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Objectives - The objective of our study was to assess humoral response in a population of health workers after vaccination with the first and second doses of Sputnik V. Methods - SARS-CoV-2 total antibodies (IgG and IgM) were measured, using the Centaur XPT autoanalyzer, Siemens, in 530 serum samples taken from health workers in Buenos Aires vaccinated with Sputnik V. Results - After 21 days of the first dose application, 10 individuals (1.9%) presented antibody levels <1.0 (non-reactive), while 520 subjects (98.1%) responded with antibody values >1.0 (reactive). The results, obtained 21 days after the second dose, show that only 2 individuals (0.38%) had antibody levels <1.0 (non-reactive) and 528 (99.6%) responded with antibody values >1.0 (reactive). Conclusion - This study results implied that two doses of Sputnik V vaccine generated a proper antibody response in virtually the entire studied population.Copyright © 2022, Russian Open Medical Journal.
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Background: One of the efforts to control SARS-CoV-2 infection in health workers is vaccination. In this study, the levels of SARS-CoV-2 neutralizing antibody (nAb) in health workers were measured with Ichroma and iFlash. Method(s): This study applied an observational analytic design with a prospective cohort and was conducted at Dr. Soetomo Regional Public Hospital, Surabaya, from January to November 2021. The population of this study included a total of 75 health workers after taking the second dose of the SARS-CoV-2 (Sinovac) vaccine. The Covid-19 NAb levels of the population were tested with Ichroma and iFlash on day 0 before vaccination, as well as days 14 and 28, and months 3 and 6 after vaccination. Result(s): The Friedman test indicated a significant difference in NAb levels according to the iFlash test on day 14, day 28, month 3, and month 6 compared to those before vaccination (p < 0.05). The Wilcoxon test revealed a significant difference in NAb levels on day 14, day 28, month 3, and month 6. The results of the Cochran test showed a significant difference in the positivity of NAb according to the Ichroma test on day 14, day 28, month 3, and month 6 compared to those before vaccination (p < 0.05). McNemar's test demonstrated that the COI at month 3 was not significantly different from that before vaccination;The COI at month 6 was not significantly different from those at days 14 and 28. The results of the Pearson correlation test and Bland-Altman plot indicated a moderate correlation between Ichroma and iFlash (r = 0.592, p = 0.002). Conclusion(s): Neutralizing antibodies for Covid-19 were formed after day 14 and started to increase on day 28 and started to decrease in months 3 and 6. The levels of NAb for Covid-19 were measured with Ichroma and iFlash in roughly the same pattern and had a moderate positive correlation.Copyright © 2023 Phcogj.Com.
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Aim: This study aimed to compare clinical data and laboratory results in patients examined for suspected pulmonary embolism (PE) in the emergency department based on three groups: patients with coronavirus disease-2019 (COVID-19), patients with PE and patients with both COVID-19 and PE. Material(s) and Method(s): This retrospective study was approved by the local ethics committee of the university. Patients included in the study were divided into three groups: Group 1, consisting of COVID-19-polymerase chain reaction (PCR) (negative) and PE (positive) patients;Group 2, consisting of COVID-19-PCR (positive) and PE (negative) patients, and Group 3, consisting of COVID-19-PCR (positive) and PE (positive) patients. Result(s): The three patient groups included in the study had no difference in terms of age (p = 0.916) or sex. The laboratory results of the groups were compared using the Kruskal-Wallis test, which showed significant differences in the levels of white blood cells (p = 0.005), lymphocytes (p < 0.001), neutrophils (p = 0.016), D-Dimer (p < 0.001) and lactate (p = 0.001). Receiver operating characteristic curve analysis with a cut-off value of >2590 for D-Dimer showed 71.43% specificity and 78% sensitivity in differentiating Group 1 from Group 2, and with a cut-off value of >3640, it