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Objective: The Covid-19 pandemic has revealed the importance of an evidence-based efficient triage system in the early identification of high risk patients and the rational use of limited medical resources for reducing mortality. The aim of this study was to evaluate the role of various inflammatory indices that can be easily calculated using readily accessible, inexpensive routine test parameters in risk stratification and prediction of prognosis in patients with Covid-19. Material and Methods: The study was carried out retrospectively with the data of 8036 patients with Covid-19, who were grouped according to their prognosis in outpatient and inpatient follow-ups, and inpatients as survivors and death. Using the complete blood count and C-reactive protein baseline results of the patients at admission, neutrophillymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocytelymphocyte ratio (MLR), MVP-platelet ratio (MPR), platelet mass index (PMI), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), and multi-inflammatory indices (MII) were calculated. Results: Our results demonstrate that almost all of the inflammatory indices were significantly different in severe patients and in patients with high mortality risk, but not all of them had a predictive value. It has been seen that the most effective factors in determining the disease severity at the onset of Covid-19 are SIRI and age, and SII, MII-1 and MII-3 may also contribute to this prediction. Our results have also revealed that NLR is the most effective independent factor to predict mortality both at disease onset and for inpatients. Conclusion: Inflammatory indices, especially SIRI, NLR, SII, MII-1 and MII-3 can substantially contribute to clinical decisions in the early identification of high-risk patients and predicting mortality beginning from the onset of Covid-19.
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Objective: To represent the effects of the severity of COVID-19 infection on platelet large cell ratio (PLC-R). Materials and Methods: A hundred eleven patients diagnosed with COVID-19 were included in this study. Positive results for SARS-CoV-2 based on a typical RT-PCR test performed on nasopharyngeal swabs were included in the study Groups. Patients with COVID-19 were divided into three Groups according to their chest CT features. Group 1 (45 patients) was defined as mild, Group 2 (34 patients) as moderate and Group 3 (32 patients) as severe. Complete blood count parameters including platelet volume indices (PVI) values, CRP, D-dimer and lipid profiles were analyzed in all study participants. The correlation between COVID-19 patient Groups and PLC-R values were demonstrated using SPSS and ANFC methods. Results: The significant impact of our study is that PLC-R was significantly higher in the severe COVID-19 patients than the moderate and mild patients. Spearman's rho correlation analysis showed that PLC-R and WBC levels increased, and Htc and Hb levels decreased with the severity of the disease. ROC analysis showed that PLC-R > 38.3% had 59.4% sensitivity and 68.4% specificity in predicting severe COVID-19 disease (AUC 0.672, %95 CI 0.560, 0.784;p=0.005, cut off=38.3). CRP, ferritin and D-dimer values of the patients in Group 3 were significantly higher than the patients in Group 1, and the iron values of the patients in Group 3 were significantly lower than the patients in Group 1. Conclusion: PLC-R values are useful for anticipating acute thrombotic events. Based on the results of our study, PLC-R values can be used as appropriate biomarkers to describe the severity of COVID-19 infection.
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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.
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Objective: To explore the application value of blood cell subtype ratio [neutrophil/lymphocyte ratio (NLR) platelet/lymphocyte ratio (PLR)], platelet/neutrophil ratio (PNR) and inflammatory indicators in clinical treatment and prognosis of coronavirus disease 2019 (COVID - 19) patients. Methods The blood routine and inflammatory data were collected from 47 hospitalized COVID- 19 patients and 30 healthy subjects and analyzed retrospectively, and the ratios of NLR, PLR and PNR were calculated. The differences of each index were compared between the two groups, and the variation trend of NLR, PLR and PNR were dynamically monitored during the course of disease. ROC curve was used to evaluate the diagnostic value of blood cell subtype ratio and inflammatory indicators. Results Compared with the control group, white blood cell (WBC) and lymphocyte (LYMPH) were decreased (Z =-3.578, -5.558, all P <0.05), and NLR, PLR, C-reactive protein(CRP), serum amyloid A(SAA) and SAA/CRP were increased in COVID-19 patients group (Z =-4.210, -5.087, -2.434, -5.263, -3.091, all /1/40.05). Trend analysis of NLR, PLR and PNR showed that NLR and PLR increased first and reached the peak, and gradually decreased with the improvement of patients' condition (x2=27.441, 38.699, all PC 0.05). ROC curve analysis results showed that the area under curve (AUC) of SAA, PLR, NLR and CRP were 0.855, 0.845, 0.786 and 0.662, respectively. Conclusions The combination of NLR, PLR, SAA and CRP could reflect systemic inflammatory status of patients, and had good clinical diagnostic value for disease monitoring and prognosis.
