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Aim: Although most patients with COVID-19 experience respiratory tract infections, severe reactions to the virus may cause coagulation abnormalities that mimic other systemic coagulopathies associated with severe infections, such as disseminated intravascular coagulation and thrombotic microangiopathy. Fluctuations in platelet markers, which are an indicator of the acute phase response for COVID-19, are of clinical importance. The aim of this study is to evaluate the relationship between disease severity and Platelet Mass Index (MPI) parameters in COVID-19 patients. Material(s) and Method(s): This retrospective observational study was conducted with patients who were diagnosed with COVID-19 in a tertiary hospital. The study was continued with the remaining 280 patients. All laboratory data were scanned retrospectively from patient files and hospital information system. Result(s): A very high positive correlation was found between PMI and PLT. The PMI value in women was significantly higher than in men. It was observed that PMI did not differ significantly in terms of mortality, intubation, CPAP and comorbidity. PMI vs. Pneumonia Ct Severity Score, biochemistry parameters (AST, CRP), hemogram parameters (WBC, HGB, HCT, MCV, LYM, MPV EO) and coagulation factors (aPTT and FIB) at various levels of positive/negative, weak and strong, and significant relationship was found. There was no significant relationship between hormone and D-dimer when compared with PMI. Discussion(s): Although platelet count alone does not provide information about the prognosis of the disease, PMI may guide the clinician as an indicator of lung damage in seriously ill patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Aim: The gold standard diagnostic method for the diagnosis of COVID-19 is based on the demonstration of viral RNA in samples taken from the upper respiratory tract in reverse transcriptase-polymerase chain reaction (RT-PCR). However, in emergencies, the World Health Organization (WHO) also recommends to use computed tomography (CT) in order to reduce the loss of time and to provide rapid diagnosis, treatment and isolation of suspicious cases. In our study, we aimed to compare the laboratory values of patients with PCR negative CT findings and PCR positive patients. Material(s) and Method(s): The medical records of 1280 COVID-19 patients registered at our Family Medicine Center were reviewed retrospectively. Result(s): In our study, it was found that 66,70 % of PCR-negative patients with CT findings were aged 60 years and older, and 50.70% of PCR-positive COVID-19 patients were between the ages of 40-59 years;61.30% of the patients with CT findings and 48% of the PCR-positive patients were male;73% of PCR-positive patients had lung involvement. When CRP, fibrinogen and D-dimer values were examined, it was found that in PCR-negative COVID-19 patients with CT findings these values were statistically significantly higher. Discussion(s): Although the definitive diagnosis of the disease is made using a PCR test, it should not be overlooked that the patients may remain PCR negative, and it should not be forgotten that thoracic tomography findings are a good diagnostic method for this group.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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The new coronavirus was first reported in China and caused a widespread global outbreak of pneumonia that spread rapidly across this country and many other countries. Acute kidney injury is one of the important complications of COVID-19, which has been shown in some cases. Exploring the diagnostic features of biomarkers of kidney function in COVID-19 patients may lead to better patient management. We collected laboratory data from 206 people with confirmed COVID-19 disease and evaluated their renal biomarkers, Blood Urea Nitrogen (BUN), and creatinine. The age range of the patients was almost 62 years old. The mean age in the dead patients and recovered patients was 71 and 54 years old, respectively. The average LDH value was 755 U/L, and creatine phosphokinase (CPK) was 267 U/L in the patients. The average BUN was 59.1 U/L, and creatinine was 1.5 U/L in COVID-2019 patients. Among all 193 patients, laboratory results revealed that 163 (85.4%) patients had an elevated BUN level. Based on creatinine levels for total patients, laboratory results revealed that 49 (25.4%) patients had an elevated value. The average BUN value in dead patients was 85 mg/dL, while in recovered patients was 40.5 mg/dL (P<0.0001). Also, the average creatinine level in dead patients was 1.86 mg/dL, while in recovered patients was 1.24 mg/dL (P=0.0004). Inflammation following COVID-19 disease causes kidney damage and elevated urea and creatinine levels, which may increase the risk of death in these patients.Copyright © 2023 Tehran University of Medical Sciences.
