Changes In COVID-19 Patients Research Articles

Radiological Assessment of Pulmonary Vascular Changes and Gastrointestinal Changes in COVID-19 Patients Referred to a Tertiary Health Care Centre in Chennai, India: A Prospective Cross-Sectional Study

Background: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to significant morbidity and mortality worldwide since its emergence in 2019. While primarily a respiratory illness, COVID-19 can also affect other organ systems, including the vascular and gastrointestinal systems. COVID-19 infection is linked to both venous and arterial thrombosis, with numerous studies indicating a heightened risk of pulmonary embolism (PE) among patients. Autopsies have revealed pulmonary vasculature thrombosis and bowel ischemia in COVID-19 cases. Aim: This prospective cross-sectional study aimed to assess radiological pulmonary vascular changes, specifically pulmonary embolism (PE), and gastrointestinal changes in COVID-19 patients referred to a tertiary healthcare center in Chennai, India. Methods: CT pulmonary angiography (CTPA) and contrast-enhanced CT of the abdomen were conducted in 100 COVID-19 positive patients meeting the inclusion and exclusion criteria. Evaluation of pulmonary vascular changes and bowel changes was performed by a radiologist with five years of experience. Subsequently, statistical analysis was carried out to determine the significance of the relationship between COVID-19 patients and the occurrence of pulmonary vascular and bowel changes. Results: In our study, 11 patients exhibited pulmonary thromboembolism, and 7 patients showed significant bowel changes. There is a positive correlation between the prevalence of PE in COVID-19 patients. PE was diagnosed at a mean of 11 days from the onset of the disease. Out of 24 patients with severe acute respiratory illness (SARI), 7 showed PE in CTPA. Additionally, out of 10 mechanically ventilated patients, 7 had PE in CTPA. Among the 7 patients with bowel changes, 4 had PE in CTPA, indicating a significant association with PE. The observed bowel changes were attributed to intravascular thrombosis. Conclusion: Based on our findings, individuals with COVID-19 often develop pulmonary emboli and bowel changes. Multivariate analyses revealed a connection between invasive mechanical ventilation and PE. Our results suggest that patients with severe clinical manifestations of COVID-19 may also have concurrent acute PE. Thus, for these patients, utilizing contrast-enhanced CT scans instead of standard non-contrast CT scans may aid in treatment decision-making.

HEMATOLOGICAL CHANGES ASSOCIATED WITH COVID-19 INFECTION IN ADEN/ YEMEN

Chronic Hematological alterations in COVID-19 patients range from mild to severe, with common changes including lymphopenia, neutrophilia, and thrombocytopenia. The gold standard for diagnosis is the polymerase chain reaction (PCR) test, which is highly specific and sensitive for detecting SARS-CoV-2 genetic material. The study was a single isolation center retrospective analysis of 200 patients with COVID-19 confirmed cases. The hematological indicators were taken after sample blood collected from the staff of Central Public Health Laboratory to determine the changes, and compared between different grades of severity and prognosis with the hematological indicators. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0. simple frequencies and percentage were used, while chi-square test used to determine the association between variables. Males consisted 73.5% in this study, while 63% of participants suffered from moderate severity. Related to the hematological changes; and comparisons made according to real-time PCR test results revealed that the Lymphocytopenia and leukocytosis presented among 47.5% and 46.5% respectively with significance association with illness severity and outcome of patients with p-value< 0.05. hematological changes in COVID-19 patients are a common and significant aspect of the disease. Lymphopenia, neutrophilia, thrombocytopenia, and increased levels of inflammatory markers are frequently observed. These hematological abnormalities are associated with disease severity, poor clinical outcomes. Blood parameters aid in COVID-19 diagnosis and prognosis, with abnormal hematological parameters providing early evidence. However, interpretation should consider limitations, sample size, and potential biases. Further research needed.

Gut Microbiota Improves Prognostic Prediction in Critically Ill COVID-19 Patients Alongside Immunological and Hematological Indicators.

