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Background: X-Linked Moesin-Associated Immune Deficiency (X-MAID) is a rare severe combined immunodeficiency (SCID) subtype that can present at any age due to its variability. Depending on severity, patients demonstrate failure to thrive, recurrent bacterial and viral infections, and increased susceptibility to varicella zoster. It has been characterized by marked lymphopenia with hypogammaglobulinemia and impaired T-cell migration and proliferation. Case Presentation: This is a report of a Cuban 7-year-old male with poor weight gain and facial dysmorphia. He had a history of recurrent bacterial gastrointestinal infections and pneumonia beginning at 4 months of age. He additionally had 4-6 upper respiratory tract and ear infections annually. While still living in Cuba, he was admitted for a profound EBV infection in the setting of significant leukopenia. A bone marrow biopsy confirmed no malignancy. After he moved to the United States, his laboratory work-up revealed marked leukopenia with low absolute neutrophil and lymphocyte count with low T and B cells, very low immunoglobulin levels IgG, IgA, and IgM, and poor vaccination responses to streptococcus pneumonia, varicella zoster, and SARS-CoV-2. Genetic testing revealed a missense pathogenic variant c.511C>T (p.Arg171Trp) in the moesin (MSN) gene associated with X-MAID. He was managed with Bactrim and acyclovir prophylaxis, and immunoglobulin replacement therapy, and considered for hematopoietic stem cell transplantation. Discussion(s): Diagnosis of X-MAID should be considered in patients with recurrent infections and profound lymphopenia. As with SCID, early diagnosis and intervention is of utmost importance to prevent morbidity and mortality. This case demonstrates the importance of genetic testing in identifying this disease as it may prompt an immunologist to consider HSCT if conservative management is suboptimal. In the current literature, HSCT appears promising, but the long-term outcomes have yet to be described.Copyright © 2023 Elsevier Inc.
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Objectives: Chilblain lupus erythematosus (LE) is a rare chronic cutaneous lupus erythematosus (CCLE) characterized by the appearance of violaceous plaques in acral regions most exposed to cold. The isolated form affects middle-aged women, while the familial form manifests in early childhood and is associated with mutations in the TREX1 gene. Result(s): A 13-year-old adolescent, with no relevant family history, was referred in March 2021 for suspected chilblain-like lesions associated with COVID-19 infection. The patient presented with multiple violaceous papules on hands and feet. The lesions were slightly painful. Small hyperkeratotic papules were also observed on finger pads. Physical examination also revealed some aphthae affecting the lips. No other systemic symptoms were reported. A skin biopsy and blood tests were performed due to presumed chilblain LE with probable systemic involvement. Histology revealed basal vacuolar damage and intense perivascular and periadnexal lymphocytic inflammatory dermal infiltrate. Remarkably, mucin was noted among the collagen bundles. Leukopenia and positive ANA antibodies (titre 1:320) were detected. Complement levels were normal. SARS-CoV2 infection was ruled out. Skin lesions disappeared within 1 month under topical corticosteroids. Hydroxychloroquine was afterwards started by Rheumatology without recurrence of skin symptoms until last follow-up. Discussion(s): We present an uncommon case of an adolescent with systemic LE presenting as chilblain LE. Chilblain LE can be accompanied by other discoid CCLE. It can progress to systemic LE in up to 20% of patients, especially when concomitant CCLE is present. This rare presentation of CCLE should be differentiated from typical chilblain and other resembling lesions, such as SARS-CoV2-associated chilblain and acral purpuric lesions (COVID toes). The Mayo Clinic diagnostic criteria can be helpful, particularly in this last SARS-CoV2 outbreak scenario, when the reporting of similar skin lesions has been significant.