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Objectives: We aimed to compare biomarkers of COVID-19 patients with the Alpha variant (B.1.1.7), the Delta variant (B.1.617), and no mutation detected in our study. Method(s): A total of 600 patients with positive COVID PCR test and Alpha, Delta variant and no mutation detected with Covid PCR mutation test were included in the study. Troponin I, creatinine, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Lactate Dehydrogenase (LDH), fibrinogen, D-dimer, ferritin, number of lymphocytes, lymphocytes (%), platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), trombosite ratio in the blood (PCT), C-reactive protein (CRP) values were analyzed retrospectively. The age, gender, and hospitalization of the patients were evaluated concurrently. Result(s): Age, troponin, creatinine, LDH, PLT, MPV, and D-dimer were laboratory parameters that vary significantly with COVID-19 virus mutation. Age, troponin, LDH, and MPV values were lower in patients with Delta variant according to patients with the Alpha variant. Lymphocytes (N) and lymphocytes (%) values were lower in hospitalized patients relative to outpatients while age, troponin, LDH, CRP, and D-dimer values were higher in hospitalized patients than outpatients irrespective of mutation. Creatinine values were higher only in hospitalized patients with no mutation detected while ferritin and fibrinogen values were higher in hospitalized patients with Delta variant and no mutation detected. Conclusion(s): Age, troponin, creatinine, LDH, PLT, MPV, D-dimer, fibrinogen, ferritin, CRP, lymphocytes (N), and lymphocytes (%) values can guide to evaluate the diagnosis and hospitalization of patients with future different mutations.Copyright © 2023 by Prusa Medical Publishing.
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BACKGROUND: While the type and the number of treatments for Coronavirus Disease 2019 (COVID-19) have substantially evolved since the start of the pandemic a significant number of hospitalized patients continue to succumb. This requires ongoing research in the development and improvement of early risk stratification tools. METHOD(S): We developed a prognostic score using epidemiological, clinical, laboratory, and treatment variables collected on admission in 130 adult COVID-19 patients followed until in-hospital death (N.=38) or discharge (N.=92). Potential variables were selected via multivariable logistic regression modelling conducted using a logistic regression univariate analysis to create a combined index. RESULT(S): Age, Charlson Comorbidity Index, P/F ratio, prothrombin time, C-reactive protein and troponin were the selected variables. AUROC indicated that the model had an excellent AUC value (0.971, 95% CI 0.926 to 0.993) with 100% sensitivity and 83% specificity for in-hospital mortality. The Hosmer-Lemeshow calibration test yielded non-significant P values (chi2=1.79, P=0.99) indicates good calibration. CONCLUSION(S): This newly developed combined index could be useful to predict mortality of hospitalized COVID-19 patients on admission.Copyright © 2022 EDIZIONI MINERVA MEDICA.
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Objectives: In this study, we aimed to investigate the prognostic value of the neutrophile-lymphocyte ratio and the effects of age, gender, and comorbidities on mortality. Method(s): In our study, 100 patients who had a ground-glass opacification on computed thorax tomography and who had a positive polymerase chain reaction test were included in our study. Demographic data, laboratory data and comorbidities of the patients were recorded. Result(s): Sixty-five (65%) of the patients participating in the study were male. The mean age of the patients was 66 (21.5). The mortality rate was found to be 27% (n=27) High neutrophile-lymphocyte ratio, low lymphocyte count, high urea, and creatin levels were significant in terms of mortality. In addition, advanced age, diabetes mellitus, and hypertension are other factors that have an impact on mortality. Conclusion(s): The neutrophile-lymphocyte ratio can solely be used as a prognostic marker because it is simple and economical.©Copyright 2022 by The Cardiovascular Thoracic Anaesthesia and Intensive Care.
