Clinical significance of viral markers testing by ELISA and Individual Donation Nucleic Acid Testing (ID-NAT) for blood screening in blood bank: Single center study in Egypt.

Prevention of transfusion-transmitted viral infections and insurance of safe blood transfusion are the main goals of all blood banks worldwide. Despite the high sensitivity and specificity of currently used enzyme linked immunosorbent assay (ELISA) for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) testing, viral transmission could still occur during the window period. Introducing viral individual donation nucleic acid testing (ID-NAT) can greatly decrease such risk providing an additional layer in securing blood transfusion. We aimed to assess the clinical significance of viral markers testing by ELISA and ID-NAT for blood screening in the Blood Bank of Suez Canal University Hospital. We studied all donations (2132) collected during a two-months period. Blood donor samples were screened by ELISA and ID-NAT tests for HBV, HCV, and HIV. Serological testing results for HCV by ELISA revealed 2,122 (99.5 %) negative donations compared to 2,131 (99.95 %) negative donations by ID-NAT testing. Of the positive ELISA samples, only one was NAT positive. For HBV ELISA testing, 2,115 (99.2 %) donations were negative, also by ID-NAT testing 2,115 (99.2 %) donations were HBV DNA negative. Out of the negative ELISA samples, two samples were ID-NAT reactive donors which were missed by serology assay being in the window period. HIV ELISA testing revealed negative 2,130 (99.9 %) donations while ID-NAT testing showed 2,131 (99.95 %) negative donations and one positive donation. In conclusion, this is the first study carried out in the Suez Canal and Sinai region, Egypt to assess the importance of ID-NAT implementation. The introduction of ID-NAT in blood banks is an effective method for increasing safety of the blood transfusion.

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.