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Coronavirus can also harm the vascular system and cause bleeding;this damage to the vascular system might be followed by dysfunctions in other body systems, therefore not a few COVID-19 survivors have experienced a stroke as a complication of COVID-19. Bleeding that occurs in the nose is a common condition that occurs as a result of a person's injury, allergies, or platelet levels that are declining. There are several simple ways to stop this bleeding, but for Indonesians betel leaf is a widely chosen traditional treatment. The subjects of experimental animal studies were divided into 4 groups. The results of the Anova test analysis showed that there was a significant difference in average platelet levels (p=0.05) in the 4 groups. The results showed that the lowest average thrombocytes and hematocrit levels were found in group 2, namely the group that was given LPS without being given betel leaf essential oil. The highest average thrombocytes and hematocrit levels were found in group 3, namely the group that was first given betel leaf essential oil, after which it was only applied LPS. Red Betel Leaf Essential Oil has the potential as an anti-bleeding in research subjects induced with infectious materials characterized by increasing average platelet levels and Hematocrit as components that play a role in the blood clotting process. Copyright © 2023, Anka Publishers. All rights reserved.
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This special issue containing 12 articles presents a fascinating collection of contributions on a wide variety of topics that share the common theme of dermatology at its best. Topics discussed are: the impact of international medical graduates in dermatology;Erasmus Wilson's role in soap advertisements;the skin as a critical window in unveiling the pathophysiologic principles of COVID-19;the histologic and molecular correlates of COVID-19 vaccine-induced changes in the skin;insomnia and other sleep disorders in dermatology patients;efficacy of topical treatments for molluscum contagiosum in randomized controlled trials;combined subcision, autologous platelet-rich plasma, and CROSS technique in the treatment of atrophic acne scars - prospective split face study;preserving wellness in dermatology residents.
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The patho-physiology of COVID19 is still not clear. This study investigated the status of coagulation, LDH activity, and inflammation in SARS-CoV-2 infected patients. One hundred and thirty-four newly diagnosed COVID19 infected patients (age ranged 65-82 years) attending Mullingar Regional Hospital, Mullingar, Republic of Ireland, volunteered to participate in this study. They all presented with a pulmonary disorder, pyrexia, vomiting, body pains, etc. SARS-CoV-2 confirmatory test was done with RT-PCR molecular test using Cepheid Genexpert System. The data of another 121 plasma samples of apparently normal, non-COVID19 infected individuals taken before the emergence of COVID19 served as controls. Levels of blood platelets was determined in the participants using Siemen ADVIA 2120 Haematological System, and plasma D-dimer was determined in the participants using Star Max-Stago-Automatic Coagulation Analyzer LDH activity, plasma ferritin, and C-reactive protein (CRP) were determined in the participants using Beckman AU680-Chemistry Analyser. SARS-CoV-2 -infected patients showed significantly (p< 0.001) higher levels of D-dimer (1522.95+1395.45 ng/ml), CRP (125.3+116.4 mg/l), ferritin (488.5+514.9pg/l), and LDH activity (574.4+446.7iu/l) compared to controls (78.8+18.1 ng/ml, 2.4+1.7 mg/l, 61.3+58.2pg/l, 304.1+76.6iu/l respectively). The blood platelet count did not show significant (p>0.05) change in the COVID19 patients (252.2 x 109+101 x 109) compared to controls (256.4 x 109+63.2 x 109). Elevated LDH activity could indicate tissue breakdown in the SARS-Cov-2 infected patients. Hyper-coagulation and inflammation are imminent in the COVID19 patients. Adjuvant anticoagulant and anti-inflammatory therapies may be useful as part of therapeutic regimen in the SARS-CoV-2 infected patients.