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BackgroundOlokizumab (OKZ), an IL-6 ligand inhibitor in doses of 64 mg every two weeks (q2w) or every 4 weeks (q4w) demonstrated significant improvements in signs and symptoms of RA. Due to lack of availability of the IL-6 receptor antagonists tocilizumab and sarilumab in the pandemic COVID-19 situation, RA patients (pts) were switched to OKZ as a registered drug in Russia in 2022.ObjectivesTo investigate safety and efficacy of OKZ after switching from an IL-6 receptor inhibitor in clinical practice.MethodsThis retrospective cohort study included available efficacy and safety data of OKZ in pts with RA after switching from tocilizumab (IV or SC) or sarilumab (SC) from 11 of participating centers.Efficacy assessments and routine biochemical data were analyzed using descriptive statistics – mean with standard deviation for continuous parameters and absolute and relative frequency for binary variables. AE were reported by participating centers according to pt's files. The statistical significance of data of the analyzed variable at a particular visit compared with previous visits or with the Switch visit was determined using paired t-test. Fisher's exact test or chi-square test was used to compare the proportion of pts with improvement/no change and worsening. All tests were 2-tailed, and a p-value <0.050 was considered statistically significant. As this is an observational study, the statistical criteria have not been pre-specified and therefore the data presented cannot be considered definitive but should be confirmed in future analyses.ResultsEfficacy and safety results were collected for 110 RA pts with a mean age of 47.8 (15.7) years, including 87 (79.1%) women. 77 (70.0%) pts were RF/ACPA positive. Mean RA duration was 13.1 (8.9) years and mean duration of treatment with an IL-6 receptor antagonist was 47.8 (30.0) months. Mean interval before switching was 54.7 (35.4) days with the main reason of unavailable IL6-R antagonist. Pts were treated with OKZ 64 mg q4w SC.Before initiation of OKZ, an increase of DAS28-CRP was observed due to a prolonged period after the last injection of the IL-6R inhibitor from 2.8 to 3.1 weeks in 32 pts on monotherapy who were transferred to OKZ faster (on average after 41.6 (23.8) days), and from 2.7 to 3.3 weeks in 73 pts on concomitant sDMARDs (60.0 (38.0) days). DAS28-CRP was improved to 2.8 on the second OKZ visit (S+1) in both groups. Response to OKZ was maintained over a period of 2 months with no difference between pts previously receiving an IL-6 R antagonist. Of note, lower disease activity based on DAS28-CRP of 2.5 and 2.6 was achieved after 8 weeks (S+2) of OKZ therapy compared to the previous IL-6R inhibitors treatment S-1 visit (P less 0.05) (Figure 1).Figure 1.Mean DAS28CRP over time, M(SD)[Figure omitted. See PDF]Abbreviation: S-2 and S-1 last visits before switching– S+1 and S+2 visits after switching,Treatment emergent AE occurred in 7 (6.4%) pts, the most common AE in 3 pts (2.7%) included arthralgia of hands and feet and transient leukopenia in 2 (1.8%) pts.Serious AE were reported by 1 (0.9%) pt (exacerbation of herpes infection that led to treatment discontinuation). No deaths were reported. There were no apparent differences in safety and efficacy outcomes between pts on OKZ monotherapy compared to combined treatment with csDMARDs. Only one pt was switched back to tocilizumab when it became available.Table 1.Summary of treatment emergent adverse events (safety population)NOKZ 64 mg q4w with MTX N=78OKZ 64 mg q4w monotherapy N=32Any AE51 carpal canal syndromeAny serious AE10Any AE leading to discontinuation of study drug10Any death00Any AE of special interest10Infections10Laboratory abnormalitiesHyperbilirubin-emiaALT, AST elevation less than 3 ULNALT, alanine transaminase;AST, aspartate transaminase;ULN, upper limit of normalConclusionIn pts with RA responding to an IL-6R antagonist, switching to OKZ was safe and well tolerated in clinical practice. The treatment response was maintained and in some pts disease activity moderately decreased in compariso to baseline level both in OKZ mono and combination therapy.Reference[1]J.Smolen, N Engl J Med 2022;387:715-726AcknowledgementsI have acknowledgements to Vinogradova I.B., Anoshenkova O.N., Antipova O.V., Baranov A.A., Bogdanova E.A., Grabovetskaya Y.Y., Ilivanova E.P.,Kalyagin A.N., Kushnir I.N., Lapkina N.A. Mokrousova M.V., Nesmeyanova O.B., Nikitina N.V., Shesternya P.A. and Yudina N.V.Disclosure of InterestsEugen Feist Consultant of: Abbvie, Eli Lilly, Galapagos, Medac, Novartis, Sanofi, Sobi, R-Pharm, Grant/research support from: Eli Lilly, Novartis, Pfizer, Evgeny Nasonov Consultant of: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer.