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Aim: The aim of this study is to analyze the effectiveness of the leukocyte albumin ratio (LAR) in predicting mortality in critical COVID-19 patients. Material(s) and Method(s): In this retrospectively-designed study, we evaluated a total of 98 critical patients who were hospitalized in the intensive care unit. Patients were divided into two groups according to hospital mortality as survivors (n=43) and non-survivors (n=55). Result(s): The non-survivors group was statistically significantly older (67.3+/-9.7 versus 62.5+/-10.9;p=0.023). HT and DM were detected more in the non-survivors group than in the survivors group (p=0.031, p=0.018, respectively). Mean LAR values were significantly higher in non-survivors than in survivors (5.9+/-3.5 versus 3.3+/-1.4;p<0.001). LAR values was positively correlated with urea (r=0.43, p<0.001), LDH (r=0.35, p<0.001), ferritin (r=0.25, p=0.015), procalcitonin (r=0.34, p<0.001), and pro-BNP (r=0.24, p=0.015) levels. A cut-off value of 3.71 ng/mL for LAR predicted mortality with a sensitivity of 76% and a specificity of 70% (AUC:0.779 95% Cl:0.689-0.870;p<0.001). Multivariable logistic regression analysis revealed that older age (OR:1.114, 95% CI:1.020-1.218;p=0.017) and increased ferritin (OR:1.003, 95% CI:1.001-1.004;p=0.002) and LAR (OR:1.583, 95% CI:1.073-2.337;p=0.021) values were independent predictors of mortality in patients with critical COVID-19. Discussion(s): LAR can be a useful and prognostic marker that can be used to predict mortality in COVID-19 patients admitted to the intensive care unit.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Aim: Recent research have shown that immature granulocytes (IG) can be utilized to predict severe infection, inflammation, and sepsis. As a result, the ability of IG levels to predict the severity of severe COVID-19 and its association with prognosis were studied in our study. Material and Mthods: A total of 317 patients diagnosed with severe COVID-19 in the emergency department were analyzed retrospectively. IGC and IG% levels were compared statistically between patient groups (survivors and non-survivors, those who received and did not get mechanical ventilation (MV) assistance, patients who required and did not require vasopressors, and hospital stays >=10 and <10 days). Result(s): When compared to patients who survived but did not get treatment, non-survivors who got MV and vasopressor support had substantially higher IGC and IG% values (for all p<0.001). Additionally, it was shown that the IG% of patients with hospital stays of >=10 days was substantially greater than that of patients with hospital stays of <10 days (p<0.001). While the IG% cut-off value was >0.45, it reached 75.5% sensitivity, 81.9% specificity, 87.6% NPV and 66.4% PPV for predicting mortality (AUC:0.86, p<0.001). Discussion(s): IG levels are a low-cost, easily accessible, and strong marker that may be used to predict mortality and prognosis in COVID-19 patients.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Aim: We use computed tomography, which is one of the frequently used imaging tests, both as a disease diagnosis method and to follow the clinical course in COVID-19 patients. This also means radiation exposure. Radiation exposure, especially in pediatric patients, can cause life-threatening diseases. Is there a blood parameter that will reduce this undesirable event and allow estimation of computed tomography findings? Are hemogram analysis, one of the most commonly used blood tests, and tomography findings of the disease related? We designed this study based on the questions. Material(s) and Method(s): Among the patients under the age of 18 who applied to the emergency department, those with a positive reverse transcription-polymerase chain reaction (RT-PCR) and chest CT and hemogram were included in the study. Chest CT findings were classified according to the CO-RADS classification. We compared the CO-RADS classification with hemogram parameters and the ratios of these parameters. Result(s): Platelet-to-lymphocyte ratio (PLR) rates were found to be significantly lower as imaging findings became more severe (<0.05). The ratio of MedianPlatelet Volume and Platelet (MPV/Plt) was found to be significantly higher as the imaging findings worsened (p<0.05). When the relationship between laboratory parameters according to imaging groups in our study was evaluated, there was a moderate negative correlation between lymphocyte and platelet levels and imaging findings (p<0.05). A moderate positive correlation with the monocyte level was found (p<0.05). Discussion(s): For the CO-RADS classification, it can be said that the patient was established to classify possible COVID-19 patients only according to chest CT. There is no study in the literature on the classification of pediatric patients with RT-PCR positive definite COVID-19 according to chest CT scans and the comparison of laboratory findings of patients with this classification. The combination of laboratory parameters and CO-RADS classification will guide clinicians in pediatric COVID-19 patient management.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Background: The incidence of thrombotic complications is high in COVID-19 patients with severe disease. As key regulators of thrombus formation, platelets likely play a crucial role as mediators of severe acute respiratory syndrome coronavirus 2 associated pathogenesis. Studies have reported that parameters reflecting platelet size, known as platelet volume indices (PVI), are raised in patients with thrombosis and can predict poor outcomes. This systematic review evaluates the potential for PVI to be used as a predictor of COVID-19 morbidity and mortality. Methods: English and Chinese databases were searched electronically to identify studies reporting data on mean platelet volume, platelet distribution width or platelet-large cell ratio in COVID-19 patients. Included articles underwent a quality rating and descriptive narrative analysis. Results: Thirty-two studies were included in the systematic review. The results show a general trend for PVI to be raised in severe COVID-19 patients and non-survivors, with 14 studies reporting significant differences of baseline PVI between severe and mild disease. Nonetheless, longitudinal studies showed varying PVI trends over the course of the disease and evidence for PVI to be associated with disease progression was limited. The quality rating of 12 studies was poor, 16 were rated fair and four were good. Most studies were retrospective in design, used small study populations and did not consider confounding factors that influence platelet volume. Studies also contained technical flaws in PVI measurement, limiting the reliability of the results. Conclusion: The evidence on the clinical usefulness of PVI is greatly limited by the lack of prospective evaluation, together with technical problems in measuring PVI. Carefully designed prospective studies are warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=304305, identifier CRD42022304305.