had 80% specificity and 81.82% sensitivity in differentiating Group 3 from Group 2. Discussion(s): COVID-19 leads to increased incidence of PE. In addition to clinical data, D-Dimer and lactate levels can be used in the differentiation of these patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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The COVID-19 pandemic is one of the most devastating and significant events of recent times. COVID-19 has so far become one of the worst infectious disease outbreaks of recent times, with more than 635 million cases and more than 6.6 million deaths. Viruses cause an explosion of inflammatory cytokines and reactive oxygen types. Oxidative stress is thought to have a key role in COVID-19. vitamin D, folic acid, calcium (Ca), magnesium (Mg) and ferritin levels are thought to be associated with COVID-19. This study aims to investigate the role of oxidative stress, inflammation, vitamin D and folic acid, ferritin, Ca and Mg in the pathogenesis of COVID-19. Material(s) and Method(s): 45 patients diagnosed with COVID-19 and 45 healthy persons (control group) were included in the study. Vitamin D, ferritin, folic acid, CRP, Ca, Mg and Phosphorus were measured in an autoanalyzer, and SOD, GSH-Px and MDA were spectrophotometrically measured in the serum of the participants. TNF-alpha, IL-1beta and IL6 levels were studied by the ELISA method. Result(s): The activity of SOD, GSH-px, antioxidant enzymes, Serum vitamin D, folic acid, Ca and Mg of the COVID-19 group was found to be significantly lower than the control group (p<0.05). Conclusion(s): Again, the levels of MDA, TNF-alpha, IL-1beta, IL-6, CRP and ferritin in the Covid-19 group were found to be significantly higher than in the control group (p<0.05).Antioxidant enzyme activities were low and oxidative stress was high in patients with COVID-19. At the same time, the levels of serum ferritin, CRP, TNF-alpha, IL-1beta and IL6 were high, and levels of Ca and Mg were low in patients with COVID-19.According to these results, we hypothesize think that the level of oxidative stress, inflammation, vitamin D, and serum ferritin, Ca, and Mg levels play a role in the pathogenesis of COVID-19. Future clinical trials should be conducted to further clarify the pathogenesis in patients with COVID-19.Copyright © 2022 Mattioli 1885. All rights reserved.
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Introduction: Coronavirus disease 2019 has challenged the global healthcare system since 2019. Cytokine storm due to the release of pro-inflammatory cytokine scan lead to systemic inflammation reaction. Dysregulation of lipid profile and liver enzymes Aspartate Transaminase (AST) and Alanine Transaminase (ALT) are reported in COVID-19 patients. De Ritis ratio (AST/ALT) ratio is a non-invasive, costeffective test however its usefulness in COVID-19 is unclear. Aim(s): To determine serum host serum lipid levels and serum levels of AST, ALT and De Ritis ratio in admitted patients and its correlation with inflammatory markers. Materials and Methods :It was a retrospective study conducted from June 2020 to December 2020, included 500 COVID-19 admitted patients. AST, ALT, Total Cholesterol, Triglycerides, Low Density Lipoprotein, High Density lipoprotein, Ferritin, Procalcitonin, hsCRP estimated in Autoanalyzer and Interleukin-6 by ELISA. Result(s): A significant increase in Serum Triglycerides and decrease in HDL-C was observed with no remarkable finding in other lipid parameters. A statistically significant (p<0.05) correlation was observed between TG (positive), HDL (negative)and inflammatory markers such as hsCRP, PCT, Ferritin, IL-6. The De Ritis ratio was significantly lower in survivors than non-survivors whereas no significant differences was seen in ALT and AST concentrations. In ROC Curve analysis, the AUC value of the De Ritis ratio was 0.80(95% CI 0.56 to 0.65, p<0.0001) with sensitivity and specificity of 70.64% and 70.27%, respectively as compared to AST (0.60) and ALT (0.64). Conclusion(s): Liver enzymes and lipid profile are cost-effective and easily accessible in all laboratories. Its correlation with inflammatory markers can be used as a significant biomarker in prognosis and management of COVID-19 admitted patients without incurring any additional cost.