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Background: During the COVID- 19 pandemic in the first wave, infected patients age was range from 4 weeks to 90 years and those who have more age and with comorbidities are more susceptible to develop serious illness and have high mortality rates.
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Background: Viscoelastic coagulation testing in COVID-19 patients often found elevated concentrations of D-dimer and fibrinogen. Thrombotic complications can be in the form of Venous Thromboembolism (VTE), where this thrombotic disease is one of the factors associated with increased mortality of COVID-19 patients. This study aims to analyze the effectiveness of antiplatelet drugs in reducing mortality in COVID-19 patients. Subjects and Method: This is a meta-analysis study using PRISMA flowchart guidelines. The article search process was carried out between 2020-2021 using PubMed, Science Direct, Google Scholar, and Scopus databases. The article search was carried out by considering the eligibility criteria defined in the PICO model. Population= COVID-19 patients, Intervention= using antiplatelet drugs, Comparison= not using anticoagulant drugs, Outcome= mortality. The keywords used were "antiplatelet" AND "mortality" AND "COVID-19". The inclusion criteria used were English full-text cohort papers and the relationship measure used as the adjusted odds ratio (aOR). Based on the database, 9 articles fulfilled the inclusion criteria. The analysis was carried out using RevMan 5.3 software.
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Objective: To investigate the effect of the systemic immune-inflammation index(SII) on the conversion time of virus nucleic acid turning negative in patients with coronavirus disease 2019(COVID-19).
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Introduction and Aim: With the coronavirus disease 2019 (COVID-19) pandemic raging on, there is a need to identify clinical and laboratory predictors which predict progression towards severe and fatal forms of this illness. Our study aims to evaluate the ability of hematologic and biochemical biomarkers to discriminate between patients with and without severe or fatal forms of COVID-19. Materials and Methods: A retrospective study was conducted on 200 Covid positive patients;100 with mild disease and 100 with severe disease. Medical records were reviewed to collect demographic data and results of the following blood investigations were noted at admission: Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer. Comparative analysis was performed between the 2 groups.
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Introduction: Atraumatic Splenic Rupture (ASR) is a rare but life-threatening clinicopathological phenomenon with limited information on patient features, occurrence, or etiology. ASR is an uncommon and lethal complication that is observed in infectious (mainly mononucleosis) and hematological diseases (mainly malignant homeopathies) in more than half of cases. Mortality is approximately around 20%, and some deaths occur before the diagnosis is confirmed, while others occur after surgery due to delayed management and poor patient status. Case Presentation: A 48-year-old man with no history of the underlying disease presented to the Emergency Department with abdominal pain. He was admitted with leukocytosis 145..103/l, hemoglobin 6.4 g/dl, platelets 15..103/l, erythrocyte sedimentation rate 89 mm/h, and D-Dimer 1043 ng/FEU ml. Sputum test through PCR ruled out severe acute respiratory syndrome coronavirus 2 infections. Due to peripheral blood smear and bone marrow aspiration/biopsy, acute myeloid leukemia was diagnosed for the patient. On the third day of hospitalization, the patient's abdominal pain intensifies. Ultrasound revealed medium free fluid inside the abdomen and pelvis. The patient was transferred to the operating room to undergo an emergency laparotomy. There was a large hematoma in the spleen with a rupture in its posterior surface. Splenectomy was performed, and the histopathological study of the spleen showed leukemic involvement, capsular ruptures, and subcapsular hematomas.
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Background: Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic with second and third waves sweeping through different countries. Patients with severe disease have a poor prognosis and it is essential for us to identify these cases to initiate timely management. Neutrophil-to-lymphocyte ratio (NLR) has been documented to be higher in the severe patients. Aim: The aim is to assess the NLR and other routine hematological parameters in severe versus Non severe patients on admission to the hospital.