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Introduction A wide range of hematological abnormalities has been observed in SARS-CoV-2 infection which is directly related to the disease progression, clinical severity, and mortality among affected individuals. The objective of this study was to evaluate the abnormalities in hematological parameters among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients in a tertiary care hospital in south India. Methods This was a cross-sectional study carried out in the pathology department of Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Chengalpattu, Tamil Nadu, India from 1st May 2021 to 30th June 2021. The hematological reports including complete blood count (CBC), neutrophil-lymphocyte ratio (NLR), serum ferritin, serum C-reactive protein (CRP), serum lactate dehydrogenase (LDH), and D-dimer levels of all the blood samples from COVID-19 positive patients were retrieved from the laboratory records. The Leishman-stained peripheral smear findings were also tabulated and analyzed. Results Out of 65 patients, 38 (58.5 %) were males and 27 (41.5%) were females with a majority (78.4%) of them being more than 40 years of age. The salient hematological abnormalities were leukopenia (21.5%), elevated NLR (43%), and thrombocytopenia (6.2%). Peripheral smear showed schistocytes (15.4%), neutrophils with ring nuclei (84.6%), and toxic granules (81.5%). A statistically significant association between elevated NLR and serum CRP was seen among male patients. The association between the presence of schistocytes with serum LDH and D-dimer levels was statistically insignificant. Conclusions The significant hematological abnormalities in patients with COVID-19 infection were elevated NLR, lymphopenia, thrombocytopenia, and elevated D-dimer levels. Careful evaluation of the hematological parameters will help in categorizing the high-risk cases and thereby initiating early intervention and appropriate intensive care management. This will bring down the morbidity and mortality among COVID-19 patients.
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Background: There is still no specific treatment strategy for COVID-19 other than supportive management. The potential biological benefits of ozone therapy include reduced tissue hypoxia, decreased hypercoagulability, modulated immune function by inhibiting inflammatory mediators, improved phagocytic function, and impaired viral replication. This study aimed to evaluate the effect of intravenous ozonated normal saline on patients with severe COVID-19 disease. Method(s): In this study, a single centralized randomized clinical trial was conducted on 80 hospitalized patients with severe COVID-19. The patients were selected by random allocation method and divided into two groups A and B. In group A (control group), patients were given standard drug treatment, and in group B (intervention group), patients received ozonated normal saline in addition to the standard drug treatment. In the intervention group, 400 mL of normal saline was weighed by 40 mug/ kg of body weight and was injected into patients within 15 to 30 minutes (80 to 120 drops per minute). This process was done daily every morning for a week. Primary and secondary outcomes of the disease included changes in the following items: length of hospital stay, inflammatory markers including C-reactive protein (CRP), clinical recovery, arterial blood oxygen status, improvement of blood disorders such as leukopenia and leukocytosis, duration of ventilator attachment, and rapid clearance of lung lesions on CT scans. The need for intensive care unit (ICU) hospitalization, the length of ICU stay, and the mortality rate in patients of the two groups was compared. Result(s): According to the results of the initial outcome variable analysis, the probability of discharge of patients who received the normal ozonated saline intervention was 33% higher than patients who did not receive this intervention;however, this relationship was not statistically significant (HR = 0.67, 95%, CI = 0.42-1.06, P value = 0.089). The chance of ICU hospitalization in patients of the intervention group was three times more than that of the comparison group, but this relationship was not significant (odds ratio = 4.4 95% CI = 1.32-14.50, P value = 0.016). The use of ozonated normal saline was found to increase the risk of death by 1.5 times but this relationship was not statistically significant (odds ratio = 1.5, 95% CI = .24-9.75, P value = 0.646). Ozonated normal saline had a significant effect on changes in respiration rate (in the intervention group the number of breaths was decreased) and the erythrocyte sedimentation rate (in the intervention group the erythrocyte sedimentation rate was increased);however, it had no significant effect on other indicators. Conclusion(s): The present study showed that ozone therapy in hospitalized patients with severe COVID-19 could help improve some primary and secondary outcomes of the disease. Governments and health policymakers should make ozone therapy an available care service so that the need for advanced treatment facilities decreases;consequently, this measure may improve patient safety, prevent lung tissue destruction, and control cytokine storms in patients. Additionally, health decision-makers need to aim for the effective clinical improvement of patients, especially severe ones, and the reduction of their mortality. However, further large-scale multicenter studies with larger sample sizes considering drug side effects and other variables influencing the clinical course of COVID-19 can provide more information on the effectiveness and importance of ozone therapy.Copyright © 2023 The Author(s);Published by Kerman University of Medical Sciences.
