ABSTRACT
Introduction: Blood tests play an important role in the early detection of disease given that they provide doctors with information about inflammatory processes. A complete blood count (CBC) is easy and inexpensive to perform. These parameters can be used alone as markers of inflammation. Their mutual ratio is also an indicator of early inflammation.4 In light of previous studies, the use of circulating biomarkers instead of inflammation and immune system has been considered a prognostic indicator for COVID-19 positive patients. Aims/ objective: To examines the role of biomarkers from peripheral blood samples in the diagnosis of hospitalized COVID-19 patients with a history of fever. Materials and Method: Haematological biomarkers and coagulation profile was compared between RT-PCR positive and negative patients. Systemic inflammatory index (SII) was calculated by multiplying thrombocyte count with neutrophil count and dividing the value by lymphocyte count. Neutrophil lymphocyte ratio (NLR) was calculated by dividing absolute neutrophil count by absolute lymphocyte count. Platelet lymphocyte ratio (PLR) was calculated by dividing absolute platelet by absolute lymphocyte count. Fisher exact test and unpaired t-test were used to compare categorical and continuous data respectively. Results: Analysis was done on 57 retrospective cases of RT-PCR positive patients and 61 RT-PCR negative patients with history of fever. COVID-19 positive patients showed leukopenia, neutropenia, thrombocytopenia, and lymphocytosis. SII and NLR decreased and PLR increased. PT and APTT were generally within normal limits in most of the patients. There was significant difference between two groups with respect to lymphocyte counts and PLR. Conclusion: The most standardized non-invasive and inexpensive tests such as CBC, coagulation and biochemical tests are available to assess disease severity for wise allocation of medical resources in developing countries such as India where resources and care are limited.
ABSTRACT
Purpose of Study: In areas endemic for murine typhus, it can be difficult to distinguish from other febrile syndromes. During COVID-19 surges, we identified several cases of typhus. Presenting symptoms and quantitative lab values at and during admission were compared between patients who were diagnosed with murine typhus or multisystem-inflammatory syndrome in children (MIS-C). Methods Used: Retrospective data was collected at a tertiary care center from July 2020 to March 2022. Inclusion criteria were patients under 21 years of age diagnosed at discharge with murine typhus or MIS-C based on clinical and laboratory evidence, serologic data, and expert consultation. Patients found to have an alternate diagnosis, and those without serologic testing were excluded. Subjects were grouped as either MIS-C or typhus based final diagnosis. Categorical data included headache, fatigue, mucocutaneous changes, rash, con-junctival injection, sore throat, rhinorrhea, palpitations, shortness of breath, chest pain, abdominal pain, nausea/vomiting, diarrhea, myalgia, and appetite change at initial presentation. The categorical data were compared using chi-square test. Quantitative data included age, maximum temperature in first 24 hours of hospitalization, duration of symptoms prior to admission, C-reactive protein, erythrocyte sedimentation rate, platelet count, white blood cell count (WBC), absolute neutrophil count (ANC), absolute lymphocyte count, serum sodium, alanine aminotransferase, hemoglobin (Hgb), and albumin (Alb). Means of the quantitative data were compared with a one-tailed 2- Sample T-Test. The maximum and minimum laboratory values during admission were also compared. Additional demographic data including gender and date of initial presentation was also collected. Summary of Results: There were 7 patients in the MIS-C group and 19 in the typhus group. The average age of MIS-C patients, 6.5 years of age vs. 11.5,was significantly lower (p < 0.5) than the typhus group. Initial mean WBC (cells x 103/mm3) was higher in MIS-C than typhus (12.21, SD = 3.52, vs. 7.85, SD = 3.52, p < 0.05), as was ANC (8.9, SD = 3.7vs. 5.12, SD = 2.05, p < 0.05). During hospitalization, minimum Hgb (g/dL) was 9.3, SD = 2.07, and11.49, SD = 1.67, in MIS-C and typhus respectively (p < 0.05). Minimum albumin (g/dL) was also lower in MIS-C than typhus (2.32, SD = 0.86 vs. 2.8, SD = 0.45, p < 0.05). There were no other statistically significant differences in categorical or quantitative data. Typhus cases typically occurred in the summer and fall months. There was no clear seasonality of MIS-C, but occurred during local COVID-19 surges. Conclusion(s): The initial presenting symptoms of typhus and MIS-C were similar. WBC and ANC were higher in MIS-C, while age, Hgb and Alb were lower. These parameters may aid in distinguishing the diseases. A high clinical suspicion for both typhus and MIS-C in endemic areas for typhus is crucial. A rapid detection for typhus would aid in distinguishing these diseases and allow prompt treatment interventions. Copyright © 2023 Southern Society for Clinical Investigation.
ABSTRACT
INTRODUCTION: Patients with multiple comorbidities who have coronavirus disease 2019 (COVID-19) have high morbidity and mortality. Glucose-6-phosphate dehydrogenase (G6PD) deficiency has been shown to have an enhanced effect on coronavirus in an earlier study. METHODS: We conducted this comparative observational study to evaluate the effects of COVID-19 disease on G6PD deficiency based on the hematologic parameters, COVID-19-related hospitalizations, and mortality in the state of Qatar between January 2020 and May 2020 at four designated COVID-19 facilities. We identified 41 patients with G6PD deficiency who had documented COVID-19 infection. We compared the results with 241 patients with COVID-19 infection who tested negative for G6PD deficiency.: Results: Comparing the COVID-19 positive G6PD deficient with COVID-19 positive G6PD normal activity showed that G6PD normal group had higher white blood cell count (WBC), absolute neutrophil count (ANC), lymphocytes, eosinophils, and monocytes counts versus the G6PD deficient group (p < 0.001). CONCLUSIONS: When compared with COVID-19 patients with normal G6PD, patients with COVID-19 infection and G6PD deficiency had lower total WBC, ANC, lymphocyte, monocyte, and eosinophil counts. However, no evidence of increased hemolysis, thrombosis, morbidity, or mortality was observed in COVID-19 patients with G6PD deficiency.