Correlation between laboratory findings and clinical severity among the COVID-19 patients in the tertiary care centre

Background: Coronavirus is a highly infectious novel virus we are in urge to know more about their clinical characteristics and laboratory findings for the characterization and selection of treatment protocol. Methods: Prospective, single centre study. Two months data was collected, clinical characteristics data from patient case sheet and the laboratoryvalues from the Hospital Information System (HIS) for the month of July and August 2020. Results: Of 462 patients, 55 (11.9%) are falls under asymptomatic category, 194 (42%) are in mild category, 167 (36.1%) are in moderate category and 46 (10%) in severe category. Fever 230 (49.8%) and cough 211 (45.7%) was most common clinical symptom with p value < 0.01. Non-severe vs severe, 340 (73.6%) and 201 (43.5%) showed decreased in eosinophil count and absolute eosinophil count, 125 (27.1%) and 80 (17.3%) patient showed decrease in lymphocyte count and absolute lymphocyte count, 200 (43.3%) showed increase in neutrophil count with a significance of p value >0.05.186 (40.3%) patients had one or more co-morbidities. Laboratory findings between Asymptomatic VS symptomatic, showed significance changes in neutrophil, lymphocyte, Aspartate aminotransferase, Alkaline phosphatase, globulin values (p value <0.05). Conclusion: Clinical severity categorization at the time of admission was very helpful for the treating doctors in proper understanding of disease progression and appropriate treatment of the patient. Presence of co-morbidity, abnormal laboratory values, old age group patients, higher Computed Tomography score, higher mortality rate are seen more in patients who were in clinical severity grade severe category than in non-severe category patients.

The effect of functional exercise along with online nutritional education on inflammatory biomarkers in children with autism spectrum disorder during COVID-19 pandemic: a randomized clinical trial

Background and Objectives: Autism spectrum disorder (ASD) is a neuro-developmental disorder which is mostly caused by deficits in social interactions. Lack of physical activity and poor nutritional habits are common problems in these patients which may be exaggerated by the Covid-19 pandemic. The study aims to assess the effect of functional training along with online nutrition education on inflammatory biomarkers in children with ASD. Subjects and Methods: In this randomized controlled clinical trial, 80 children with ASD (age=9.73+or-1.29 years, weight=49.94+or-2.08 kg, height=146.08+or-40 cm, body mass index=24.71 +or-1.48 kg/m2) were randomly divided into four groups of training, education, training+ education, and control. The interventions lasted for 8 weeks. The inflammatory biomarkers including white blood cell (WBC) count, C-reactive protein (CRP) level, neutrophil count, eosinophil count, and basophil count were assessed (using blood samples collected from antecubital vein) before and after the interventions. Results: There was no significant difference between the groups before the interventions (P>0.05). After the intervention, the results showed a significant decrease in WBC (P<0.001), CRP (P=0.001), neutrophils (sig.=0.009), and eosinophil (P=0.003) in all groups. Basophil count decreased in all groups (P=0.01) except in the education group. Conclusion: Functional training and online nutrition education are beneficial interventions for management of inflammatory biomarkers in children with ASD which can be used during the Covid-19 pandemic.

Translating the biology of ß common receptor-engaging cytokines into clinical medicine.

The family of cytokines that comprises IL-3, IL-5, and GM-CSF was discovered over 30 years ago, and their biological activities and resulting impact in clinical medicine has continued to expand ever since. Originally identified as bone marrow growth factors capable of acting on hemopoietic progenitor cells to induce their proliferation and differentiation into mature blood cells, these cytokines are also recognized as key mediators of inflammation and the pathobiology of diverse immunologic diseases. This increased understanding of the functional repertoire of IL-3, IL-5, and GM-CSF has led to an explosion of interest in modulating their functions for clinical management. Key to the successful clinical translation of this knowledge is the recognition that these cytokines act by engaging distinct dimeric receptors and that they share a common signaling subunit called ß-common or ßc. The structural determination of how IL-3, IL-5, and GM-CSF interact with their receptors and linking this to their differential biological functions on effector cells has unveiled new paradigms of cell signaling. This knowledge has paved the way for novel mAbs and other molecules as selective or pan inhibitors for use in different clinical settings.