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COVID-19 pandemic is an important public health concern in dengue endemic areas due to overlapping of clinical and laboratory features, representing a significant challenge for health care providers that often hampers a correct diagnosis and management of both diseases. Therefore, during the COVID-19 pandemic, healthcare providers in areas where dengue is endemic or who treat patients with recent travel history to these areas, need to consider dengue and COVID-19 in the differential diagnosis of acute febrile illnesses. Global Implications and Opportunities and COVID-19 have mild illness and do not require hospitalization, both diseases can cause severe illness that may result in death. Indeed, clinical management for people with severe illness due to either of these two diseases is quite different, often requiring hospital-based care. High index of suspicion is necessary in handling COVID-19 cases in tropical setting where dengue is endemic. Acute febrile cases with leucopenia and thrombocytopenia should be screened for dengue. Since false positive dengue serology or cross-reactivity with SARS-Cov-2 infections are known to occur, and have a potential impact on clinical outcome, or else, result in delay in COVID-19 or dengue appropriate treatment, the risk of occurrence of complications and death is increased.Copyright © 2023
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Objective. We analyzed clinical features and laboratory markers of COVID-19 patients according to favorable outcomes versus fatal outcomes. Material and methods. The medical history of 80 patients was analyzed: 51 patients with favorable outcomes were included in group 1, 29 patients with a fatal outcome were included in group 2. Demographic data, duration of the disease, comorbid-ities, laboratory markers, and results of the instrumental studies were included. The ammonia level in the peripheral blood was de-termined by the express method using a PocketChem BA 4140 photometric portable analyzer. Results. Patients in group 2 were older (68+/-11 years) had hypertension stage 3 with high cardiovascular risk;every third had a history of myocardial infarction. At admission, patients from group 2 were most likely with febrile fever and high levels of inflammatory markers - predictors of a cytokine release syndrome. In addition, 71% of patients at admission had elevated ammonia levels. Hyperammonemia correlated with high ferritin levels, leukopenia, non-alcoholic fatty liver disease in patients, and lethal outcomes. Conclusions. The risks of poor COVID-19 outcomes are higher in comorbid patients of the older age group. Hyperammonemia may be one of the predictors of poor COVID-19 outcomes.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.
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While copper deficiency is rare, it can have serious consequences, including pancytopenia and neuropathy. This treatable micronutrient deficiency can present very similarly to myelodysplastic syndrome (MDS), a group of myeloid neoplasms which can carry devastating prognoses. Copper deficiency is an essential differential diagnosis in suspected MDS, as it can present with similar laboratory findings, bone marrow biopsy, and clinical picture. While copper deficiency has multiple potential causes, it typically occurs in patients with a predisposing gastrointestinal pathology. One possible cause of copper deficiency is zinc overload. Interestingly, zinc over-supplementation has been prevalent during the COVID-19 pandemic, as some believe that zinc can help prevent COVID-19 infection. Multiple case reports have illustrated the similarities between copper deficiency and MDS. They have also highlighted zinc over-supplementation as a potential cause. The following case report is unique in that our patient lacked gastrointestinal pathology. He still presented with the clinical and laboratory findings of MDS in the setting of copper deficiency. These include anemia, leukopenia, fatigue, and neuropathy. Further, this deficiency was caused by zinc over-supplementation in efforts to prevent COVID-19. The deficiency and the accompanying symptoms were treated with copper supplementation and cessation of zinc intake.
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Purpose - to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease's manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4-6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7-12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child's age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.Copyright © 2022 Modern Pediatrics. Ukraine. All rights reserved.