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Background: The novel coronavirus disease (COVID-19) has affected over 50 million people and has inflicted more than 1.2 million casualties ever since its inception in December 2019. Besides, multiple hematological and biochemical parameters have emerged as potential biomarkers to predict severe disease and mortality in COVID-19. One such biochemical biomarker is hypocalcemia. Hypocalcemia is associated with severe disease, organ failure, increased likelihood of hospitalization, admission to the intensive care unit, need for mechanical ventilation, and death from COVID-19. Hence, the present study was undertaken to compare the serum total calcium in patients infected with COVID-19 and a normal healthy population. Aim(s): To compare serum total calcium in patients infected with COVID-19 and normal healthy populations. Material(s) and Method(s): This is a case-control study with 50 COVID-19 patients and 50 normal healthy individuals as controls. Serum calcium was determined by Arsenazo III method using Vitros 5600 autoanalyser. Result(s): Chi-square analysis was done and the p-value between cases and control was < 0.05 which is significant. 20% of the COVID -19 patients had very severe hypocalcemia ranging between 4.5-6 mg/dl, 47% of the COVID-19 patients had moderate to severe hypocalcemia with values between 6.6-8.5 mg/dl, and 33% of the COVID -19 patients had normal calcium levels ranging from 8.6-10 mg/dl. Conclusion(s): Hypocalcemia is highly prevalent in COVID-19 patients implying that hypocalcemia is intrinsic to the disease. Prospective studies with a larger number of patients are required to prove this hypothesis and unravel the underlying pathophysiological mechanisms. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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This study aims to investigate traces of COVID - 19 on renal system during infection & after recovery in city of Baghdad from October 2021 till April 2022. Method(s): Patients were consisted of 120 individuals with acute then to convalescent phase of COVID-19 and 60 healthy controls, all aged between 19 & 61 years. They were consisted of equal halves of males & females, for both patients & controls. Tests that were depended in this study are: Blood urea, serum creatinine & serum uric acid;all samples are of serum;that had been done using Roche - Integra 400 plus auto analyser at Al-Karkh Medical Laboratory in Baghdad. Result(s): Renal impairment & problems were of several dilemmas that raised highly with proceeding of COVID - 19, made dysfunction of kidneys & other correlated parts of renal system parts a very significant criterion among patients suffering this problem;especially if there was a familiar history in these organs;like renal stone formation, uricemia & recurrent urinary tract infection;making consequences of this disease the worst among other problems that can take effect on renal system;rather than chemical toxification & cancers. Blood urea had scored in males in acute & recovery phases of (38.08+/-15.36) & (43.27+/-18.13) respectively, while in females was (28.57+/-7.56) & (32.25+/-8.49) in same attribute, with high significance of (p<0.01 HS) in acute phase & (p>0.05 NS) for recovery phase. Serum creatinine levels were lower in females than of males in both phases;where scores at (0.6517+/-0.19) in acute phase & (0.81+/-0.19) after recovery;which means that they stayed in normal ranges;while in males level of creatinine scored (0.94+/-0.370) & (1.19+/-0.45) in cue;hitting the highest normal ranges & made males in higher risk for any renal proper functioning, with high significance of (p<0.01 HS) for both. Results of S. uric acid were slightly near the upper limits for females at (5.23+/-1.13) & (5.48+/-0.79) for acute & recovery phases in correspondence, while males crossed the borders of normal ranges in both phases;(6.31+/-1.17) & (7.07+/-1.09) respectively, (p<0.01 HS) for both. