Correlation of leucocyte and platelet indices in patients with type 2 diabetes mellitus with microvascular complications at a tertiary care hospital in south India - A prospective cross-sectional study.

Objective. The present study was directed to assess the correlation between leukocyte and platelet indices and microvascular complications in patients with type 2 diabetes mellitus (T2DM). Methods. A prospective cross-sectional study was conducted between January 2020 and May 2021 at a tertiary healthcare center. Sixty T2DM patients, who fulfilled the inclusion and exclusion criteria, were included into the study and divided into 2 groups: T2DM patients with microvascular complications and T2DM patients without vascular complications. Clinical history was taken and examinations (routine complete blood count) were done to obtain platelet indices, neutrophillymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) were obtained and tabulated. A correlation was statistically analyzed from the obtained data, p value <0.05 was considered to be statistically significant. Results. From the patients with microvascular complications, 18 cases suffered from retinopathy and nephropathy. Majority of the participants suffered from moderate non-proliferative retinopathy. The creatine median and absolute neutrophil count (ANC) were significantly higher in T2DM patients with microvascular complications (p<0.0001 and p<0.0054, respectively) compared to T2DM patients without vascular complications. No significant correlation was found between platelet indices, NLR, PLR with regard to fasting blood sugar, post prandial blood sugar, HbA1C in T2DM patients. Conclusions. Since no significant correlation was found between the different platelet indices and microvascular complications, it is evident that these markers cannot be used as the predictors of microvascular complications in T2DM patients.

Clinical Profile and Factors Associated with Adverse Outcomes in Coronavirus Disease 2019-associated Mucormycosis: A Single-centre Study.

Background: The coronavirus disease 2019 (COVID-19) pandemic was associated with an increased incidence of mucormycosis globally. However, the clinical pattern, epidemiologic features and risk factors for adverse outcomes are not well established. Methods: We performed a retrospective analysis of the data from patients hospitalized with proven mucormycosis between April 2021 and August 2021. Patients were managed with a multi-disciplinary approach involving medical, surgical, and comorbidity treatment. The clinical presentation, management details, complications and outcomes, including mortality, were reviewed from clinical records. Results: The mean age of presentation was 53.7 (± 11.8) years, and 88 (84.6%) were men. Of the 104 cases with COVID-19-associated mucormycosis, 97 (93.27%) patients had diabetes, and 80.8% had a haemoglobin A1C (HbA1c) of ≥6.4% at diagnosis. Seventy percent of diabetes cases experienced steroid-induced hyperglycaemia during treatment. Even with appropriate treatment, 17 (16.35%) patients died. High HbA1c and creatinine levels, presence of chronic kidney disease (CKD), need for intensive care unit admission, and orbital evisceration were the risk factors associated with high mortality on multivariate logistic regression analysis. Cox regression analysis revealed that the overall mortality increased by a factor of 12% with each 1 percentage point increase in HbA1c ≥6.4% (hazard ratio 1.12; 95% confidence interval 0.95- 1.31). The mortality risk was even higher when diabetes was associated with CKD (hazard ratio 1.82; 95% confidence interval 0.24-14.00). Conclusion: High HbA1c and creatinine levels, intensive care unit admission, CKD, and aggressive disease requiring orbital evisceration are the predictors of mortality in patients with COVID-19-associated mucormycosis. Patients with these risk factors should be managed more actively to reduce morbidity and mortality.