Study of CD4+ T-lymphocytes in chronic kidney disease patients with COVID-19 infection.

Chronic kidney disease (CKD) is a functional and/or structural kidney damage that lasts more than three months duration. This study aimed to analyze CD4+ T-lymphocytes levels in chronic CKD patients specifically, during the coronavirus disease 2019 (COVID-19) pandemic to assess the adaptive cell-mediated immunity. The study measured absolute CD4+ T-lymphocytes counts by flowcytometry among participating individuals. The study included 146 subjects, 40 CKD patients and tested positive for COVID-19, 44 CKD patients and tested negative for COVID-19 and 62 normal individuals as controls. There was a significant impact of COVID-19 infection in CKD patients showing lower absolute CD4+ T-lymphocytes values to more than six folds compared to the control individuals (Odds Ratio: 72.63, p= 0.0001). Also, there was a significant correlation between the decrease in absolute CD4+ T-lymphocytes counts and the advanced stages of CKD. Therefore, the study indicated that CKD causes an obvious alteration in the body immune system as decreased CD4+ T-lymphocytes levels alongside with the advanced CKD stages. While COVID-19 infection exposes CKD patients to be 50% more likely to express lower values of CD4+ T-lymphocytes levels compared to the negative tested CKD patients. In conclusion, poor immune response and increased morbidity and mortality could be correlated with CKD patients especially when associated with COVID-19 infection as comorbidity.

Risk factors for severity of thrombocytopenia in full term infants: a single center study.

BACKGROUND: Neonatal thrombocytopenia (NT) (platelet count < 150 × 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants. METHODS: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded. RESULTS: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P = 0.001) and had higher rates of mortality (P = 0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P = 0.001). CONCLUSION: Severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.