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Introduction: The COVID-19 pandemic has been raging across the globe since early January 2020. Various geographical regions have been passing multiple swells of upsurge of cases which aren't matched temporally as well as in severity. The diapason of the complaint ranges from asymptomatic to severe life-hanging complaint. Advanced age and the presence of comorbidities similar as cardiovascular complaint, diabetes mellitus, hypertension, chronic lung complaint, chronic kidney complaint, cancer, and obesity are among the major threat factors for severe disease. Aims and objectives: Significance of lab parameter among Corona Patients. Materials and methods: The covid- 19 opinion was verified by reverse transcription- polymerase chain reaction (RT- PCR) assay of nasopharyngeal swab sample. Hematology blood samples were used to analyze by flow cytometry. Biochemical samples were used to analyze by completely auto analyzer diagnostic outfit. Serology tests were carried out the styles based on indirect ELISA technique, immune plates are coated with a admixture of purified viral antigen and probe using the patient serum. Results: It is found that there is statistically significant (p-value<0.05) mean difference within the lab parameters (IL-6, LDH and Ferritin) in Covid patients using the Post Hoc Analysis. It is also found that there statistically significant (p-value<0.05) mean difference between RBC, Hb level, Hematocrit, MCV, MCH, MCHC, Platelet, RDW, PCT and NL ratio while Age, WBC, MPV, M(Monocyte), E(Eosinophil), B(Basophil), D-dimer and PDW were found to be statistically insignificant (p-value>0.05) with respect to gender. Discussion: CBC, D- dimer, IL-6, LDH and Ferritin were analysed and found associated with adverse outcomes. There is significant association of age, gender, comorbidity. Conclusion: High NLR at admission associated with a higher mortality. Laboratory features (e.g., IL-6, LDH, Ferritin D-dimer etc.) were associated with poor outcomes.
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In this study, it was aimed to evaluate the relationship between the clinical course of the disease and hematological data, serum 25-hydroxyvitamin D (25 (OH) D), iron (Fe), free iron-binding capacity (UIBC), and D-dimer levels in calves with diarrhea in the neonatal period. Within the scope of the study, 10 healthy calves (group-I) and 30 diarrheal calves in the neonatal period of different races, ages and genders were used. Calves with diarrhea were divided into mild (group-II, n=10), moderate (group-III, n=10) and severe (group-IV, n=10) groups. Blood samples were taken from calves in all groups at once. Hematological analyzes were performed using a veterinary-specific hematology analyzer device. In serum samples, 25 (OH) D3, Fe and UIBC levels were determined with an autoanalyzer, and D-dimer levels were determined with an automatic immunoassay analyzer. In the hematological analysis, an increase was observed in the number of LYMs (lymphocytes) in group-II (5.04±1.3) and III (5.2±3.3) compared to group-I (4.47±1.2), and a decrease was observed in group IV (2.76±0.9) (P<0.05). Fe levels in group-II (59±56), group III (56±52) and group IV (72±63) were found to be decreased compared to group-I (131±66) (P<0.05). It was determined that the 25 (OH) D3 level of group IV (13.4±8.5) was higher than that of group-I (6.12±2.73) (P<0.05). D-dimer levels of group-III (1.15±1.13) and group-IV (0.96±0.88) were found to be higher than group-I (0.10±1.46) (P<0.05).
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Favipiravir, a selective RNA polymerase inhibitor agent, is an antiviral drug currently used effectively in treating pandemic diseases such as Covid-19. The present study aims to determine the effects of favipiravir use on bone marrow and blood cells. Twelve male Wistar rats were divided into two groups, namely control and favipiravir groups. Physiological saline at a dose of 1 ml/kg was administered to the rats in the control group by oral gavage for 10 days. Rats in the favipiravir group were administered favipiravir by oral gavage at a dose of 200 mg/kg for 10 days. At the end of the study, the blood tissue was collected from the heart, and bone marrow samples were collected from the femur bone of the rats sacrificed under anesthesia. The hematologic parameters in the blood samples obtained were measured using an auto-analyzer device with the help of rat compatible kits. Bone marrow cell counts were performed by examining structural changes and myeloid and erythroid cell series in the smear samples. The results obtained in the study revealed that favipiravir use caused a decrease in the counts of some hematologic parameters containing erythrocytes, lymphocytes, and monocytes. In addition, it was determined that the ratio of myeloid and erythroid cells in bone marrow smears changed significantly with the use of favipiravir. It was concluded that treatment with favipiravir caused suppression of erythrocyte and some leukocyte series. The suppressor effects were also determined in bone marrow cell series in the rats.