The gut microbiota undergoes substantial changes in COVID-19 patients; yet, the utility of these alterations as prognostic biomarkers at the time of hospital admission, and its correlation with immunological and hematological parameters, remains unclear. The objective of this study is to investigate the gut microbiota's dynamic change in critically ill patients with COVID-19 and evaluate its predictive capability for clinical outcomes alongside immunological and hematological parameters. In this study, anal swabs were consecutively collected from 192 COVID-19 patients (583 samples) upon hospital admission for metagenome sequencing. Simultaneously, blood samples were obtained to measure the concentrations of 27 cytokines and chemokines, along with hematological and biochemical indicators. Our findings indicate a significant correlation between the composition and dynamics of gut microbiota with disease severity and mortality in COVID-19 patients. Recovered patients exhibited a higher abundance of Veillonella and denser interactions among gut commensal bacteria compared to deceased patients. Furthermore, the abundance of gut commensal bacteria exhibited a negative correlation with the concentration of proinflammatory cytokines and organ damage markers. The gut microbiota upon admission showed moderate prognostic prediction ability with an AUC of 0.78, which was less effective compared to predictions based on immunological and hematological parameters (AUC 0.80 and 0.88, respectively). Noteworthy, the integration of these three datasets yielded a higher predictive accuracy (AUC 0.93). Our findings suggest the gut microbiota as an informative biomarker for COVID-19 prognosis, augmenting existing immune and hematological indicators.

Investigating the Electrolyte Changes of COVID-19 Patients Admitted to the Intensive Care Unit

Background and Objectives Serum electrolyte imbalance is very common in COVID-19 patients. However, there is conflicting evidence regarding their relationship with COVID-19 and its severity, and their prognostic value is unknown. Our aim of this study is to investigate electrolyte changes in COVID-19 patients admitted to the intensive care unit of Imam Khomeini Hospital in Ahvaz. Subjects and Methods The present study is a cross-sectional and descriptive-analytical epidemiological type that was conducted in 1400. The target population was the COVID-19 patients admitted to the intensive care unit of Imam Khomeini Hospital in Ahvaz. Required tests were performed on all patients admitted to the special care department and diagnostic tests including Ca, K, Na, Cr, BUN, Mg, and P were collected and the effect on the prognosis of patients including intubation, mortality and extubating and discharge from the ward and The hospital was registered. Then the data were analyzed by SPSS 22 software and appropriate statistical tests. Results Finally, 87 people were included in the study. Hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia, Cr, and high BUN respectively in 2.55%, 3.4%, 6.27%, 8.59%, 8.82%, 5.5%, patients with covid- 19 were observed. There was a significant difference between the two groups of men and women and the average potassium was higher in women than in men (P=0.041). No significant relationship was found between other electrolytes and the variables of age, gender, history of disease, intubation, discharge, and mortality (P>0.05). Conclusion The present study showed that electrolyte imbalance is one of the common laboratory abnormalities in COVID-19 disease.

The effects of Annual SZ drug on dynamic changes in lymphocytes and cytokines of COVID-19 patients: A randomized clinical trial

BackgroundThe search for a potent anti-coronavirus therapy has remained an overwhelming task since the outbreak of COVID-19. Annual SZ is a novel formulation of artemisinin and its derivatives. We aim to investigate the effect of Annual SZ on clinical outcomes, cellular immune responses, and cytokine changes in COVID-19 patients. MethodsThis study included 80 COVID-19 hospitalized patients, which were randomly allocated into two groups (intervention and control). Both groups received standard supportive treatment. In addition, the intervention group (n = 40) received Annual SZ syrup, and the control group (n = 40) received a placebo. Dynamic changes in lymphocytes, cytokines, and clinical status were evaluated since hospital admission to 7 and 14 days after treatment. ResultsThe dynamic count of total T lymphocytes and T lymphocyte subsets (CD4+ and CD8+) in the Annual SZ group was significantly higher than the placebo group (p < 0.05). In addition, Programmed Death 1 (PD-1) was significantly increased in the CD4+ and CD8+ T cells in the placebo group compared with the Annual SZ group (p < 0.05). Also, the CD4+/CD8+ ratio was not significantly different between the groups (p > 0.9). Moreover, IL-6 levels were significantly reduced (p < 0.05), while IL-4 and IFN-γ levels were not statistically different between the two groups (p > 0.05). ConclusionThis research indicated that the Annual SZ syrup significantly improved clinical status and lymphocyte frequency with less exhaustion of T lymphocytes and a reduction of inflammatory responses, which seems to be beneficial in the treatment process of COVID-19 patients.

COVID-19-related health utility values and changes in COVID-19 patients and the general population: a scoping review.