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BACKGROUND: The long coronavirus disease 2019 (COVID-19) syndrome is defined as persistent physical, cognitive and/or psychological symptoms that continue for more than 12 weeks following the acute illness. METHODS: In all, 2,646 patients were randomly selected from all individuals who were diagnosed with COVID-19. They were interviewed so as to assess the persistence of symptoms and health-related quality of life. Blood investigations were also taken. RESULTS: The median (interquartile range (IQR)) age was 44 (31-55) years and 48.6% were males. Five per cent had been hospitalised. Follow-up was for a median of 142 days (IQR: 128-161). Twenty-two per cent of the participants claimed that they were feeling worse than they felt before COVID-19. The most common symptoms were anosmia, ageusia, fatigue, shortness of breath, headaches and myalgia. The Short Form-36 questionnaire revealed that 16.4% felt that they were somewhat worse than in the previous year and that hospitalised patients fared worse in all domains except for role-emotional. New-onset diabetes was similar to the rate of undiagnosed diabetes in the background population. Hospitalised patients had significantly higher liver transaminases, fasting plasma glucose, glycated haemoglobin, uric acid, red cell distribution width, mean platelet volume, triglyceride levels and troponin levels but lower estimated glomerular filtration rate and high-density lipoprotein-cholesterol at follow-up. DISCUSSION: A significant proportion of patients were symptomatic at a median follow-up of 142 days and felt worse than 1 year previously. Hospitalised patients had more biochemical and haematological abnormalities compared to non-hospitalised ones, suggesting ongoing inflammation in subjects who were more severely affected by the disease.
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COVID-19 , Male , Humans , Adult , Middle Aged , Female , COVID-19/epidemiology , Quality of Life , Follow-Up StudiesABSTRACT
Background: Nuclei acid-based COVID-19 vaccines have proved highly effective in reducing the risk of hospitalisation and death. As they were distributed for the first time on a large-scale population, the adenovirus-based vaccines were linked to a very rare thrombosis with thrombocytopenia syndrome and the interplay between vaccination and platelet activation gained increasing attention. Aim(s): To compare the effect of mRNA-based and adenovirus-based vaccines on platelets of young healthy adults. Method(s): We prospectively enrolled 15 healthy volunteers (53% females) who received two doses of the mRNA-based vaccine BNT162b2, 21 days apart, and 25 healthy volunteers (64% females) that received one dose of the adenovirus-based vaccine, AZD1222, followed by one dose of BNT162b2 and we studied their platelet response before and after each dose of the vaccine (3 and 10 days post-injection). Result(s): Subjects receiving the AZD1222 vaccine experienced a transient but significant 20% decrease of the platelet count 3 days after the first injection, which was not detected after the first dose of BNT162b2. The BNT162b2, but not the AZD1222, vaccine was followed by increased plasmatic thrombopoietin concentration and mean platelet volume, indicative of higher platelet turnover. Three days after the AZD1222 injection, basal platelet integrin activation was elevated, but P-selectin exposure was unchanged. Conversely, the BNT162b2 vaccine induced a gradual increase in platelet P-selectin exposure and platelet-leukocyte aggregate formation, which correlated with the ability of the vaccines to evoke neutralizing antibodies against the Sars-COV- 2 spike protein. Moreover, three days after the AZD1222 injection we detected a transient 10-fold increase of the plasmatic concentration of IFN-gamma, while BNT vaccination induced a progressive increase of IL-1beta. Conclusion(s): Based on these observations we propose that the adenovirus-based vaccines, not the mRNA-based vaccines, transiently impair platelet count homeostasis. Future studies will investigate how these distinct vaccine vectors and inflammatory profiles affect platelet consumption and platelet production.