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BACKGROUND AND AIM: SARS-CoV-2 has caused a pandemic and COVID-19 challenged both human and public health over the world. Different types of COVID-19 vaccines were developed against the disease virus with various techniques. In this research, it was aimed to evaluate the antibody responses induced by mRNA vaccines and inactivated vaccines or SARS-CoV-2 infection. METHODS: Between January and August 2021, 651 patients tested for immunoglobulin G antibody levels against the spike protien of SARS-CoV-2. Antibody levels(AU/mL) were detected by Chemiluminescence-Microparticle-Immunoassay, detection was carried on Abbott-Architect ci8200-Autoanalyzer. RESULTS: Among 651 patients 298 of them were vaccinated without previous COVID-19 history (77 mRNA, 221 inactivated), 123 were infected with SARSCoV-2 and not vaccinated, 58 were vaccinated after the infection (19 mRNA, 39 inactivated) while 172 of all did not have previous infection or vaccination history. of 172 patients 29 of them tested positive for anti-Spike antibody levels with a median value of 223.9. Inactivated vaccine induced antibody responses were significantly lower than mRNA vaccine induced levels (p=0.000, median:304.5, 7530.8 respectively). In previously infected population who were not vaccinated;higher antibody levels were observed than inactivated vaccine administred patients (p=0.000, median:737.1, 304.5 respectively), when compared to the patients who received mRNA vaccine antibody levels were found to be lower (p=0.000, median:737.1, 7530.8). Among the patients who were vaccinated after the infection;latterly mRNA vaccine administred patients were found to have higher antibody levels than patients who received inactivated vaccine after the infection (p=0.000, median:12070.4, 1183.9 respectively). CONCLUSIONS: Higher levels of antibody response were observed in patients who received mRNA vaccine when compared to those who received inactived vaccine or were infected with SARS-CoV-2. The highest levels were observed among patients who were infected then also received mRNA vaccine. This study whose preliminary data were examined should be supported by larger sample groups and longer follow-up with further studies.
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Introduction Coronavirus disease 2019 (COVID-19) caused by the SARS coronavirus 2 has challenged the global healthcare system since 2019. Lipids are integral component of this enveloped virus that play an essential role in in its life cycle starting from fusion of viral membrane to host cell, viral replication and exocytosis. It also disrupts metabolic profile due to the release of pro-inflammatory cytokines leading to systemic inflammation reaction. Aim and Objective Therefore, it was aimed to find association between human host serum lipid levels and its association with inflammatory markers. Materials and Methods It was a retrospective study conducted from June 2020 to December 2020, included 500 COVID-19 admitted patients tested positive by Oral/Nasopharyngeal swab by Real time PCR. Total Cholesterol, Triglycerides (TG), Low Density Lipoprotein (LDL-C), High Density lipoprotein (HDL), Ferritin, Procalcitonin (PCT), High sensitive C Reactive protein (hsCRP) estimated in Vitros XT 7600 Autoanalyzer and Interleukin-6(IL-6) by ELISA. Results A significant increase in Serum Triglycerides(185mg/dL) and decrease in HDLC(30mg/dL) was observed with no remarkable finding in other lipid parameters. A statistically significant (p<0.05)positive correlation was observed between TG and inflammatory markers such as hsCRP, PCT, Ferritin, IL-6. Likewise, a negative correlation was detected between HDL-C and hsCRP, PCT, Ferritin, IL-6. Conclusion Lipid profile and host cell metabolism is altered in COVID 19 patients either by cellular infection or by systemic inflammation. Hence it is important to study lipid profile alterations in synergism with inflammatory markers. It may act as guiding step in management and prognosis of this disease.
