Assessment of diagnostic and prognostic laboratory biomarkers in severe COVID-19 patients admitted to intensive care unit.

Coronavirus disease (COVID-19) is a global pandemic. In the first two years of the pandemic, nearly 15 million people died worldwide. Accurate and rapid laboratory diagnosis of COVID-19 infection is one of the milestones of pandemic control. Therefore, this study aimed to compare the diagnostic and prognostic accuracy of mainly used laboratory biomarkers (CRP, ferritin, IL-6, D-dimer, procalcitonin, and LDH) in the sera of severe COVID-19 Egyptian patients, to assess the most appropriate biomarker used in severe COVID-19 patients. A total of 120 COVID-19 patients and 50 normal controls were enrolled into our study. Demographic data, hospitalization time, medical history, oxygen saturation, respiratory rate, oxygen supply, laboratory findings and thorax tomography of the patients were obtained from the hospital electronic information system retrospectively. Our results revealed that the serum levels of CRP, ferritin, IL-6, D-dimer, PCT and LDH were highly significantly increased in severe COVID-19 patients as compared to normal controls (p < 0.001), and in non-survivors as compared to survivors (p < 0.001). By using ROC curve analysis, IL-6 appeared to be the most sensitive and specific marker with 80.9% sensitivity and 84.9% specificity; followed by LDH with 85.1% sensitivity and 82.8% specificity in the prediction of death. In conclusion CRP and IL-6 could be the most appropriate biomarkers in the diagnosis of severe COVID-19 disease, while IL-6 and LDH may be good predictors of mortality between severe COVID-19 patients.

Neutrophil to lymphocytic ratio and other inflammatory markers as adverse outcome predictor in hospitalized COVID-19 patients.

Early risk classification of coronavirus disease 2019 (COVID-19) patients admitted to hospital is a critical key for providing optimal interventions. We investigated whether neutrophil-to-lymphocyte ratio (NLR) levels and other inflammatory and coagulation markers could be predictors for the severity and mortality of hospitalized COVID-19 patients. This cross-sectional study included 155 COVID-19 patients diagnosed by the reverse transcription polymerase chain reaction (RT-PCR) using oropharyngeal swabs. All patients had clinical examination, routine laboratory investigation, and chest computerized tomography scan. O2 saturation, serum D dimer, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), and serum ferritin were assessed. NLR can predict the adverse outcome (e.g., disease deterioration and shock) at cut-off 6.65, with 92% sensitivity and 20.7% specificity. LDH at cut-off value of 364.5 had 79.3% sensitivity and 47% specificity. Ferritin at a cut-off value of 1036 had 60.9% sensitivity and 60.6% specificity. NLR alone was not an independent predictor for ICU, however, combining NLR with ferritin and LDH predicted the need for ICU. Total leucocytic count (TLC), neutrophil count, lymphocytic count, D dimer, and CRP were independent predictors for the need of ICU admission (P < 0.05). Admitted patients to ICU and dead patients had higher COVID-19 Reporting and Data System, length of stay, LDH, and ferritin and lower O2 saturation than non-admitted and alive ones. We concluded that NLR with ferritin and LDH markers had higher degree of sensitivity and specificity in detecting adverse outcomes in COVID-19 patients. Other inflammatory biomarkers such as TLC, neutrophil, lymphocyte, D dimer, and CRP were predictive in this case.

Serum 25-hydroxyvitamin D and CD4+CD25(+high) FoxP3+ Regulatory T cell as Predictors of Severity of Bronchial Asthma in Children.

Bronchial asthma (BA) is one of the common chronic diseases of childhood. Vitamin D deficiency has been associated with BA. Suppressor regulatory T cells (Treg) are important for the induction, maintenance of immunological tolerance to allergens. This study assessed serum 25-hydroxyvitamin D (vitamin D) and the percentages of CD4+CD25+(high) Foxp3+ Treg, in peripheral blood, as predictors of asthma severity and level of clinical control. The study enrolled 72 children divided equally between asthmatic children (AC) and age and sex matched controls. Diagnostic criteria and level of asthma severity followed the Global Initiative for Asthma guidelines. Serum vitamin D was determined by an immunoassay and the percentages of CD4+CD25+ig Foxp3+ Treg by flow cytometry. Serum vitamin D level and percentage of CD4+CD25+(high) Treg were lower in AC compared to controls (P < 0.001) whereas Fox p3 expression was higher in AC compared to controls, P < 0.001. Serum vitamin D levels were lower in severe asthma compared to mild and moderate forms (P = 0.008) and in uncontrolled attacks compared to partially or completely controlled children. No difference in percentage of Treg in relation to asthma severity and clinical control was observed. Since AC has decreased serum vitamin D with inverse relationship between its levels and asthma severity, we conclude that it can be used to predict severity of asthma.

Prevalence of schistosomiasis among patients attending Qena General Hospital over the years 2011 and 2012.

Schistosomiasis is a public health problem in Egypt. To detect the prevalence of schistosomiasis in Qena Governorate, 1601 urine and stool samples of patients attending Qena General Hospital were examined of whom 1601 patients had urinary symptoms and 893 patients had dysentery and bloody stool. Sheets were filled out on each patient. Also, a total of 7590 Bulinus truncatus and Biomphalaria alexandrina snails were collected from water bodies in Qena Governorate. The overall prevalence of S. haematobium was 13.9%; with maximum among 6-18 year-old age group and higher in males than in females. Risk factors for S. haematobium infection were this age group; particularly males. However, males swim and play in water bodies and women wash cloths and utensils there, and children swimming or playing in canals. The S. haematobium peak of infection was in winter correlated with the highest prevalence in Dandara City, Qena City, Awlad-Amr and El Hijarat. S. mansoni were negative in the examined individuals. The infective rate among snails was 1.82% in B. truncatus and 0.0% among B. alexandrina and M. tuberculata.