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INTRODUCTION: Patients Infected with CORONA VIRUS- 2019 (COVID-19) showed changes in their platelet counts and Mean platelet volume (MPV). The present study was aimed to observe any association between lowered platelet counts with mean platelet volume (MPV) from the corana positive individuals. METHOD(S): It is a prospective study from 1-8-2020 to 30-9-2020 .Patients who presented with complaints of Fever, sore throat, body pains, cough, breathlessness, diarrhoea were evaluated at the triage area of the Hospital. Throat swab was taken and RT-PCR was done and only 200 confirmed cases were included in the study. Patient blood samples were collected and processed in SYSMAX 5 -part Haematology analyser in the Hospital Central Laboratory. The patients CBP, Platelet count and MPV were tabulated. RESULT(S): Out of 200 COVID-19 confirmed cases, the numbers of males were 145 (72.5%) and females 55 (27.5%). Most of the patients belonged to age group 50 years (25.5%), 60yrs age group (21%). The Maximum age in our study group was 80 years, minimum age was 19 years and mean age was 50 years. In our study it was noticed that Severe thrombocytopenia was seen in one patient with platelet count 38,000/muL,(0.5%), Moderate thrombocytopenia was seen in two patients(1%) and mild thrombocytopenia was seen in 12 (6%) cases. In our study only fifteen cases (7.5%) showed thrombocytopenia. The MPV for all fifteen cases were studied and MPV was in Range of 9.6- 11.8 fl. CONCLUSION(S): Low platelet count and high MPV are associated with disease severity. Platelet count is one of easy cheap method for the assessing the disease severity along with other parameters Copyright © 2022 Ubiquity Press. All rights reserved.
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Stratifying patients according to disease severity has been a major hurdle during the COVID-19 pandemic. This usually requires evaluating the levels of several biomarkers, which may be cumbersome when rapid decisions are required. In this manuscript we show that a single nanoparticle aggregation test can be used to distinguish patients that require intensive care from those that have already been discharged from the intensive care unit (ICU). It consists of diluting a platelet-free plasma sample and then adding gold nanoparticles. The nanoparticles aggregate to a larger extent when the samples are obtained from a patient in the ICU. This changes the color of the colloidal suspension, which can be evaluated by measuring the pixel intensity of a photograph. Although the exact factor or combination of factors behind the different aggregation behavior is unknown, control experiments demonstrate that the presence of proteins in the samples is crucial for the test to work. Principal component analysis demonstrates that the test result is highly correlated to biomarkers of prognosis and inflammation that are commonly used to evaluate the severity of COVID-19 patients. The results shown here pave the way to develop nanoparticle aggregation assays that classify COVID-19 patients according to disease severity, which could be useful to de-escalate care safely and make a better use of hospital resources.
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Objective: It is thought that hyperinflammation has an important role in the pathogenesis of severe COVID-19 and tests that determine the de-gree of inflammation can be used to predict the severity of the disease. From this point of view, we aimed to determine the hematological parameters that can predict the severity of COVID-19 in pediatric patients. Material and Methods: Symptomatic and SARS-CoV-2-PCR test positive 105 children were included to study. Seventy-nine patients had mild, 26 had moderate to severe COVID-19 at admission. Data about their demo-graphic characteristics, clinical and laboratory findings were collected from their medical records. Correlations between the hematological parameters and disease severity of patients were investigated by using uni-variate and multivariate regression analyses. Predictive value of different diagnostic markers was studied. Results: Mean age was older (177 months vs. 70 months) and mean body mass index (BMI) was higher (18.8 kg/m2 vs. 25.0 kg/m2) in patients with severe COVID-19 than those with mild. Univariate analysis showed that mean leucocyte (WBC), lymphocyte, eosinophiles, and platelet counts were lower;mean platelet volume (MPV), neutrophil to lympho-cyte ratio (NLR), and derived neutrophil to lymphocyte ratio (dNLR) were higher in severe COVID-19 group (p< 0.05). Multivariant analysis showed low lymphocyte (OR 0.072) and WBC count (OR 0.085), high dNLR (OR 2.14) and MPV (OR 2.35) indexes were the most valuable parameters to predict disease severity, ROC curve analysis revealed lymphocyte count has superior predictive value (<1.55 /mm3 has 84.6% sensitivity, 70.9% specificity) than other CBC parameters have. Conclusion: Low lymphocyte and leukocyte count, high MPV and dNLR values have significant predictive value in predicting COVID-19 severity. In particular, lymphopenia appears to be a valuable parameter to identify patients at high risk for severe disease and initiate accurate treatment to prevent disease deterioration.