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Objective : In this study, we have assessed the hematological characteristics of the patients. This study aimed to evaluate the accuracy of laboratory parameters in predicting cases with positive RT-PCR for COVID19. Methodology: This was a cross-sectional study that included 32 RTPCR +ve and 64 RTPCR -ve cases over a period of 5 weeks. The blood samples were collected from symptomatic patients who presented to cough OPD. On the day of swab sampling, blood sampling was done for each participant. All tests were performed in an appropriate autoanalyzer after complying with internal quality control. Results: The mean CT value of RT-PCR test was found to be 22.7, while mean PCT value was 0.3 ng/ml. The mean ferritin value came out to be 133.5 ng/ml and mean D-dimer values calculated to be just 1.3 mg/L. The mean LDH and CRP levels were 340.4 IU/L and 12.6 mg/L respectively. The sensitivity and specificity for procalcitonin analysis among these patients were 97% with CI (93.8-100) followed by serum ferritin with 82%, CI (70-94) and CRP levels were having just 77.3%, CI (61.2-93.4). Conclusion: In the current study, the AUC of procalcitonin and serum ferritin were above 0.80;thus, they are effective and have very good predictive value for predicting COVID-19. It seems that these blood laboratory parameters could be used in screening cases with positive RT-PCR for COVID-19. However, serum LDH, D Dimer, and vitamin D levels or liver function tests, renal function tests remain insignificantly linked with covid positivity rate in this study.
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Background : COVID-19 outbreak caused by SARSCOV-2 which primarily targets lungs causing other organs dysfunction including liver have been reported .However studies on liver function in COVID 19 patients are limited. Hence, this study aimed to evaluate the Liver enzymes in COVID-19 cases admitted in RIMS, Imphal. Methodology: We performed a cross sectional study on the liver function parameters of 488 COVID-19 positive patients admitted in RIMS, Imphal during April 2020 to September 2020. The COVID-19 positivity was determined on basis of RNA real time PCR. Serum samples were analyzed using Randox Auto analyzer. Results: Out of 488 patients with COVID-19, 431cases (88.32%) had abnormal LFTs and 57 cases (11.68%) had normal LFTs. Out of these 431 cases 330 (76.57%) were males and 101 (23.43%) were females. Median age of abnormal LFTs cases was 35 years. The primary liver enzymes;AST, ALT, ALKP and GGT were found to be elevated in 79.3%, 78.1%, 30.8% and 25.5% cases respectively. However, serum albumin levels were low in 24.1% cases. Conclusion: The prevalence of abnormal LFTs in COVID-19 patients is relatively high (88.31%).Abnormal liver enzymes may be a frequent finding in COVID-19 cases. These patients may be at a higher risk of progressing to severe diseases and therefore they should be observed and evaluated frequently for further treatment.
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Background/Objectives : Corona virus disease 2019(COVID19) pandemic has caught the world into pronounced health crisis as number of patients is dramatically increasing worldwide. COVID19 is caused by severe acute respiratory syndrome corona virus 2 (SARSCoV2) which mainly infects respiratory system but can damage other systems also. So, its early diagnosis is very necessary. Biochemical Parameters can effectively diagnose COVID19 earlier. This study is to analyze alterations in biochemical parameters in COVID19 patients of our region as there is scarcity of COVID19 related biochemical data of our region & to compare them according to disease severity. Methodology: This study involved 112 COVID19 positive patients admitted between 01/09/2020 & 30/11/2020 at IGGMC, Nagpur. Patients were categorized on the basis of ICMR guidelines into two groups i.e. moderate(n=56) & severe(n=56) each between 18 & 80 years of age. Blood samples were processed in ERBA-XL-640 autoanalyzer for estimation of serum levels of C-reactive protein(CRP), Ferritin, Lactate Dehydrogenase (LDH), Creatinine, Urea, Aspartate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP),Total Proteins (TP), Albumin. Results were compared between these two groups & evaluated using independent samples t-test. Result: Severely ill patients had significantly higher levels of LDH (p=0.0001), CRP (p=0.0001), Ferritin (p=0.0001), Creatinine (p=0.0001), Urea (p=0.007), AST (p=0.02) & ALT (p=0.02) as compared to moderate patients. No significant difference was observed in values of TP (p=0.4), Albumin (p=0.6), ALP (p=0.7) between both groups. Conclusion: Biochemical investigations of COVID19 patients are simple, costeffective & rapid marker which helps in early identification of critically ill patients & monitoring of disease progression aiming to improve recovery & reduce mortality of COVID19 patients.
