Idiopathic anomalous congenital band causing small intestinal obstruction in a 5-month-old dog

A 5-month-old, intact male, yellow Labrador retriever was presented with a 24-hour history of anorexia and vomiting. Abdominal imaging revealed the presence of a mechanical obstruction in the jejunum and peritoneal effusion. Cytologic evaluation and culture of the effusion prior to surgery identified a suppurative exudate with bacteria consistent with septic peritonitis and suspected to be related to the intestinal lesion. An exploratory laparotomy was performed, and a segment of jejunum was circumferentially severely constricted by an off-white, fibrous band of tissue. Resection and anastomosis of the strangulated segment of jejunum and excision of the constricting band provided resolution of the clinical signs. The dog made a complete recovery. Histologic evaluation revealed the band to be composed of fibrovascular and smooth muscle tissue, consistent with an idiopathic anomalous congenital band. No other gastrointestinal lesions were observed, either grossly at surgery or histologically in the resected segment of intestine. To our knowledge, a similar structure has not been reported in the veterinary literature.Copyright © 2022 Canadian Veterinary Medical Association. All rights reserved.

Procalcitonin/Albumin Ratio as a Novel Biomarker for Predicting Mortality in COVID-19

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.

Diagnostic value of platelet indices in COVID 19 infection: a case-control study from a single tertiary care center.

Introduction: Platelets are not only involved in hemostasis and coagulation, but play a significant role in innate immunity and inflammatory response. Excess production of cytokines and acute phase reactants affect megakaryopoiesis resulting in the release of immature platelets from the bone marrow altering platelet indices. Aim: To study platelet indices in RT-PCR-proven COVID patients and non-COVID patients. Methods: A case-control study was conducted on 199 COVID-19 patients and 198 normal individuals. Blood samples were analyzed in an automated hematology analyzer. The platelet indices like platelet count, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell count (PLCC), and platelet large cell ratio (P-LCR) were compared among two groups. Results: Platelet count in COVID-19 patients were significantly low (p<0.01) compared to controls, and a significant number of COVID-19 patients had thrombocytopenia. Plateletcrit (PCT) was also significantly decreased in COVID-19 patients compared to non-COVID individuals. MPV, PDW, and PLCR were significantly (p<0.05) high in COVID-19 patients in comparison to controls, but was not significantly raised in a large number of cases. In contrast, there were no significant differences in platelet large cell count (PLCC) values between COVID-19 cases and non-COVID-19 controls. Conclusion: Platelet indices like platelet count, PCT, MPV, PDW, and P-LCR are significantly altered in COVID-19 infection and thereby can be used as biomarkers in COVID-19. Further research is needed to find if these simple, cost-effective parameters can be used to predict the severity and prognosis in COVID-19 infection.

Early changes in laboratory tests predict liver function damage in patients with moderate coronavirus disease 2019: a retrospective multicenter study.

BACKGROUND: Most patients with coronavirus disease 2019 demonstrate liver function damage. In this study, the laboratory test data of patients with moderate coronavirus disease 2019 were used to establish and evaluate an early prediction model to assess the risk of liver function damage. METHODS: Clinical data and the first laboratory examination results of 101 patients with moderate coronavirus disease 2019 were collected from four hospitals' electronic medical record systems in Jilin Province, China. Data were randomly divided into training and validation sets. A logistic regression analysis was used to determine the independent factors related to liver function damage in patients in the training set to establish a prediction model. Model discrimination, calibration, and clinical usefulness were evaluated in the training and validation sets. RESULTS: The logistic regression analysis showed that plateletcrit, retinol-binding protein, and carbon dioxide combining power could predict liver function damage (P < 0.05 for all). The receiver operating characteristic curve showed high model discrimination (training set area under the curve: 0.899, validation set area under the curve: 0.800; P < 0.05). The calibration curve showed a good fit (training set: P = 0.59, validation set: P = 0.19; P > 0.05). A decision curve analysis confirmed the clinical usefulness of this model. CONCLUSIONS: In this study, the combined model assesses liver function damage in patients with moderate coronavirus disease 2019 performed well. Thus, it may be helpful as a reference for clinical differentiation of liver function damage. Trial registration retrospectively registered.