Automated COVID-19 Detection from WBC-DIFF Scattergram Images with Hybrid CNN Model Using Feature Selection

In the medical diagnosis such as WBC (white blood cell), the scattergram images show the relationships between neutrophils, eosinophils, basophils, lymphocytes, and monocytes cells in the blood. For COVID-19 detection, the distributions of these cells differ in healthy and COVID-19 patients. This study proposes a hybrid CNN model for COVID-19 detection using scatter images obtained from WBC sub (differential-DIFF) parameters instead of CT or X-Ray scans. As a data set, the scattergram images of 335 COVID-19 suspects without chronic disease, collected from the biochemistry department of Elazig Fethi Sekin City Hospital, are examined. At first, the data augmentation is performed by applying HSV(Hue, Saturation, Value) and CIE-1931(Commission Internationale de l'éclairage) conversions. Thus, three different image large sets are obtained as a result of raw, CIE-1931, and HSV conversions. Secondly, feature extraction is applied by giving these images as separate inputs to the CNN model. Finally, the ReliefF feature extraction algorithm is applied to determine the most dominant features in feature vectors and to determine the features that maximize classification accuracy. The obtaining feature vector is classified with high-performance SVM in binary classification. The overall accuracy is 95.2%, and the F1-Score is 94.1%. The results show that the method can successfully detect COVID -19 disease using scattergram images and is an alternative to CT and X-Ray scans.

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review.

BACKGROUND: Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory virus infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital. METHODS: Among the BAL procedures performed at the University of the Ryukyu Hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on BAL eosinophil fraction was analyzed using statistical analysis. A case study was conducted on respiratory virus detection, which showed an elevated BAL eosinophil fraction. RESULTS: A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a higher BAL eosinophil fraction than the PCR-negative group (p = 0.030), and more cases had a BAL eosinophil fraction > 3% (p = 0.017). Multivariate analysis revealed that being PCR-positive was significantly associated with BAL eosinophil fraction > 1% and > 3%. There were nine PCR-positive cases with a BAL eosinophil fraction > 1%, of which two cases with parainfluenza virus infection had a marked elevation of BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia. CONCLUSIONS: Cases of viral infection of the lower respiratory tract showed an elevated BAL eosinophil fraction. The increase in eosinophil fraction due to respiratory virus infection was generally mild, whereas some cases showed marked elevation and were diagnosed with eosinophilic pneumonia. Respiratory virus infection is not a rare cause of elevated BAL eosinophil fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.

Investigating the role of obstructive pulmonary diseases and eosinophil count at admission on all-cause mortality in SARS-CoV-2 patients : A single center registry-based retrospective cohort study.

INTRODUCTION: The impact of asthma and chronic obstructive pulmonary disease (COPD) in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV­2) infection is not clearly defined. Blood eosinophil count is a standard diagnostic test which, according to the previously published literature, might have a potential prognostic role on mortality in patients with SARS-CoV­2 infection. AIM: To investigate the potential prognostic value of peripheral blood eosinophil count on all-cause mortality of patients hospitalized with SARS-CoV­2 infection, as well as to assess the impact of asthma or COPD premorbidity on all-cause mortality. MATERIAL AND METHODS: We conducted a retrospective registry-based cohort study. Survival analysis was performed by employing the Cox proportional hazards regression model at 30 days of follow-up. Prognostic value of eosinophil count on all-cause mortality was assessed using receiver-operating characteristic (ROC) curve analysis. RESULTS: A total of 5653 participants were included in the study. Our model did not reveal that pre-existing asthma or COPD is a statistically significant covariate for all-cause mortality but, indicated that higher eosinophil count at admission might have a protective effect (hazard ratio, HR 0.13 (95% confidence interval, CI 0.06-0.27), p = 0.0001). ROC curve analysis indicates cut-off value of 20 cells/mm3 (81% specificity; 30.9% sensitivity). CONCLUSION: Our results indicate that eosinophil count at hospital admission might have a potential prognostic role for all-cause mortality at 30 days of follow-up; however this was not demonstrated for pre-existing obstructive lung diseases.