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Background: Coronavirus disease 2019 (Covid-19) is associated with a high incidence of thromboembolic events, both venous and arterial. Currently, there are no clinical or laboratory markers to guide riskstratification or antithrombotic therapy in Covid-19 patients. Circulating immature platelets represent a population of hyper-reactive platelets, which are associated with arterial thrombotic events. Objectives: To assess whether the proportion of immature platelets in the circulation is associated with disease severity in patients with Covid-19 Methods: This prospective study evaluated consecutive patients with COVID-19 admitted with various degrees of disease severity, as determined by the standard Covid-19 severity Score. Disease severity was evaluated during hospitalization. Immature platelet fraction (IPF) absolute number and percentage were measured on admission and at additional time points during the hospital course using the SysmexXN-3000 auto-analyzer. The maximal values of IPF% and absolute IPF was analyzed according to disease severity. Results: A total of 136 consecutive patients with Covid-19 were recruited. Mean age was 60±19 years for patients with mild and moderate disease and 69±14 years for patients with severe disease, 52% with mild and moderate disease and 48% with severe disease were woman, 11% with mild and moderate disease and 20% with severe disease with concurrent cardiovascular disease The median of IPF% was higher in the severe COVID-19 group compared to patients with mild or moderate disease [4.2 (IQR 2.73-6.45) vs 5.8 (IQR 3.9-8.7), P=0.01, Figure 1)]. The median of IPF absolute number was also significantly higher in patients with severe disease comparing to patients with mild or moderate disease (4.2 (2.85-6.1) vs 5.1 (IQR 3.65-7.35), P<0.0001, Figure 2]. Conclusions: Patients with severe Covid-19 have a higher level of IPF in the circulation than patients with mild or moderate disease. IPF may serve as a reliable prognostic marker for in-hospital disease severity in patients with Covid-19.
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Background: Coronavirus disease 2019 (Covid-19) is associated with high incidence of thromboembolic events, both venous and arterial. Currently, there are no clinical or laboratory markers to guide antithrombotic therapy in COVID-19 patients. Immature platelets represent a population of hyper-reactive platelets associated with arterial thrombotic events. Objectives: To determine indices of immature platelets and platelet reactivity in Covid-19 patients. Methods: This prospective study compared consecutive COVID-19 patients (n=47, median age = 56 years) to patients with acute myocardial infarction (AMI, n=100, median age = 59 years) and a group of stable patients with cardiovascular risk factors (n=64, median age=68 years). Immature platelet fraction (IPF) and immature platelet count (IPC) were determined by the Sysmex XN-3000 auto-analyzer on admission and at subsequent time-points. Results: IPF% on admission was higher in the Covid-19 group than the stable group and similar to the AMI group (4.8% [IQR 3.4-6.9], 3.5% [2.7- 5.1], 4.55% [3.0-6.75], respectively, p=0.005 for Covid-19 vs. stable). IPC on admission was also higher in the Covid-19 group than the stable group and similar to the AMI group (10.8×109/L [8.3-18.1], 7.35×109/L [5.3- 10.5], 10.7×109/L [7.7-16.8], respectively, P<0.0001 for Covid-19 vs. stable). The maximal IPF% among the Covid-19 group was higher than the stable group and similar to the AMI group. The maximal IPC in the Covid-19 group was higher than the maximal IPC in both the stable and AMI groups (Covid-19: 14.4×109/L [9.4-20.9], AMI: 10.9×109/L [7.6-15.2], P=0.0035, Stable: 7.55×109/L [5.55-10.5], P<0.0001). Conclusions: Patients with Covid-19 have increased immature platelets indices compared to stable patients with cardiovascular risk factors, and as the disease progresses also compared to AMI patients. Enhanced platelet turnover and reactivity may, therefore, have a role in the development of thrombotic events in Covid-19 patients.