Efficacy of WBC and Platelet Parameters in Predicting Survival in Patients with COVID-19 Infection

Introduction: Coronavirus disease 2019 (COVID-19) is an infectioncaused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Since there is activation of both inflammatory and thrombotic pathways in this disease, indices derived from routinelymeasured blood parameters, whose role is established in severe sepsis,are being evaluated worldwide as potential prognostic markers.Aims &Objectives: In this study we aimed to evaluate the role ofAbsolute Neutrophil count (ANC), Absolute Lymphocyte Count(ALC), Mean platelet volume (MPV), platelet distribution width(PDW), Plateletcrit (PCT), Platelet-large cell ratio(P-LCR), Neutrophil Platelet ratio (NPR) and Platelet Lymphocyte ratio (PLR) inpredicting survival amongst patients admitted with COVID-19infection.Materials &Methods: We conducted a retrospective chart review ofall moderate to severely ill adult patients admitted with COVID-19pneumonia admitted at All India Institute of Medical Sciences,Bhopal, a tertiary care hospital in Central India from April 2020-November 2020. Information about their demography, clinical features, laboratory investigations and in-hospital survival were collectedfrom charts.Result: The study included 1331 patients, out of these 1181 weresurvivors (389 females;792 males) and 150 were non survivors (35females;115 males). Amongst the various parameters studied ANC,NPR and PCT were found to be significantly lower amongst thesurvivors as compared to the non survivors whereas ALC was significantly higher amongst the survivors.Conclusions: The results of the current study showed that ANC,ALC, NPR and PCT can be used as useful cost-effective prognosticmarkers in patients with COVID-19 infection.

Platelet index in patients with confirmed coronavirus disease 2019 cases

BACKGROUND: Changes found on hematological examination are a helpful modality for assessing coronavirus disease 2019 (COVID-19). In addition, platelet index is a parameter that can help in assessing the COVID-19 disease prognosis. AIM: Objective of the study is to determine the difference in platelet index in nucleid acid amplification test (NAAT) confirmed COVID-19 patients, suspected COVID-19 with negative NAAT results, and non-COVID-19 controls. METHODS: This is an analytical observational study with 96 subjects;48 subjects with confirmed COVID-19, 23 subjects suspected COVID-19 with negative NAAT results, and 24 non-COVID-19 control subjects. First, NAAT examination was carried out using the GeneXpert tool with the target genes of the E and N2 genes. Then, the platelet index was compared between the three groups by the Kruskal-Wallis test. RESULTS: There was no significant difference in the number of platelet (PLT), mean PLT volume (MPV), and PLT crit (PCT) between the three groups with p = 0.732, 0.741 and 0.483, respectively. In general, the number of PLT, MPV, and PCT in the three groups was within the normal reference value. CONCLUSIONS: There were no significant differences observed in the number of PLT, MPV, and PCT between COVID-19 patients with positive NAAT, COVID-19 suspects with negative NAAT, and non-COVID-19 controls. Therefore, detecting the severe acute respiratory syndrome coronavirus 2 virus by NAAT examination in COVID-19 patients has not altered the PLT index changes.

