laboratory investigations. This study aims to assess the cost-effectiveness of requesting a complete blood count (CBC) for COVID-19 patients, as opposed to ordering a COVID-19 antibody titer in Saudi Arabia. METHODS: The prices of a CBC, COVID-19 PCR, and antibody titer were obtained from 40 healthcare establishments in Saudi Arabia, between January and February 2022. RESULTS: Requesting a CBC is significantly cheaper than requesting a COVID-19 antibody titer, which was available in almost all of the establishments, as compared to COVID-19 PCR and antibody titer testing. The investigation prices did not differ significantly between hospitals and private laboratories, nor across cities in Saudi Arabia. CONCLUSIONS: CBC, which provides valuable information on the patient's condition and prognosis, is a cost-effective and widely available tool for managing COVID-19. The price and availability of CBC warrant it to be included in the COVID-19 management protocols.

Commercialized kits to assess T-cell responses against SARS-CoV-2 S peptides. A pilot study in health care workers.

Background: It is crucial to assess the levels of protection generated by natural infection or SARS-CoV-2 vaccines, mainly in individuals professionally exposed and in vulnerable groups. Measuring T-cell responses may complement antibody tests currently in use as correlates of protection. Our aim was to assess the feasibility of a validated assay of T-cell responses. Methods: Twenty health-care-workers (HCW) were included. Antibody test to SARS-CoV-2 N and S-proteins in parallel with a commercially available whole-blood-interferon-gamma-release-assay (IGRA) to S-peptides and two detection methods, CLIA and ELISA were determined. Results: IGRA test detected T-cell responses in naturally exposed and vaccinated HCW already after first vaccination dose. The correlation by the two detection methods was very high (R > 0.8) and sensitivity and specificity ranged between 100 and 86% and 100-73% respectively. Even though there was a very high concordance between specific antibody levels and the IGRA assay in the ability to detect immune response to SARS-CoV-2, there was a relatively low quantitative correlation. In the small group primed by natural infection, one vaccine dose was sufficient to reach immune response plateau. IGRA was positive in one, with Ig(S) antibody negative vaccinated immunosuppressed HCW illustrating another advantage of the IGRA-test. Conclusion: Whole-blood-IGRA-tests amenable to automation and constitutes a promising additional tool for measuring the state of the immune response to SARS-CoV-2; they are applicable to large number of samples and may become a valuable correlate of protection to COVID-19, particularly for vulnerable groups at risk of being re-exposed to infection, as are health-care-workers.

Introducción: Es fundamental evaluar los niveles de protección inmune en infectados o tras la vacunación frente a SARS-CoV-2. La cuantificación de la respuesta inmune celular T puede complementar la determinación de anticuerpos. Evaluamos la viabilidad de un ensayo comercial validado de respuesta celular T específica frente a SARS-CoV-2. Métodos: Se incluyeron veinte trabajadores sanitarios (TS). Medimos anticuerpos contra las proteínas N y S de SARS-CoV-2 y realizamos el ensayo de liberación de interferón-gamma (IFNγ) en sangre completa (IGRA) frente a péptidos de la proteína S. IFNγ se determinó mediante dos métodos de detección: CLIA y ELISA. Resultados: IGRA detectó respuesta celular T en TS tanto infectados como vacunados. La correlación de los dos métodos de detección de IFNγ fue muy alta (R >0,8) y la sensibilidad y la especificidad variaron entre 100 y 86% y 100-73% respectivamente. Hubo una concordancia muy alta entre los niveles de anticuerpos específicos y el ensayo IGRA aunque la correlación cuantitativa fue relativamente baja. En el grupo de infectados, una dosis de vacuna fue suficiente para alcanzar el «plateau¼ de respuesta inmune. IGRA fue claramente positivo en un profesional vacunado inmunosuprimido que presentaba anticuerpos contra la proteína S negativos. Conclusiones: IGRA frente a péptidos de la proteína-S es susceptible de automatización y constituye una herramienta prometedora para medir la respuesta inmune celular frente a SARS-CoV-2; es aplicable a un gran número de muestras y puede servir para valorar la protección, particularmente en los grupos vulnerables en riesgo de volver a exponerse a la infección, como los TS.

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.

How is test laboratory data used and characterised by machine learning models? A systematic review of diagnostic and prognostic models developed for COVID-19 patients using only laboratory data.

The current gold standard for COVID-19 diagnosis, the rRT-PCR test, is hampered by long turnaround times, probable reagent shortages, high false-negative rates and high prices. As a result, machine learning (ML) methods have recently piqued interest, particularly when applied to digital imagery (X-rays and CT scans). In this review, the literature on ML-based diagnostic and prognostic studies grounded on hematochemical parameters has been considered. By doing so, a gap in the current literature was addressed concerning the application of machine learning to laboratory medicine. Sixty-eight articles have been included that were extracted from the Scopus and PubMed indexes. These studies were marked by a great deal of heterogeneity in terms of the examined laboratory test and clinical parameters, sample size, reference populations, ML algorithms, and validation approaches. The majority of research was found to be hampered by reporting and replicability issues: only four of the surveyed studies provided complete information on analytic procedures (units of measure, analyzing equipment), while 29 provided no information at all. Only 16 studies included independent external validation. In light of these findings, we discuss the importance of closer collaboration between data scientists and medical laboratory professionals in order to correctly characterise the relevant population, select the most appropriate statistical and analytical methods, ensure reproducibility, enable the proper interpretation of the results, and gain actual utility by using machine learning methods in clinical practice.