ABSTRACT
Birth chest circumference(CC) shows often, like birth gestational age(GA), tight direct relations to birth body weight(BW). However distinct connections of hypoxia/undernutrition with different body structures might be suspected based on brain-, heartand adrenal-sparing following intrauterine growth restriction and, postnatally, on higher chest size for body mass observed at high altitude. Growth retarded fetuses gestated by hypoxic rats may present increments of blood serum Insulin-like Growth Factor Binding Protein(IB) 2, but not of IB3. Relevance of human newborn(NWB) CC/BW ratio(i.e., CC through BW, CC/BWR) to relationships between BW<=10.th centile for GA(SGA), and IB2/ IB3 ratio(IB2/IB3R) was evaluated. NWBs with any among total parenteral nutrition, parenteral nutrition other than dextrose, blood component transfusion, postnatal corticosteroid-, catecholamine- or methylxantine-based treatments, life-threatening disease, diabetes mellitus(DM) or other endocrine diagnosis, malformation, and mother with DM were excluded. 78 included NWBs, all studied before covid-19 pandemic and from conception to study end near sea-level, had complete data for 1) same-day records at one of the first 5 postnatal days(x), 5 days after x(y) and 10 days after x(z) of postnatal age(PNA, unit:day), IB2 and IB3 radioimmunoassay(unit=uM/dl), and for 2) gender(SEX), GA(unit: complete week;extremes=28-42), GA<=36 present(PTB, n=46), CC(25th-75th centiles=27-32cm), BW(25th-75th centiles=1926-2942g), and SGA(n=20)(computations;male SEX(n=43), SGA;condition absent=0, condition present=1). SPSS-27 software was used to generate GA-unrelated CC/BWR standardized residuals(CC/BWRsr)(i.e., Linear regression procedure- Save pushbutton/ Standardized residual checkbox-Continue pushbutton/ regress CC/BWR on only GA). IB2/IB3R(i.e., IB2 through IB3) calculated at x-y-z time-poins, was averaged(i.e., (x+y+z)/3;IB2/IB3RM). IB2/IB3RM normal scores according to Van der Waerden(IB2/IB3RM-NS) were normally distributed. SGA evidenced significantly higher CC/BWR, CC/BWRsr and IB2/IB3RM than non-SGA(Mann-Whitney Test). Spearman rank correlations between the following variable pairs are reported(Rho;significance): GA vs CC/BWR(-.706, p<.0001), GA vs CC/BWRsr (-.024;p=.8315), GA vs IB2/IB3R(-,409;p=.0002), CC/BWRsr vs IB2/IB3R(.346;p=.0019). Partial correlation(pc) coefficient(pcc) of SGA pc with outcome IB2/IB3RM-NS in multiple linear regression(MLR) was significant (t=4.194, p<.0001, pcc=.565) with SEX-GA-SGA-PNAx as predictors, but non-significant with SEX-GA-SGA-CC/BWRsr-PNAx as predictors(MLR R2, .447- .492, always significant). CC/BWRsr could be involved in direct relationships between SGA and IB2/IB3RM-NS after controls including GA in not-life-threatened NWBs.
ABSTRACT
Birth chest circumference(CC) shows often, like birth gestational age(GA), tight direct relations to birth body weight(BW). However distinct connections of hypoxia/undernutrition with different body structures might be suspected based on brain-, heartand adrenal-sparing following intrauterine growth restriction and, postnatally, on higher chest size for body mass observed at high altitude. Low BW and hypoxia may be associated with circulating Insulin-like Growth Factor-I(IG1) lower levels. Relevance of human newborn(NWB) CC/BW ratio(i.e., CC through BW, CC/ BWR) to relationships between BW<=10.th centile for GA(SGA), and blood serum IG1(IG1s) was evaluated. NWBs with any among total parenteral nutrition, parenteral nutrition other than dextrose, blood component transfusion, postnatal corticosteroid-, catecholamine- or methylxantine-based treatments, life-threatening disease, diabetes mellitus(DM) or other endocrine diagnosis, malformation, and mother with DM were excluded. 78 included NWBs, all studied before covid-19 pandemic and from conception to study end near sea-level, had complete data for 1) same-day records at one of the first 5 postnatal days(x), 5 days after x(y) and 10 days after x(z) of postnatal age(PNA, unit:day) and IG1s radioimmunoassay(unit=uM/dl), and for 2) gender (SEX), GA(unit:complete week;extremes=28-42), GA<=36 present(PTB, n=46), CC(25th-75th centiles=27-32cm), BW(25th-75th centiles=1926-2942g), BW standard deviation scores(BW-SDS), and SGA(n=20)(computations;male SEX(n=43), SGA;condition absent=0, condition present=1). SPSS-27 software was used to generate GA-unrelated CC/BWR standardized residuals(CC/ BWRsr)(i.e., Linear regression procedure-Save pushbutton/ Standardized residual checkbox-Continue pushbutton/ regress CC/BWR on only GA). IG1s at x-y-z time-points was averaged (i.e., (x+y+z)/3;IG1sM). IG1sM normal score according to Van der Waerden(IG1sM-NS) resulted normally distributed. Mann- Whitney Test: PTB did not differ significantly from non-PTB for CC/BWRsr;SGA showed significantly lower IG1sM than non- SGA. Spearman rank correlations between the following variable pairs are reported(Rho;significance): BW-SDS vs CC/BWR(-.361;p=.0012), BW-SDS vs CC/BWRsr(-.766;p<.0001), CC/BWR vs IG1sM(-.659, p<.0001), CC/BWRsr vs IG1sM(-.271, p=.0166). Partial correlation(pc) coefficient(pcc) of SGA pc with outcome IG1sM-NS in Multiple linear regression (MLR) was significant(t=-3.349, p<.0013, pcc=-.365) with SEX-GA-SGAPNAx as predictors, but was non-significant with SEX-GASGA- CC/BWRsr-PNAx as predictors (MLR R2, .486-.513, always significant). CC/BWRsr could be involved in inverse relationships between SGA and IG1sM-NS after controls including GA in NWBs free of life-threatenig disease.