To summarise the diverse literature reporting the impact of COVID-19 on health utility in COVID-19 patients as well as in general populations being affected by COVID-19 control policies. A literature search up to April 2023 was conducted to identify papers reporting health utility in COVID-19 patients or in COVID-19-affected general populations. We present a narrative synthesis of the health utility values/losses of the retained studies to show the mean health utility values/losses with 95% confidence intervals. Mean utility values/losses for categories defined by medical attendance and data collection time were calculated using random-effects models. In total, 98 studies-68 studies on COVID-19 patients and 30 studies on general populations-were retained for detailed review. Mean (95% CI) health utility values were 0.83 (0.81, 0.86), 0.78 (0.73, 0.83), 0.82 (0.78, 0.86) and 0.71 (0.65, 0.78) for general populations, non-hospitalised, hospitalised and ICU patients, respectively, irrespective of the data collection time. Mean utility losses in patients and general populations ranged from 0.03 to 0.34 and from 0.02 to 0.18, respectively. This scoping review provides a summary of the health utility impact of COVID-19 and COVID-19 control policies. COVID-19-affected populations were reported to have poor health utility, while a high degree of heterogeneity was observed across studies. Population- and/or country-specific health utility is recommended for use in future economic evaluation on COVID-19-related interventions.

Morphological abnormalities of peripheral blood cells among patients with COVID-19 disease

PurposeThe hematological changes in COVID-19 patients continue to receive great attention, especially in the field of public health. To our knowledge, coronavirus disease may be identified based on the severity of illness, and the study of peripheral blood smears may offer important information to facilitate the identification. Thus, we evaluated the morphological abnormalities (atypical and immature lymphocytes, lymphocytes with micronuclei, various nuclear abnormalities among erythrocytes) and quantitative changes in peripheral blood cells among 48 individuals with COVID-19 disease. MethodsThe present study is a retrospective analysis of 48 individuals, including 24 hospitalized patients diagnosed with COVID-19 disease. The blood smears of all patients were subjected to a hematological examination to identify various morphological abnormalities in white and red blood cells. In addition, a micronucleus test was conducted to assess the incidence of chromosomal damage in lymphocytes. Furthermore, the complete blood count (CBC) was performed to evaluate changes in peripheral blood cells, particularly the differential total leukocyte count, which could indicate the immune response against viral infection in COVID-19 patients. ResultsThe findings of the hematological study conducted on patients diagnosed with COVID-19 disease revealed neutrophilia, eosinophilia, mild monocytosis, decreased hematocrit level, elevated erythrocyte sedimentation rate (ESR), and immature leukocytes. It was observed that patients who were infected with coronavirus demonstrated mild thrombocytopenia. Furthermore, the micronucleus test indicated the presence of immature cells with micronuclei among lymphocytes and numerous nuclear abnormalities in red blood cells. These results help to shed light on the hematological changes that occur in COVID-19 patients, and could potentially contribute to the development of more effective treatments for the disease. ConclusionsThe examination of complete blood counts (CBCs) in conjunction with peripheral blood smears offers a potential means of identifying the impact of SARS-CoV-2 infection on the hematopoietic and immune systems, thereby providing early indications of inflammation. Based on a study, it has been suggested that SARS-CoV-2 may affect red and white blood cells causing morphological alterations thereby establishing a corresponding relationship with disease severity.

Olfactory Bulb Volume and Morphology Changes in COVID-19 Patients With Olfactory Disorders Using Magnetic Resonance Imaging.