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Aim: This study was aimed at examining the role of hematological parameters among COVID-19 patients in Bihar. Method(s): The study was conducted at Bhagwan Mahavir Institute of medical science, pawapuri, Bihar, India for 7 months to compare hematological parameters of red blood cells (RBCs), platelets, and white blood cells (WBCs) among patients with and without COVID-19 diagnosis. In this study, 500 patients were recruited, a study group of 250 patients testing positive and a control group of 250 testing negative. Result(s): The result showed that 160 (64%) of COVID-19 patients were male and 90 (36%) were female, while 150 (60%) of non-COVID-19 patients were male and 100 (40%) were female. The age range of COVID-19 patients was 20-90 years old;150 of these (60%) between 30 and 60 years old, 75 (30%) over 60, and the remaining 25 (10%) below 30. The non-COVID-19 patients' age range was 20-88;150 of these (60%) between 30 and 60, 55 (22%) over 60, and the remaining 45 (18%) below 30. Regarding the clinical information of COVID-19 patients, 79 of them (31.6%) were attending the hospital in critical status, 54 (21.6%) with mild symptoms, 50 (20%) asymptomatic, 52 (20.8%) with moderate symptoms, and 25 (10%) with severe symptoms. Regarding the COVID-19 patients' situation during the study period, 175 (70%) recovered and were discharged from the hospital, 25 (10%) were still ICU patients at the end of the study period, 15 (6%) were isolated in hospital wards, and 35 (14%) unfortunately passed away. Conclusion(s): Our study results indicate that mild anemia associated with leukopenia may have diagnostic value for COVID-19. Careful assessment of hematological parameters, at baseline and throughout the disease path, will assist physicians in formulating personalized approaches to treatment and promptly offer intensive care to those in greater need.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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X-linked inhibitor of apoptosis (XIAP) deficiency is a primary immunodeficiency associated with recurrent hemophagocytic lymphohistiocytosis (HLH) episodes. The clinical phenotypes of XIAP deficiency vary, ranging from splenomegaly to life-threatening inflammation. We report a case of XIAP deficiency with unusual late-onset HLH presentation likely triggered by a drug allergy. A previously healthy adolescent boy presented to the hospital with fever and rash seven days after starting antibiotics for a neck abscess. Laboratory evaluation demonstrated cytopenias, elevated liver enzymes, and increased inflammatory markers. Initially, antibiotics were discontinued due to concern for drug rash. He continued to deteriorate clinically and became hypotensive. Additional testing revealed decreased NK cell function, as well as elevated ferritin, triglycerides, and soluble IL-2 receptor. SLAM-Associated Protein (SAP) and XIAP evaluation by flow cytometry demonstrated decreased XIAP expression. Subsequently, genetic testing revealed a known pathogenic mutation in BIRC4 (c.421_422del), confirming the diagnosis of XIAP deficiency.Copyright © 2023
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Background: Currently, the present world is facing a new deadly challenge from a pandemic disease called COVID-19, which is caused by a coronavirus named SARS-CoV-2. To date, no drug or vaccine can treat COVID-19 completely, but some drugs have been used primarily, and they are in different stages of clinical trials. This review article discussed and compared those drugs which are running ahead in COVID-19 treatments. Method(s): We have explored PUBMED, SCOPUS, WEB OF SCIENCE, as well as press releases of WHO, NIH and FDA for articles related to COVID-19 and reviewed them. Result(s): Drugs like favipiravir, remdesivir, lopinavir/ritonavir, hydroxychloroquine, azithromycin, ivermectin, corticosteroids and interferons have been found effective to some extent, and partially approved by FDA and WHO to treat COVID-19 at different levels. However, some of these drugs have been disapproved later, although clinical trials are going on. In parallel, plasma therapy has been found fruitful to some extent too, and a number of vaccine trials are going on. Conclusion(s): This review article discussed the epidemiologic and mechanistic characteristics of SARS-CoV-2, and how drugs could act on this virus with the comparative discussion on progress and drawbacks of major drugs used till date, which might be beneficial for choosing therapies against COVID-19 in different countries.Copyright © 2022 Bentham Science Publishers.
