Haematological profile abnormalities; and its relationship with severity and outcome of COVID-19 infection.

Background: Corona virus disease (Covid-19) caused by corona virus (SARS Cov-2) has affected millions of people around the world. Many diagnostic modalities have been tested but the blood complete picture remains the initial and most easily accessible investigation in Covid-19. Objectives: The objective of this study was to find out the haematological abnormalities in relation to Covid-19 severity and outcome. Methods: This cross-sectional study was carried out from April 2020 to July 2020. One--hundred and fifty polymerase chain reaction (PCR) confirmed Covid-19 patients were inducted by random sampling. Haematological profile at admission was recorded. Data thus obtained was analyzed with respect to Covid-19 severity and outcome. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 19. Results: Out of a total of 150 patients included in the study, 77(51.3%) patients had mild disease at the time of admission, 42 (28%) had moderate disease while 31 (20.7%) had critical disease at the time of admission. Medians (interquartile range) of total leucocyte count (TLC), neutrophils, lymphocytes, neutrophils to lymphocytes ratio (NLR), platelets to lymphocytes ratio (PLR), neutrophils to monocyte ratio (NMR), monocyte to lymphocyte ratio (MLR) were 8.11 (IQR=4.88), 5.95 (IQR=4.58), 1.66 (IQR=1.10), 3.48 (IQR=4.20), 146.24 (IQR=130.75), 18.87 (IQR=14.07), 0.16 (IQR=0.13). Median NLR was higher in patients with critical illness 11.23 (IQR=10.70) as compared to those with stable 2.51 (IQR=1.77) and moderate 3.22 (IQR=3.60) disease (p< 0.000). Similarly TLC (p< 0.000), neutrophils (p< 0.000), lymphocytes (p< 0.000), NLR (p< 0.000), PLR (p< 0.000, p=0.001), MLR (p< 0.000), NMR (p< 0.000) had significant relationship with the severity and outcome of Covid-19 infection. Conclusion: Many haematological parameters are significantly different and can be used to predict the severity and outcome of Covid-19 infection.

Correlation of biochemical profile at admission with severity and outcome of COVID-19.

BACKGROUND: COVID-19 was detected in China in December 2019. The rapid dissemination and novelty of the disease resulted in an epidemic. This study aimed to identify biochemical parameters at admission that can be used to categorize severity and outcome of COVID -19 infection. MATERIALS AND METHODS: This cross-sectional study was conducted at Allied Hospitals of RMU from April 2020 to July 2020. It included 128 randomly selected confirmed COVID-19 patients. At admission, biochemical profile (total bilirubin, alanine aminotransferases {ALT}, aspartate aminotransferases {AST}, urea, creatinine, uric acid, sodium, potassium, and chloride were correlated with severity and outcome of COVID-19 by employing t-tests and ANOVA where required. Cut-off values to predict disease severity and outcome were calculated using ROC curve. RESULTS: The study comprised 46.1% non-severe, 29.7% severe, and 24.2% critical COVID-19 patients. 84.4% patients improved and 15.6% expired. Urea was increased in critical disease patients (p < 0.000). Higher ALT (p 0.030) and AST (p 0.004) levels were noted in severe and critical disease. Sodium (p 0.001) and chloride (p 0.026) were decreased in critical disease. Patients who expired had increased urea (p 0.000), ALT (p 0.040) and AST (p 0.002). At admission, urea >42.7 mg (sensitivity of 64.7%, specificity of 87.5%), AST >43.5 IU/L (64% sensitivity, 60% specificity), and sodium <136.9 mmol/L (sensitivity of 70.6%, specificity of 71.2%) predicted critical COVID-19 infection. CONCLUSION: At admission, increased urea, AST, and ALT along with decreased sodium can help in identifying COVID-19 patients with severe illness and poor outcome.

The Spasmolytic Effect of Astragalus Sarcocolla on the Intestinal Smooth Muscles of Rabbit In Vitro: Potassium Channel Opening.

Introduction Astragalus species have been widely used in Chinese herbal medicine to treat gastrointestinal and inflammatory disorders. This study was conducted to evaluate the efficacy of Astragalus sarcocolla (ASE) and to rationalize its medicinal use as an antispasmodic drug for the treatment of spasmodic gastrointestinal and inflammatory disorders associated with increased intestinal motility. Methods The ethanolic extract of ASE was studied to examine its antispasmodic effect on the isolated rabbit ileum preparations, and the contractions were recorded on PowerLab (ADInstruments, Sydney, Australia). Results ASE was able to inhibit spontaneous ileum contractions. It also completely inhibited K+ (25 mM)-induced contractions but was unable to inhibit high K+ (80 mM)-induced sustained contractions. Pretreatment of the tissue with glibenclamide, a potassium channel blocker, caused a rightward shift of the dose-response curve when stimulated with K+ (25 mM) in the presence of an increasing concentration of the extract. Verapamil at very low doses inhibited both the 25 mM and 80 mM K+-induced contractions. Conclusion The results of our study demonstrated the spasmolytic activity of ASE with the potential mechanism of activation of K+ATP, which provides a strong basis for its medicinal use in motility and inflammatory disorders of the intestine.

Development of Resistance Against Mefloquine Prophylaxis in Peace-Keeping Forces in the Central African Republic.

Objective To record the frequency of malaria-like symptoms in patients who have been given mefloquine as chemoprophylaxis and to determine the effectiveness of antimalarials against these symptoms. Methodology It was an observational study that took place at a United Nations Level 1 hospital, Kaga-Bandoro, Central African Republic. The total duration of the study was three months. Patients presenting to the clinic with multiple symptoms despite chemoprophylaxis with mefloquine were assessed through a physical examination and screening test for malaria. Malaria treatment with a six-dose regimen of artemether (20 mg), along with lumefantrine (120 mg) two tablets BD for three days, was given after informed consent to those patients and post-treatment symptoms were observed and recorded. Results Out of 61 patients, 93% of them presented with body aches, 92% with headache, 52% with shivering, 44% with vertigo, 38% with fever, sweating, and nausea/vomiting, 18% with diarrhea, and 10% with pain in the abdomen. Conclusion It had been seen that patients presented with symptoms despite standard mefloquine prophylactic therapy, which were resolved with other antimalarial drugs. The presentation of the symptoms was also not classical.