The aims of the study are to explore the morphological changes of olfactory bulb (OB) and olfactory sulcus in COVID-19 patients with associated olfactory dysfunction (OD) by measuring the OB volume (OBV) and olfactory sulcus depth (OSD) and to compare the measurement values with those of healthy individuals. Between March 2020 and January 2022, 31 consecutive hospitalized patients with a diagnosis of COVID-19 with anosmia and hyposmia who underwent brain magnetic resonance imaging and 35 normosmic control individuals were retrospectively included in the study. Bilateral OBV and OSD were measured and shape of the OB was determined based on the consensus by a neuroradiologist and an otorrhynolaryngologist. The mean measurements for the right and the left sides for OBV (38 ± 8.5 and 37.1 ± 8.4, respectively) and OSD (7.4 ± 0.1 and 7.4 ± 1.0 mm, respectively) were significantly lower in COVID-19 patients with OD than those in control group (for the right and the left sides mean OBV 56.3 ± 17.1 and 49.1 ± 13.5, respectively, and mean OSD 9.6 ± 0.8 and 9.4 ± 0.8 mm, respectively). Abnormally shaped OB (lobulated, rectangular, or atrophic) were higher in patient group than those of controls.For the optimal cutoff values, OBV showed sensitivity and specificity values of 90.32% and, 57.14%, for the right, and 87.1% and 62.86% for the left side, respectively (area under the curve, 0.819 and 0.780). Olfactory sulcus depth showed sensitivity and specificity values of 90.32% and 94.29%, for the right, and 96.77% and 85.71%, for the left side, respectively (area under the curve, 0.960 and 0.944). Decrease in OBV and OSD measurements in COVID-19 patients with OD at the early chronic stage of the disease supports direct damage to olfactory neuronal pathways and may be used to monitor olfactory nerve renewal while returning back to normal function.

Early decrease in blood lymphocyte count is associated with poor prognosis in COVID-19 patients: a retrospective cohort study

BackgroundPrevious studies have declared that baseline lymphocyte count is associated with COVID-19-related death. However, whether dynamic lymphocyte change over time affects prognosis in COVID-19 patients is unknown. This study aims to investigate the significance of lymphocyte count during the progression of the disease in COVID-19 patients.MethodsThe retrospective cohort study recruited COVID-19 patients at the First People’s Hospital of Jiangxia District in Wuhan from January 7, 2020, to February 28, 2020. The demographics, medical histories, results of the blood routine test, and patients’ outcomes were collected. We utilized a generalized additive mixed model to compare trends in lymphocyte count over time among survivors and non-survivors, with an adjustment for potential confounders. The statistical analysis used R software and EmpowerStats. Significance was determined at a P-value of less than 0.05 (two-sided).ResultsA total of 532 patients were included in the study. Overall, there were 29/532 in-hospital deaths (5.45%). Lymphocytes declined over time in the non-survivor group and increased in the survivor group in the first 10 days of hospitalization. Within 10 days after admission, lymphocyte count increased in the survivor group and decreased in the non-survivor group. The difference in lymphocyte counts between survivors and non-survivors increased by an average of 0.0732 × 109/L daily. After adjusting for several covariables, the increasing value remained at 0.0731 × 109/L per day.ConclusionIn the early stage, lymphocyte count can dynamically reflect the pathophysiological changes in COVID-19 patients. An early decrease in lymphocyte count is associated with mortality in COVID-19 patients.

Urea Cycle and Arginine Metabolic Changes in COVID-19 Patients

Urea Cycle and Arginine Metabolic Changes in COVID-19 Patients

Simulation of optimal dose regimens of photoactivated curcumin for antimicrobial resistance pneumonia in COVID-19 patients: A modeling approach.

Secondary antimicrobial resistance bacterial (AMR) pneumonia could lead to an increase in mortality in COVID-19 patients, particularly of geriatric patients with underlying diseases. The comedication of current medicines for AMR pneumonia with corticosteroids may lead to suboptimal treatment or toxicities due to drug-drug interactions (DDIs). This study aimed to propose new promising dosage regimens of photoactivated curcumin when co-administered with corticosteroids for the treatment of antimicrobial resistance (AMR) pneumonia in COVID-19 patients. A whole-body physiologically-based pharmacokinetic (PBPK) with the simplified lung compartments model was built and verified following standard model verification (absolute average-folding error or AAFEs). The pharmacokinetic properties of photoactivated were assumed to be similar to curcumin due to minor changes in physiochemical properties of compound by photoactivation. The acceptable AAFEs values were within 2-fold. The verified model was used to simulate new regimens for different formulations of photoactivated curcumin. The AAFEs was 1.12-fold. Original formulation (120 mg once-daily dose) or new intramuscular nano-formulation (100 mg with a release rate of 10/h given every 7 days) is suitable for outpatients with MRSA pneumonia to improve patient adherence. New intravenous formulation (2000 mg twice-daily doses) is for hospitalized patients with both MRSA and VRSA pneumonia. The PBPK models, in conjunction with MIC and applied physiological changes in COVID-19 patients, is a potential tool to predict optimal dosage regimens of photoactivated curcumin for the treatment of co-infected AMR pneumonia in COVID-19 patients. Each formulation is appropriate for different patient conditions and pathogens.