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+or-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+or-3.51 x109/L, the average red blood cell count was 4.61+or-0.88 x106/microL, and the average haemoglobin level was 12.80+or-2.15 g/dl upon admission. The average absolute neutrophil count was 3.81+or-3.46x109/L, the average absolute lymphocyte count was 2.31+or-1.40x109/L, the average absolute monocyte count was 0.38+or-0.31x109/L, and the average absolute eosinophil count was 0.15+or-0.18x109/L. Overall, the average number of platelets per microliter of blood was 149.21+or- 80.25. Neutrophil to lymphocyte ratio (NLR) at admission was 3.806;platelet to lymphocyte ratio (PLR) was 116.32+or-13.1;lymphocyte to monocyte ratio (LMR) was 8.91+or-5.25, and derivative neutrophil to lymphocyte ratio (d-NLR) was 2.61+or-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.

Critical evaluation of haematological and biomarker variation in COVID -19 patients - a prospective study in level 2 tertiary care hospital (Lucknow West)

Background: In India, the first case of COVID-19 was reported on January 30, 2020. The case reporting is based on the testing of individuals by Real-time Reverse Transcription- Polymerase Chain Reaction (RT-qPCR). The present study was conducted to evaluatedifferent parameters, Haematological and Biomarker variations in patients with SARS-CoV2 Infection to assess the prognostic significance. Material & Methods: The present prospective study was conducted among 70 patients who were diagnosed with COVID-19 infection. Relavant physical examination and clinical data of the patient and routine blood investigations including, CBC, serum biochemistry, coagulation function and measurement of inflammatory markers were performed. The results were analyzed by using a SPSS Statistics software version 25.0. Results: In the present study total patients were 70 out of which 58.6% were males and 41.4% were females. Maximum subjects belong to age group 61-80 yrs (47.1%). Mean haemoglobin was 12.89g/l, mean platelet was 9.96x103/l. Mean neutrophil were 88.21%, mean lymphocyte were 8.84%, mean eosinophil were 1.47%, mean monocyte was 1.59%, mean TLC was 12007.14/l. Mean random blood sugar was 148.09 mg/dl. Mean D-dimer was 0.56. Mean CRP levels were 65.5 mg/l. Mean LDH was 516.03 IU/L, mean IL-6 was 282.6pg/ml, and mean procalcitonin was 0.8 ng/ml. Mean SGOT was 62.36u/l, mean ALP was 171.87IU/L, mean urea levels were 57.10 mg/dl and mean INR was 1.22. Outcome mortality was present in total 14 subjects (5 were male and 9 were female) out of all 70 subjects. Conclusion: The present study concluded that Mean values of neutrophil, eosinophil, TLC, random blood sugar, IL6, SGOT, ALP, urea levels and INR were increased in patients with SARS-CoV2 Infection.

Evaluation of Inosine-Acedoben-Dimepranol as an immunomodulator in broiler chicks vaccinated with Infectious bronchitis virus vaccine

Protecting livestock against diseases by enhancing its immunity is essential and required in poultry industry. Therefore, the aim of the present study was to evaluate the possible immunoenhancing effects of Inosine-Acedoben-Dimepranol (IAD) in broiler chicks. A total of 150 chicks were used in the present study, divided into 6 groups (25 for each) and subjected to different treatments. It has been found that IAD significantly (P 0.05) increased total leukocytic count, with increased granulocyte (neutrophils, eosinophils, basophils), lymphocyte and monocyte counts compared to control chicks. IAD significantly (P 0.05) increased total protein as a result of increased globulins in plasma when compared with those of control. IAD has been found to significantly (P 0.05) increase immune response of IB vaccine in IAD + IB vaccine-treated groups compared to control measured by ELISA. IAD exhibited antiviral effect indicated by increased survival percent of chicks challenged with virulent IB virus with survival 100% in the groups received IAD large dose plus vaccine. Data of the present study may indicate that supplying chicks with IAD in drinking water is a good recommendation in poultry industry based on its immune enhancing properties.