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Livestock products supply about 13 percent of energy and 28 percent of protein in diets consumed worldwide. Diarrhea is a leading cause of sickness and death of beef and dairy calves in their first month of life and also affecting adult cattle, resulting in large economic losses and a negative impact on animal welfare. Despite the usual multifactorial origin, viruses are generally involved, being among the most important causes of diarrhea. There are several viruses that have been confirmed as etiological agents (i.e., rotavirus and coronavirus), and some viruses that are not yet confirmed as etiological agents. This review summarizes the viruses that have been detected in the enteric tract of cattle and tries to deepen and gather knowledge about them.Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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Coronavirus disease 2019 (COVID-19) emerged in China and then has spread worldwide. It has been seen in Turkey since March. Brucellosis is a zoonotic disease which is observed in Turkey endemically. Here, we report the firstcase of Brucellosis relapse in a COVID-19 patient. A 39-year-old female had cough, dispnea, fatigue and backpain and miyalgia for one week was admitted. She had leucopenia and lymphopenia in whole blood count. She had a contact history with her COVID-19 positive sister. COVID-19 polymerase chain reaction (PCR) test resulted positive. She received hydroxychloroquine treatment for five days. Her COVID-19 PCR became negative and laboratory improved. Her miyalgia, back pain and fatigue got worse. When her medical history was elaborated, she had a brucellosis history seven years ago. She was completely treated and her Brucella serology tests were negative in 2015. She stated that she didn't consume any unpasteurized milk product recently. Rose-Bengal and Coombs agglutination tests were positive (1:320 titers). She was initialized on treatment and symptoms started to resolve after 15 days of treatment. Severe COVID-19 patients show lymphopenia, particularly reduction of T-cells. Cell mediated immunity is crucial against brucellosis. During pandemic, endemic infections like brucellosis can be observed in patients due to lymphopenia. Further immunological studies are needed.Copyright © 2022, Kuwait Medical Association. All rights reserved.
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Background: Rhino-orbito-cerebral mucormycosis was seen in increasing severity in the recent second wave of COVID-19 in India. The incidence of mucormycosis is increased significantly in patients with diabetes. The most common cause attributed to the rise of mucormycosis in COVID-19 patients are uncontrolled diabetes. Lymphopenia and increased levels of certain cytokines, such as IL-6, have been closely associated with the disease severity. Aims and Objectives: The aims of this study were to analyze risk factors involved in Mucormycosis in 2nd wave of COVID-19. Materials and Methods: The study was done in the Mucormycosis ward, Department of ENT, Patna Medical College and Hospital, Patna, between May 2021 and July 2021. A total of 100 patients of both gender and all age groups were taken into the study. Results: Out of 100 patients included in the study, 57% (n=57) of patients had history of steroid intake, while 43% (n=43) had no history. About 41% (n=41) of patients needed oxygen support during treatment, while 59% (n=59) had no history of oxygen inhalation. About 88% (n=88) of patients had prior history of diabetes or detected during treatment, while 12% (n=12) had no prior history of diabetes or detected during treatment. About 91% (n=91)of patients had uncontrolled hyperglycemia, while 9% (n=9) had controlled blood sugar level. Conclusion: Uncontrolled hyperglycemia and delta strain are mainly associated major risk factors that lead to such high number of mucormycosis cases in India (post 2nd wave of COVID-19). Steroid role is not that much significant in our study and oxygen inhalation is not associated with mucormycosis.
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Objective. An outbreak of pneumonia named COVID-19 caused by a novel coronavirus in Wuhan is rapidly spreading worldwide. The objective of the present study was to clarify further the clinical characteristics and blood parameters in COVID-19 patients. Materials and Methods. Twenty-three suspected patients and 64 patients with laboratory-confirmed SARS-Cov-2 infection were admitted to a designated hospital. Epidemiological, clinical, laboratory, and treatment data were collected and analyzed. Results. Of the 64 patients studied, 47 (73.4%) had been exposed to a confirmed source of COVID-19 transmission. On admission, the most common symptoms were fever (75%) and cough (76.6%). Twenty-eight (43.8%) COVID-19 patients showed leukopenia, 10 (15.6%) showed lymphopenia, 47 (73.4%) and 41 (64.1%) had elevated high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), respectively, and 30 (46.9%) had increased fibrinogen concentration. After the treatment, the counts of white blood cells and platelets, and the level of prealbumin increased significantly, while aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and hsCRP decreased. COVID-19 patients with the hospital stay longer than 12 days had higher body mass index (BMI) and increased levels of AST, LDH, fibrinogen, hsCRP, and ESR. Conclusions. Results of blood tests have potential clinical value in COVID-19 patients.Copyright © 2020 by the Association of Clinical Scientists, Inc.
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Guidelines on the use of PCR for fungal (ringworm), Parvovirus, Panleukopenia, and Covid-19 detection are discussed. Advantages of using PCR was also presented and emphasized its significance in assessing the context, history, clinical presentation and consequences of action (or inaction), as well as the laboratory result from tested animal patients.