Gene expression changes in COVID-19 patients impact pathways related to circadian rhythm, phosphatidylinositol signaling, cytokine storm, and platelet aggregation

The emergence of SARS-CoV-2 and the resulting COVID-19 disease pandemic had a grave impact on human society causing severely ill patients were to be placed on mechanical ventilators. The severity of the disease depended on such factors as age and the presence of pre-existing conditions. Although with the earnest effort, vaccines have been developed against the disease, there is still a long way to go to completely eradicate COVID-19. Currently, there are concerns about the complications associated with COVID-19 patients and associated conditions. This research aimed to find correlation between gene expression profiles of COVID-19 patients and factors such as age, severity, and mechanical ventilators. To do this, we probe COVID-19 patient data for dysregulated genes and pathways in severe disease. The relevant data was selected from the Gene Expression Omnibus (GEO) datasets GSE152418, GSE171110 and GSE157103. We identified differentially expressed genes (DEGs) between defined groups: COVID-19 patients and control individuals, severe ill and moderately ill COVID-19 patients, young (<40 years) and old (>70 years), and patients who require versus do not require mechanical ventilation. Analyses of over-represented pathways among DEGs and identification of enriched gene sets among cohorts provided further etiological insights. The impact of DEGs on protein-protein interactions (PPIs) between products of these genes were evaluated. The results highlight pathways related to immune response as well as inflammation, cancer, circadian clock, and PI signaling in COVID-19 patients. Key genes regulating circadian clock and PI signaling were downregulated, however, various genes and proteins regulating inflammation and cancer were upregulated in the COVID-19 patients. The product of the up-regulated gene, FLT3, which promotes phosphorylation of STAT5A/STAT5β, resulting in increased cytokine production is connected to VAV1 and TET proteins which play a role in cytokine production. Among old patients, besides pathways related to inflammation and the immune system, pathways such as platelet activation, signaling and aggregation as well as extracellular matrix organization were affected by gene expression dysregulation. In patients requiring mechanical ventilation, pathways impacted include PD-1 signaling, TCR signaling, translocation of ZAP-70 to immunological synapse, and phosphorylation of CD3 and TCR zeta chains. These observations shed insights into relevant genes and pathways impacting COVID-19 patients.

Effect of Breathing Exercises on Spo2 Levels and Pulse Rate in Covid-19 Patients

The impact of COVID-19 grew worse by its quick onset, the overwhelming number of patients in need of urgent care, and the lack of awareness of its signs beforehand. It mostly affected the respiratory system, making respiratory rehabilitation extremely important. This study was carried out to see the effectiveness of breathing exercises along with the postural changes in COVID-19 patients under acute hospital care. A total of 40 subjects with age group between 18 years to 60 years, diagnosed with COVID-19 were included according to the selection criteria and were divided into 2 equal groups of 20 subjects each. The subjects in Group A received positioning protocol while those in Group B received breathing exercises along with positioning protocol. After 7 days of intervention, the mean SpO2(88.6% vs 89.9%, P&lt;0.001) and pulse rate (82 vs 91 beats/minute, P&lt;0.001) for Group A and Group B respectively. This study concluded that breathing exercises along with postural changes in patients hospitalized with COVID-19 is an effective rehabilitation program for improving SPO2 levels and pulse rate. KEYWORDS: Breathing exercises, COVID-19, Postural changes, Respiratory rehabilitation.

CASE REPORT: BRUGADA- LIKE ECG PATTERN IN PATIENT AFTER SUCH AS LONG-TERM OUTCOME OF COVID-19

This article presents a clinical case of a patient who developed a Brugada-like electrocardiogram (ECG) pattern as a delayed complication after recovering from COVID-19. Brugada syndrome is a rare genetic disorder characterized by abnormal changes on the ECG and an increased risk of sudden cardiac death. Although the association between COVID-19 and cardiovascular complications is well-studied, the development of Brugada-like ECG changes in COVID-19 patients is a rare occurrence. This clinical case emphasizes the importance of early detection and appropriate management of cardiac complications in patients recovering from COVID-19, including the development of Brugada-like ECG changes. Consideration of these factors is crucial for optimal patient care and reducing the risk of sudden cardiac death.