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Objective: In this study, we aimed to evaluate the importance of predicting the severity of the disease by measuring the hematological parameters such as the neutrophil-lymphocyte ratio and mean platelet volume, are positively correlated or not. We used COVID-19 PCR positive children who applied to the pediatrics outpatient clinic of our hospital for measurement. Material and Methods: Our study was designed retrospectively and included 136 children aged 6-18 years who applied to the pediatrics outpatient clinic of our hospital between 29 March 2020 and 31 November 2020. Sixty-eight of these children were found to be healthy and COVID-19 negative, while the other 68 were positive. COVID-19 PCR-positive patients were divided into four groups, each consisting of 17 patients, as asymptomatic infection, acute upper respiratory tract infection, mild pneumonia and severe pneumonia. Results: The three most common clinical findings in COVID-19 PCR positive patients are;cough was present in 44 (64.7%), fever in 37 (54.4%), and tachypnea in 17 (25%). Neutrophil count, neutrophil-lymphocyte ratio and mean platelet volume were found to be statistically significantly higher in COVID-19 PCR positive children compared to negative ones (p< 0.05). The lymphocyte count was found to be significantly lower in COVID-19 PCR positive children (p< 0.05). When the subgroups of COVID-19 PCR positive patients are evaluated;as the clinical severity increased between the groups, a significant increase was found in neutrophil count and neutrophil-lymphocyte ratio (p< 0.05). A significant decrease was observed in the lymphocyte count with the increase in clinical severity (p< 0.05). There was no significant difference between subgroups in the mean platelet volume of COVID-19 patients, consistent with clinical severity (p> 0.05). Conclusion: In our study, increased neutrophil count and neutrophil-lymphocyte ratio and decreased lymphocyte count were found to be associated with the clinical severity of COVID-19 disease. It is thought that these parameters can be used as good markers to predict the severity of COVID-19 disease. Although mean platelet volume was found to be significantly higher in COVID-19 PCR positive cases, it was not significantly associated with the clinical severity of the disease. Therefore, it was concluded that mean platelet volume is not a good prognostic predictor of the clinical course of the disease.
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Introduction: This study aims to assess the association between mean platelet volume (MPV) and poor outcome in patients with COVID-19. Methods: We performed a comprehensive literature search using the PubMed, Embase and Scopus databases with keywords “2019-nCoV” OR “SARS-CoV-2” OR “COVID-19” AND “mean platelet volume” OR “MPV” on 8 July 2021. The primary outcome was composite poor outcome, defined as severe COVID-19 or mortality. The pooled effect estimate was reported as mean differences in terms of MPV between the group with and without outcome. Results: There were 17 studies which consist of 4549 patients with COVID-19 were included in this study. The incidence of poor outcome was 25% (20%–30%). Mean MPV was found to be higher in the poor outcome group in compare to no poor outcome group (10.3 ± 1.9 fL vs 9.9 ± 1.7 fL). The mean MPV difference between both group was 0.47 fL [95% CI 0.27, 0.67], p < 0.001;I2: 62.91%, p < 0.001). In the sub-group analysis, patients with severe COVID-19 had higher MPV (mean difference 0.54 fL [95% CI 0.28, 0.80], p < 0.001;I2: 54.84%, p = 0.014). Furthermore, MPV was also higher in the mortality group (mean difference 0.54 fL [95% CI 0.29, 0.80], p = 0.020;I2: 71.11%, p = 0.004). Meta-regression analysis showed that the association between MPV and poor outcome was not affected by age (p = 0.789), gender (p = 0.167), platelets (p = 0.056), white blood cells (p = 0.639), and lymphocytes (p = 0.733). Conclusion: This meta-analysis indicated that increased MPV was associated with severity and mortality in patients with COVID-19. Further research is needed to determine the optimum cut-off point.