ABSTRACT
Background: The first wave of COVID-19 outbreak in Malaysia started with the first case in January 2020 followed by the second wave in February 2020 and the third wave in October 2020. In the early phase, COVID-19 patients were treated in designated Ministry of Health (MOH) hospitals only. However towards the end of 2020, as the crises set in, COVID-19 patients were also being treated in private centres and university hospitals including our centre, Universiti Teknologi MARA (UiTM) Medical Specialist Centre. Aims: To evaluate the utilization of blood components among hospitalized COVID-19 patients. Methods: Retrospective study of blood component transfusions among hospitalized COVID-19 patients from January 2021 to December 2021 was conducted in Transfusion Medicine Unit, UiTM Medical Specialist Centre. The data was retrieved from Blood Bank Information System (BBIS) and transfusion request forms. The type of blood products and the number of blood components transfused to the patients were analysed. Results: Overall, 256 COVID-19 patients were admitted to our centre in 2021. Twenty-eight of the patients received blood product transfusions for an overall transfusion rate of 10.9%. Out of a total of 2438 blood components used by all patients admitted to our centre in 2021, 4.3% of blood components were transfused to COVID-19 patients in which the majority were red blood cells, 56 units (4.2%) followed by platelets 40 units (9.5%) and fresh frozen plasma 9 units (1.8%). Summary/Conclusions: The transfusion rate of blood components among hospitalized COVID-19 patients is lower than other hospitalized non-COVID-19 patients.
ABSTRACT
Background: The novel coronavirus disease 2019 (COVID-19) has caused a sudden and unexpected rise in hospitalizations and deaths around the world. Many hospitals have changed their daily work and become infectious. A reduction in blood collection of 10 to 50% has been reported. In Russia, in 2020, compared to 2019, blood collection decreased by 4%. Data on the use of blood products by patients with COVID-19 is very limited and highly variable. According to various sources, from 3.3 to 13.4% of patients with COVID-19 need a blood transfusion. In different hospitals transferred to the COVID-19 mode, blood transfusion changes in different ways: somewhere it increases, and somewhere it decreases. Aims: To identify the features of transfusion therapy in the COVID- 19 hospital of the Pirogov Center. Methods: We studied the structure of recipients and blood transfusions in the COVID-19 hospital and other departments of the Pirogov Center in 2020. We transfused leucodepleted red blood cells in PAGGS-M, leucodepleted amotosalen/UVA pathogen inactivated platelets in SSP+ and methylene blue/white light pathogen inactivated male plasma. No COVID-19 convalescent plasma has been transfused. Results: Among the 1141 patients of the COVID-19 hospital, 61 patients (5.3%) and among 37,136 patients in other departments, 710 (1.9%) patients received transfusions of blood components. During the operation of the COVID-19 hospital, the Pirogov Center's need for donor blood components was fully met. In the COVID-19 hospital compared to other departments: • the part of recipients of all blood components, red blood cells and plasma was higher (p < 0.01);• 4 units and 4-6 units of red blood cells were transfused more often (p < 0.01), more than 11 units of red blood cells were not transfused;• among recipients of red blood cells, the part of people over 60 years old is 42.4% higher than the same part among other patients (p < 0.01);• among plasma recipients, the part of persons under 45 years of age is significantly reduced (p < 0.05). Red blood cells transfusion helped to save most of the most severe patients: • over 70 years old, • anaemia on admission, • the period of D-dimer concentration over 1.5 mg/l-more than 20 days, • concomitant oncological diseases-in 20% of patients. Among patients with new coronavirus infection and no indication for red blood cell transfusion, haemoglobin concentration negatively correlates with age and D-dimer level. The absence of such connections in red blood cells recipients indicates the importance of other factors (oncological process, bleeding) in the development of anaemia that requires transfusion correction. Summary/Conclusions: The data on the needs of patients in the COVID-19 hospital for transfusion therapy can be used as a benchmark for the related work planning.