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The aboveground biomass of dry knotweed was administered daily to large groups of young (1- to 3-year-old) stallions of the Czech Warmblood, Czech-Moravian Coldblood and Silesian Norik breeds, fed individually for 4 and 6 months in two successive winter experiments. Their fitness was compared with control groups consisting of equally numerous subgroups comparable in age, breed, body mass and initial blood parameters. The effects of knotweed on the horses’ fitness were evaluated based on changes in blood characteristics. Even if administered in small amounts, 150 g per day, knotweed could (1) increase the thrombocyte numbers, (2) increase the globulin content (thus improving the horses’ immunity, which is desired in large groups of animals), (3) stimulate lipid metabolism in cold-blooded horses and (4) decrease the concentration of cholesterol. The long-lasting effect of knotweed on both the urea and triglyceride–cholesterol ratio presumably reflected, between the two experiments, the temporary protein starvation of horses on pastures with poor quality of grass in a dry summer.
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Background: The struggle of humanity with Coronavirus disease 2019 (COVID-19) infection, which affected the whole world and caused severe social and health crises, continues without deceleration. Objectives: This study aimed to determine the relationship between the abnormal laboratory parameters upon admission and the intensity of lung involvement using chest computerized tomography severity score (CT-SS).
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Objective: Severe respiratory syndrome Coronavirus-2 (SARS-CoV-2) caused a global pandemic that spread all over Turkey following the announcement of the first case on March 11, 2020. The present study aimed to investigate the diagnostic utility of complete blood count (CBC) parameters, C-reactive protein (CRP), and their ratios as well as their prediction on intensive care unit (ICU) admission among patients with Coronavirus Disease-2019 (COVID-19).
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OBJECTIVES: Intracerebral hemorrhage/bleeding (ICH) after an infection with SARS-CoV-2 (COVID-19) treated with the Janus-kinase inhibitor baricitinib has not been reported. CASE PRESENTATION: A 86yo Caucasian female suddenly developed aphasia with a systolic blood pressure of 220 mmHg. Cerebral imaging revealed an ICH in the left temporal lobe without mass effect and no need for neurosurgical intervention. Her previous history was positive for arterial hypertension, hyperlipidemia, heart failure, renal insufficiency, hyperuricemia, macula degeneration, lumbalgia, and glaucoma bilaterally. Additionally, she had experienced an infection with SARS-CoV-2 with onset 44 days earlier having been treated with ceftriaxone (2 g/d for 7 d), dexamethasone (6 mg for 6 d), and bariticinib (2 mg for 6 d). CONCLUSIONS: Though ICH was time-linked to COVID-19, a causal relation could not be unequivocally established. Whether baricitinib increased the bleeding risk remains speculative. As long as causalities between ICH and baricitinib remain unproven, it should be given with caution and only under close blood pressure monitoring.
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Acquired thrombotic thrombocytopenic purpura (TTP) is an autoimmune disease that can be triggered by different events, including viral infections. It presents as thrombotic microangiopathy and can lead to severe complications that often require management in the intensive care unit (ICU). We report a patient who presented with acquired TTP following COVID-19 infection. A 44-year-old woman presented to the emergency department with severe anemia, acute kidney injury and respiratory failure due to COVID-19. Clinical and laboratory findings were suggestive for thrombotic microangiopathy. On day 8 laboratory tests confirmed the diagnosis of acquired TTP. The patient needed 14 plasma exchanges, treatment with steroids, rituximab and caplacizumab and 18 days of mechanical ventilation. She completely recovered and was discharged home on day 51. Acquired TTP can be triggered by different events leading to immune stimulation. COVID-19 has been associated with different inflammatory and auto-immune diseases. Considering the temporal sequence and the lack of other possible causes, we suggest that COVID-19 infection could have been the triggering factor in the development of TTP. Since other similar cases have already been described, possible association between COVID and TTP deserves further investigation.