A study of association of eosinophil count with severity and outcome in corona virus disease (COVID-19) in paediatric cases

Recently, COVID-19 has been investigated for questions pertaining to eosinophils. Eosinopenia, often known as a decrease in eosinophil levels, was identified as a characteristic feature associated with SARSCoV- 2 infection. However, in the past researchers have found conflicting evidence on the connection between eosinopenia and the severity of the disease. It is not quite obvious if these changes occurred as a consequence of the immunomodulation that the medication provided or of the disease process itself. In addition, additional study is required to shed light on the possible connection that exists between the eosinophil count and the development and severity of COVID-19. The current analysis was to report changes in the eosinophil count in symptomatic COVID- 19 patients and to link such changes with severity and prognosis. The purpose of the investigation was also to record variations in the eosinophil count.

Evaluation of incidence and prognosis of COVID-19 in patients with Nasal Polyps

Objective: Coronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Type 2 immune response accompanied by type 2 cytokines such as IL-4, IL-5, IL-13, and eosinophilic inflammation, may have a potential protective effect against COVID-19 in chronic rhinosinusitis patients with nasal polyps (CRS + P). In the study, it was aimed to investigation the prevalence and prognosis of COVID-19 in chronic rhinosinusitis patients with nasal polyps (CRS + P). Materials and Methods: Patients between the ages of 15-65 operated for CRS + P and were compared with the control group in terms of incidence and disease severity. Results: Covid RT-PCR test was positive in 5.04% of CRS + P patients. This rate was 8.96% in the control group, and the difference between both groups was statistically significant. When the two groups were compared in terms of disease severity, no significant difference was found. Conclusions: The incidence of COVID-19 was lower in patients with CRS + P. However, further prospective studies are needed to research the relationship between nasal polyp and COVID-19.

A retrospective study of age-defined hematologic inflammatory markers related to pediatric COVID-19 diagnosis.

BACKGROUND: The aim of this study was to examine age-related differences in hemogram parameters and hematologic inflammatory markers in pediatric patients with COVID-19. METHODS: This retrospective study included children aged 2 months to 18 years (n = 208) who have a confirmed diagnosis of COVID-19 and a control group comprising 117 healthy children between February 2021 and July 2021. The analysis of subgroup hematological values were performed according to the children's age cutoffs. RESULTS: The most significant difference between pediatric patients with COVID-19 and controls were peripheral blood eosinophil counts and eosinophil-to-monocyte ratio (EMR) levels on admission. The levels of monocyte-to-lymphocyte ratio, aggeregate index of systemic inflammation (neutrophil × platelet × monocyte/lymphocyte), neutrophil-to- lymphocyte × platelet ratio, and systemic inflammation response index (neutrophil × monocyte/ lymphocyte) were higher in patients than in controls. EMR had the highest area under the curve (AUC) value of 0.777, with a cutoff value of 0.26. The sensitivity for EMR was 75% under 2 years of age, and between 78.6-87.5% in the other age groups. CONCLUSION: In children younger than 6 months, the discriminative power of hematological indices is low, while the discriminative power of EMR is high at all ages when age appropriate cutoffs are used. Hematological inflammatory parameters may be particularly practical in pediatric clinics to help identify COVID-19 infection.

Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study.

Purpose: Hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is considered as severe exacerbations. Readmission for severe exacerbations is a crucial event for COPD patients. However, factors associated with readmission for severe exacerbations are incomplete. The study aimed to investigate different characteristics between the severe and non-severe exacerbation groups. Patients and Methods: Patients hospitalized for severe AECOPD were included in multi-centers, and their exacerbations in next 12 months after discharge were recorded. According to exacerbations, patients were separated into the severe-exacerbation group and the non-severe exacerbation group. Propensity-score matching (PSM) and multivariable analyses were performed to compare the baseline characteristics of two groups. The Hosmer-Lemeshow test and receiver operating characteristic curve were applied to evaluate how well the model could identify clusters. Results: The cohort included 550 patients with severe AECOPD across 27 study centers in China, and 465 patients were finally analyzed. A total of 41.5% of patients underwent readmission for AECOPD within 1 year. There were no significant differences in baseline characteristics between groups after PSM. Severe exacerbations in the 12 months were related to some factors, eg, the duration of COPD (13 vs 8 years, P<0.001), the COPD Assessment Test (CAT) score (20 vs 17, P<0.001), the blood eosinophil percentage (1.5 vs 2.0, P<0.05), and their inhaler therapies. Patients readmitted with AECOPD had a longer time of diagnosis (≥9 years), more symptoms (CAT ≥10), and lower blood eosinophils (Eos <2%). A clinical model was derived to help identify patients at risk of readmission with severe exacerbations. Conclusion: These analyses confirmed the relevance of COPD at admission with future severe exacerbations. A lower blood eosinophils percentage appears to be related to readmission when combined with clinical history. Further studies are needed to evaluate whether this study can predict the risk of exacerbations.