COVID-19-Induced Changes in Photoplethysmography.

Photoplethysmography (PPG) is the science behind many commonly used medical devices such as the pulse oximeter. PPG changes, herein as "PPG dropouts," have been described in existing in vitro studies following artificially induced clot activation. Because COVID-19 causes increased arterial, venous, and microvascular clot formation, our hypothesis is that PPG dropouts identified in vitro can also be found in vivo in patients with COVID-19. The aim of this study is to evaluate PPG recordings and D-dimer levels for patients hospitalized with COVID-19 and compare them with the PPG tracings from non-COVID controls. PPG recordings were obtained for 197 ICU patients with COVID-19 and 300 non-COVID controls. PPG tracings were obtained using a TigerTech CovidPlus monitor, which received U.S. FDA emergency use authorization in March 2020 for monitoring the biometrics of patients with COVID-19 and featured unfiltered red and infrared spectrum PPG monitoring. D-dimer lab results were also recorded whenever available. The results demonstrated significant differences in the prevalence rate of PPG dropout among patients with COVID-19 vs. non-COVID controls. The median PPG dropout rate was 0.58 for COVID-19 patients (median 0.58, IQR 0.42-0.72, P < .05) as opposed to a median 0.0 for non-COVID patients (median 0.0, IQR 0.0-0.0, P < .05). Furthermore, at least one incidence of PPG dropout was detected in 100% of COVID-19 patients, as opposed to 2.3% of non-COVID controls (P < .05). PPG dropout also correlated closely with the normalized serum D-dimer levels taken on the same day. The change in the normalized D-dimer levels was plotted against the change in PPG dropout, and a line of best fit was created. Linear regression resulted in R2 = 0.743 (P < .05), indicating that changes in the PPG dropout rate correlate with hemorheological changes in COVID-19 patients. PPG dropout, like D-dimer, may not be specific for COVID-19. However, the inflammatory nature of the disease and the prevalence of prolonged ICU created a large sample size and allowed the authors to observe PPG changes in vivo in a statistically meaningful way. Further confirmatory studies are needed to confirm the potential application of PPG dropout as a measure of inflammation in other disease processes.

Electrocardiographic Changes among Moderate and Severe COVID-19 Patients in a Tertiary Care Teaching Hospital at Shahdol, Madhya Pradesh, India: A Record-based Study

Introduction: Electrocardiographic (ECG) abnormalities in Coronavirus Disease 2019 (COVID-2019) patients are largely unknown. ECG changes in COVID-19 disease may guide to initiate therapeutic anticoagulation, more so in moderate and severe disease. Aims: To identify various ECG changes in moderate and severe COVID-19 patients and to ascertain the association between initial ECG changes and disease outcome. Materials and Methods: This was retrospective record-based study was conducted in the Department of Internal Medicine, Birsa Munda Medical College, Shahdol, Madhya Pradesh, India, on 216 patients with laboratory-confirmed COVID-19 in a tertiary care teaching hospital from March 2021 to June 2021. Demographic and clinical data including ECG were extracted from medical records of the patients and if needed, the patients were followed-up till outcome. COVID-19 disease severity was considered based on oxygen saturation at room air (moderate: 94%-90%; severe: &lt;90%). Data were entered using the Epicollect5 mobile application to minimise errors. Results: A total of 216 patients were included (35 to 54 years), the majority were male. Mortality rate was 46.3%. Total 57.4% of ECG changes were classified as abnormal. Sinus tachycardia was the most common abnormality followed by ischaemic changes. Left axis deviation in ECG was more commonly seen than right axis deviation. Total 53.2% of patients with abnormal ECG findings and 36.9% with normal ECG findings died. Mortality was very high in patients with ischaemic changes. Conclusion: COVID-19 patients with ischaemic changes in ECG were significantly associated with increased mortality. Hence, early detection of these changes in COVID-19 patients is vital and will help primary care physicians to intervene early and help in deciding therapeutic anticoagulation requirements in patients with COVID-19.