Prospective analysis of inflammatory response markers, endothelial dysfunction and hemostasis parameters in COVID-19 associated pneumonia patients with and without type 2 diabetes mellitus

Background: The coronavirus disease 2019 (COVID-19) has spread around the world with high cardiovascular complications and mortality. Patients with heart pathology and diabetes mellitus were at greatest risk. An accurate and timely laboratory diagnosis is a vital step to help manage cardiovascular disease during this pandemic. Purpose: To conduct a prospective analysis of complete blood count parameters, inflammatory response, endothelial dysfunction of arterial wall and hemostasis in groups of patients undergoing COVID-19 associated pneumonia with and without type 2 diabetes mellitus (DM2);to highlight indicators of long-term adverse cardiovascular events. Methods: The study was carried out within register on one-year cardiac follow-up of patients after COVID-19-associated pneumonia. Patients (n=380) were identified in the period from April to July 2020 according to the data of medical information system of monoinfectious hospital. At the moment, data of the first 65 patients with cardiovascular pathology are obtained. Group 1 included 53 patients without DM2 (mean age 47.83±15.86 years), group 2 consisted of 12 patients with DM2 (61.71±9.12 years). Baseline parameters of complete blood count, biochemistry and hemostasis were assessed on the day of hospitalization. In-depth analysis of laboratory parameters was carried out in 3 months. Results: In group 1 significant decrease of coagulogram parameters: INR (p=0.004), fibrinogen, APTT, thrombocrit, large platelets level (p<0.0001), CRP level, liver enzymes (p<0.0001), leukocytes (p=0.015), erythrocytes (p=0.006) and increase in hematocrit (p<0.0001) were registered in 3 months compared to baseline data. In group 2 positive dynamics of CRP (p=0.018), platelets (p=0046), APTT (p=0.043) and erythrocytes (p=0.028) were revealed, while CRP concentration remained higher than reference values in 3 months. In group 2 in-depth analysis of biomarkers revealed values exceeding normal levels: hs-CRP (4.72±3.33 mg/L), homocysteine (13.17±7.95 μmol/L), myeloperoxidase (47.6±38.51), NT-proBNP (154.56±127.30 mg/ml), P-selectin (141.29±124.71) TgFb1 (6549.86±1987.87 pg/ml). Correlation analysis detected positive association of homocysteine level with platelets level (p=0.002. R=0.998), myeloperoxidase with fibrinogen (p=0.012. R=0.865). Conclusion: Three months after COVID-19 elevated levels of inflammatory markers (CRP, hs-CRP, homocysteine), endothelial dysfunction and thrombophilia (large platelets, P-selectin, TgFb1) are indicators of prolonged arterial inflammatory syndrome and increased predisposition to coagulopathy with thrombosis determining a very high risk of developing adverse cardiovascular events in patients with DM2.

Profile of platelet parameters in coronavirus disease – Positive cases — An observational study

Background: Coronavirus disease affects mainly the respiratory system. Other systems, including blood, are also affected. Blood cell abnormalities have varied between studies. The majority of patients present with platelet abnormalities. Methods: This was a laboratory observation study. All cases positive for the coronavirus disease 2019 (COVID-19) by reverse transcriptase — polymerase chain reaction (RT-PCR) test during the study period were considered for inclusion. Platelet index data were captured from an automated hematology analyzer: platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet–large cell ratio (P-LCR). Platelet lymphocyte ratio (PLR), platelet neutrophil ratio (PNR), and platelet monocyte ratio (PMR) were calculated. The cases were classified into two groups: moderate and severe. The difference in alteration of platelet parameters between moderate and severe COVID-19 cases was analyzed using SPSS 22 version software. A p-value of < 0.05 was considered statistically significant. Results: Most cases (44.9%) were in the age group of 41 – 60 years. The male-to-female ratio was 1.9:1. Moderate cases comprised 53.4%, and 46.6% of cases were severe. The association of PLR and PNR between moderate and severe cases was statistically significant. PLR was higher in severe cases than moderate cases, whereas PNR was higher in moderate cases than severe cases. Conclusions: Studying platelet index profiles in COVID-19 patients can improve our limited knowledge of the disease progression regarding platelet parameters. PLR and PNR are the more reliable platelet parameters in managing COVID-19 patients, which help predict the prognosis and aid in improving therapeutic options for severe cases.