Rare forms of inflammatory myopathies - part I, generalized forms.

INTRODUCTION: the idiopathic inflammatory myopathies traditionally comprise dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, anti-synthetase syndrome and inclusion body myositis. However, there are uncommon forms that are less well characterized. In this review, we aimed to cover the uncommon forms of generalized myositis. AREAS COVERED: we identified rare forms of widespread myositis on the basis of list provided by the homepage of the Neuromuscular disease center of Washington University, USA and on the basis of the authors' knowledge. We searched PubMed® and EMBASE® for relevant articles on these forms with the aim of providing as much as possible information on their clinical manifestations as well as guidance on their work-up and treatment. EXPERT OPINION: herein, we provide un updated description of various rare forms of generalized myositis. There is substantial heterogeneity among these forms in terms of their frequency and characterization. Some forms are reasonably well defined, while others may not represent truly well-defined diseases, but rather variants of other myopathies. The landscape of rare forms appears to have evolved over time, with some forms now being better characterized, while others, such as SARS-Cov-2- and immune checkpoint inhibitor-related myositis have come to the fore only in recent years. Knowledge about rare forms of myositis can aid in their recognition and treatment.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.

The BNT162b2 mRNA COVID-19 Vaccine Increases the Contractile Sensitivity to Histamine and Parasympathetic Activation in a Human Ex Vivo Model of Severe Eosinophilic Asthma.

The BNT162b2 COVID-19 vaccine is composed of lipid-nanoparticles (LNP) containing the mRNA that encodes for SARS-CoV-2 spike glycoprotein. Bronchospasm has been reported as an early reaction after COVID-19 mRNA vaccines in asthmatic patients. The aim of this study was to investigate the acute impact of BNT162b2 in a human ex vivo model of severe eosinophilic asthma. Passively sensitized human isolated bronchi were challenged with the platelet-activating factor to reproduce ex vivo the hyperresponsiveness of airways of patients suffering from severe eosinophilic asthma. BNT162b2 was tested on the contractile sensitivity to histamine and parasympathetic activation via electrical field stimulation (EFS); some experiments were performed after mRNA denaturation. BNT162b2 increased the resting tone (+11.82 ± 2.27%) and response to histamine in partially contracted tissue (+42.97 ± 9.64%) vs. the control (p < 0.001); it also shifted the concentration-response curve to histamine leftward (0.76 ± 0.09 logarithm) and enhanced the response to EFS (+28.46 ± 4.40%) vs. the control. Denaturation did not significantly modify (p > 0.05) the effect of BNT162b2. BNT162b2 increases the contractile sensitivity to histamine and parasympathetic activation in hyperresponsive airways, a detrimental effect not related to the active component but to some excipient. A possible candidate for the bronchospasm elicited by BNT162b2 could be the polyethylene glycol/macrogol used to produce LNP.

Association between immunity and viral shedding duration in non-severe SARS-CoV-2 Omicron variant-infected patients.