Peripheral blood lymphocyte subset count in COVID-19 patients

Abstract Background: (COVID-19) pathophysiology and the predictive factors are not fully understood, but lymphocyte dysregulation appears to play a role. Aim and Objectives: To explore the clinical value of lymphocyte subset changes in COVID-19 patients’ peripheral blood, which may illustrate the pathogenesis of COVID-19. Methods: This is prospective cohort study of 73 hospitalized patients with confirmed COVID-19 who were classified into two groups: non-severe and severe. Lymphocyte subsets (CD3, CD4, CD8, CD19, and CD56) were assessed using flow cytometry. Results Lymphocyte gate, CD3, CD4, CD8, and CD56 counts were significantly reduced in severe cases compared with nonsevere cases (P0.001, 0.006, 0.016, 0.011, and 0.008 respectively). Patients were divided into two groups according to cut off age (&lt;50 and ≥ 50years) and (NLR) (NLR &lt;4.14 and NLR ≥ 4.14). There was a significant difference in severe illness probability in two groups P0.001 and 0.001 respectively). Then, patients were divided into four groups by both NLR cutoff and age, There also significant difference in severe illness probability between four groups (P&lt;0.001). Conclusion Based on our data, management of patients with COVID-19 pneumonia can be improved based on NLR and age model. We suggest that patients with NLR ≥ 4.14 should be admitted to isolation ward with close follow-up and actively transfer to intensive care unit.

Изменения показателей агрегатограммы у пациентов с COVID-19 под воздействием клопидогреля и аспирина

Изменения показателей агрегатограммы у пациентов с COVID-19 под воздействием клопидогреля и аспирина

A study on the morbid histopathological changes in COVID-19 patients with or without comorbidities using minimally invasive tissue sampling.

COVID-19 causes morbid pathological changes in different organs including lungs, kidneys, liver, and so on, especially in those who succumb. Though clinical outcomes in those with comorbidities are known to be different from those without-not much is known about the differences at the histopathological level.To compare the morbid histopathological changes in COVID-19 patients between those who were immunocompromised (Gr 1), had a malignancy (Gr 2), or had cardiometabolic conditions (hypertension, diabetes, or coronary artery disease) (Gr 3),postmortem tissue sampling (minimally invasive tissue sampling [MITS]) was done from the lungs, kidney, heart, and liver using a biopsy gun within 2 hoursof death. Routine (hematoxylin and eosin) and special staining (acid fast bacilli, silver methanamine, periodic acid schiff) was done besides immunohistochemistry.A total of 100 patients underwent MITS and data of 92 patients were included (immunocompromised: 27, malignancy: 18, cardiometabolic conditions: 71). In lung histopathology, capillary congestion was more in those with malignancy, while others like diffuse alveolar damage, microthrombi, pneumocyte hyperplasia, and so on,were equally distributed. In liver histopathology, architectural distortion was significantly different in immunocompromised; while steatosis, portal inflammation, Kupffer cell hypertrophy, and confluent necrosis were equally distributed. There was a trend towards higher acute tubular injury in those with cardiometabolic conditions as compared to the other groups. No significant histopathological difference in the heart was discerned.Certain histopathological features were markedly different in different groups (Gr 1, 2, and 3) of COVID-19 patients with fatal outcomes.

STUDY OF HEMATOLOGICAL PARAMETERS IN PATIENTS WITH COVID-19 DISEASE IN KURDISTAN REGION-IRAQ

&nbsp; Background: Coronavirus disease 2019 is an infectious disease that was found at the end of 2019. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was recognized as the virus that leads to COVID-19. The study was directed to find out the hematological parameter changes in COVID-19 patients according to the severity of the disease. Methods: The study has been done in two centers Sulaymaniyah and Duhok Governorates for a period of six months between September 2021 to March 2022. A total of 201 enrolled patients were included. For each patient demographic characteristics and blood test results (total and differential WBC, Hb, platelet, ferritin, CRP, D-dimer, NLR, PLR) were collected, following the severity of the disease and the outcome of each one of the patients. SPSS software was used for statistical analysis. Results: The study revealed that female patients were more than males 60.2% and 39.8% respectively with an overall mean age of 54.65±17 years. The mean duration of hospitalization is 14.4 ± 7.7 days. Furthermore, the study showed that patients had 30.8% leukocytosis,17.4% lymphopenia, and 31.8% neutrophilia. Higher NLR and PLT are seen in severe cases with NLR ≥3.1and PLR ≥ 285. Also, high levels of CRP, D-dimer, and ferritin were seen in severe COVID-19 patients. Conclusions: Changes in hematological parameters can be useful in predicting of the disease severity of COVID-19 patients.