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In this study, our aim was to examine the diagnostic and prognostic significance of lymphocyte/C-reactive protein ratio (LCR), neutrophil/lymphocyte ratio (NLR) and D-dimer parameters in COVID-19 infection. The LCR, NLR, neutrophil count, mean platelet volume (MPV), C-reactive protein (CRP), and D-dimer parameters were evaluated retrospectively. This was a retrospective cohort study with 1000 COVID-19 positive and 1000 healthy control groups, all over the age of 18 years. Odds ratio (OR) and 95% confidence interval (CI) values were calculated for each parameter found to be statistically significant in the univariate and multivariate logistic regression models. Herein, 127 (12.7%) of the COVID-19+ patients, whose data was included in this study, died. The neutrophil, MPV, CRP, D-dimer, and NLR values were higher in the COVID-19+/deceased group than in the COVID-19+/alive and control groups (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001). The lymphocyte and LCR values were lower in the COVID-19+/deceased group than in the COVID-19+/alive and control groups (p < 0.001, p < 0.001). Variables with statistically significance in predicting COVID-19 infection were lymphocyte, LCR, D-dimer, NLR, CRP, MPV, PLT, and neutrophil values. Statistically significant variables in predicting mortality due to COVID-19 were LCR, CRP, NLR, lymphocyte, D-dimer, neutrophil, and MPV values. A low LCR and high NLR are associated with the presence, prognosis, and mortality due to COVID-19. LCR and NLR parameters can thus be used in clinical monitoring to reduce morbidity and mortality rates. [ FROM AUTHOR] Copyright of Biocell is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: Frailty is associated with increased risk of hospitalization in diabetic patients. Both SARS-CoV-2 pandemic and type 2 diabetes mellitus contribute to the frailty. In this study we aimed to observe clinical and laboratory indices of the diabetic subjects during COVID-19 pandemic who were either frail or not according to Edmonton frail score. Material and methods: During the pandemic era, 100 consecutive patients with type 2 diabetes mellitus divided into two groups either as frail or non-frail according to the Edmonton Frail Scale scores. Laboratory and clinical features of the frail and non-frail subjects were compared. Results: Frail patients were older than the non-frail diabetics. Blood urea, serum creatinine, eGFR, plasma albumin, total cholesterol, triglyceride, HbA1c, mean platelet volume (MPV), and monocyte lymphocyte ratio (MLR) levels of the frail and non-frail groups were significantly different. Moreover, Edmonton frail score was significantly and positively correlated with blood urea, serum creatinine, MLR, MPV, HbA1c and inversely correlated with eGFR and plasma albumin levels. Conclusions: We think that HbA1c, MPV and MLR could be surrogate markers of frailty in diabetic elderly during COVID-19 outbreak. Strategies to keep them in normal range do not only improve diabetes control but also reduce the risk of frailty in this population.
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Background: Coronavirus disease 2019 (COVID-19) first appeared in China in December 2019, and has become a global pandemic. Because the clinical progression of the disease is highly variable, better prediction of prognosis and mortality is important. In the present study, we investigated the role of procalcitonin/albumin ratio (PAR) as a new biomarker in predicting mortality in patients with COVID-19 infection. Methods: In this study, patients with COVID-19 diagnosis were enrolled from Sakarya Yenikent State Hospital and Ayancık State Hospital between 09.11.2020 and 04.05.2021. The demographic characteristics, biochemical and hematological parameters such as age, gender, length of hospital stay, and comorbidities of the patients were collected retrospectively from medical records. Results: Of the 105 patients, 51 were mild and 54 were critically ill. Between mild and critical cases, age, lymphocyte count, red cell distribution width, neutrophile count, mean corpuscular volume (MCV), monocyte count, albumin, C-reactive protein, ferritin, procalcitonin, D-dimer, and PAR were statistically different (p<0.001 for all). All patients in the critical group and only 2% of the mild group died. PAR showed the largest area under the curve (0.949) for the prediction of mortality (p<0.001). Conclusion: We report that PAR, a simple, cheap, and easily accessible biomarker, can be used to predict the prognosis in patients with COVID-19 infection.