Background: Coronavirus disease 2019 (COVID-19) is a respiratory-related disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). More than 200 countries worldwide are affected by this disease. The Omicron variant of SARS-CoV-2 is the major epidemic variant worldwide and is characterized by higher infectivity. However, the immunity and risk factors for prolonged viral elimination in patients with non-severe SARS-CoV-2 Omicron variant infections are unclear. Therefore, this study aimed to examine the relationship between immunity and duration of viral elimination in non-severe SARS-CoV-2 Omicron variant-infected patients in Shanghai. Methods: In total, 108 non-severe SARS-CoV-2 Omicron variant-infected patients from Shanghai New International Expo Center Fangcang Shelter Hospital were recruited in this study. They were further allocated to the early elimination (EE) and prolonged elimination (PE) groups according to SARS-CoV-2 nucleic acid positivity duration. Results: Compared to patients with EE, those with PE had increased serum concentrations of interleukin (IL)-5, IL-6, and IL-8; higher neutrophil count and neutrophil-to-lymphocyte ratio (NLR); lower lymphocyte, eosinophil, and red blood cell counts; and lower concentrations of hemoglobin and albumin (ALB). In lymphocyte subpopulation analysis, lower numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, and NK cells and a higher CD4/CD8 ratio were observed in patients with PE. In addition, correlation analysis results revealed that cycle threshold values of SARS-CoV-2 Omicron variant ORF1ab and N were negatively correlated with IL-6 and IL-8 levels and positively correlated with eosinophil count in patients with COVID-19. Finally, multivariate regression analysis showed that ALB, CD4/CD8 ratio, NLR, and eosinophil count were predictors of the SARS-CoV-2 Omicron variant elimination. Conclusion: In this study, we identified that the ALB, CD4/CD8 ratio, NLR, and eosinophil count were risk factors for prolonged viral elimination in non-severe SARS-CoV-2 Omicron variant-infected patients. These factors might be efficient indicators in the diagnosis, evaluation, and prognosis monitoring of the disease.

Targeting eosinophils in chronic respiratory diseases using nanotechnology-based drug delivery

Asthma, COPD, COVID-19, EGPA, Lung cancer, and Pneumonia are major chronic respiratory diseases (or CRDs) affecting millions worldwide and account for substantial morbidity and mortality. These CRDs are irreversible diseases that affect different parts of the respiratory system, imposing a considerable burden on different socioeconomic classes. All these CRDs have been linked to increased eosinophils in the lungs. Eosinophils are essential immune mediators that contribute to tissue homeostasis and the pathophysiology of various diseases. Interestingly, elevated eosinophil level is associated with cellular processes that regulate airway hyperresponsiveness, airway remodeling, mucus hypersecretion, and inflammation in the lung. Therefore, eosinophil is considered the therapeutic target in eosinophil-mediated lung diseases. Although, conventional medicines like antibiotics, antiinflammatory drugs, and bronchodilators are available to prevent CRDs. But the development of resistance to these therapeutic agents after long-term usage remains a challenge. However, progressive development in nanotechnology has unveiled the targeted nanocarrier approach that can significantly improve the pharmacokinetics of a therapeutic drug. The potential of the nanocarrier system can be specifically targeted on eosinophils and their associated components to obtain promising results in the pharmacotherapy of CRDs. This review intends to provide knowledge about eosinophils and their role in CRDs. Moreover, it also discusses nanocarrier drug delivery systems for the targeted treatment of CRDs.

Hematological Alterations in Patients Recovered from SARS-CoV-2 Infection in Havana, Cuba.

INTRODUCTION: COVID-19 sequelae, or the short-, medium-, and long-term manifestations of the disease are under continuous study. There are currently few reports on the evolution of hematological variables following a demonstrated absence of SARS-CoV-2 after infection. OBJECTIVE: Identify hematological alterations in Cuban adults recovered from SARS-CoV-2 infection, and their relation with disease severity. METHODS: We selected 348 persons recovered from COVID-19 residing in Havana, Cuba with an RT-PCR study negative for SARS-CoV-2 performed two weeks after hospital discharge; a structured survey was administered to obtain clinical-epidemiological data. Three groups were established according to COVID-19 clinical criteria: asymptomatic, mild/moderately symptomatic, and severely symptomatic, which, in turn, were divided according to hospital discharge date and blood sample collection date. We performed hemograms with differential leukocyte counts and compared results among groups. We then measured the associations between hematological variables, personal medical history, and relevant lifestyle habits (smoking). RESULTS: All hematological variables were within normal reference limits, although men from the group of severely ill patients had increased total leukocytes, neutrophils and lymphocytes, and decreased hemoglobin and eosinophils, which was also evident in those with a recovery time of 31-90 days. CONCLUSIONS: The relation between hematological variables and degree of clinical severity offers evidence as to persistence of systemic alterations (possibly inflammatory) associated with viral infection. Their identification and characterization can facilitate personalized patient followup and rehabilitation.