Hematological changes in SARS-COV-2 positive patients

Abstract Introduction The novel SARS-CoV-2 infection has been spreading around the world since January 2020 causing the Corona Virus Disease 2019. Leukopenia, lymphopenia and hypercoagulability with elevated D- Dimers have been described in COVID-19 patients to date. This study aimed to clarify if some blood parameters can be used as biomarkers to facilitate diagnosis and establish prognosis. Methods: We selected patients who had tested positive for SARS-CoV-2 and had had a hemogram performed between the March 15 and April 15, 2020. Socio-demographic and analytical data were obtained from 274 patients at admission in two Portuguese public hospitals. We then analyzed the hemogram parameters at admission in the intensive care and collected data on patient survival during the SARS-CoV-2 disease follow-up. The data were analyzed using appropriate statistical tests. Results: Patients requiring the intensive care unit (ICU) present an increase in leukocytes and neutrophils (+3.1 × 109/L and +6.4 × 109/L, respectively), a lymphocyte decrease and a platelet rise (-1.6 × 109/L and +60.8 × 109/L, respectively). The erythrocytes, hemoglobin and median globular volume tend to decrease (-0.5 × 1012, - 1.2 g/dL; -3 fL, respectively). The lactic acid dehydrogenase (LDH) at admission was significantly higher (+58.1 U/L). The age, sex, platelets, lymphocyte count neutrophil counts, neutrophil/lymphocyte ratio, erythrocytes and cell hemoglobin concentration mean (CHCM) are independently associated with mortality (odds ratio (OR) = 0.046, p < 0.001; OR = 0.2364, p= 0.045; OR = 9.106, p= 0.001; OR = 0.194, p= 0.033; OR = 0.062, p= 0.003; OR = 0.098, p= 0.002; OR = 9.021, p < 0.001; OR = 7.016, p= 0.007, respectively). Conclusion The hematological data at admission in the health care system can predict the mortality of the SARS-CoV-2 infection and we recommend its use in the clinical decisions and patient prognosis evaluation.

Hematological, clinical and epidemiological aspects of Hepatozoon canis infection by parasitological detection in dogs from the rural area of Sousa, Paraíba, Brazil / Aspectos hematológicos, clínicos e epidemiológicos da infecção por Hepatozoon canis por detecção parasitológica em cães da zona rural de Sousa, Paraíba, Brasil

ABSTRACT: Hepatozoonosis is caused by protozoa of the genus Hepatozoon. In dogs, the infection is caused mainly by Hepatozoon canis, and there are a few descriptions of the prevalence of this infection in the Northeast region of Brazil, especially in the semi-arid region. Therefore, we aimed to determine the prevalence of Hepatozoon canis infection in dogs in the rural area of ​​Sousa, Paraíba, Brazil, as well as to determine the possible clinical and epidemiological aspects of this infection. Ninety-eight dogs in the rural zone of the municipality of Sousa that were at least 4 months old were evaluated, regardless of their breed or gender. Clinical examinations were carried out, and samples of systemic and peripheral blood were collected to determine the presence of the parasite in blood smears and carry out hemograms. In addition, epidemiological questionnaires about animal health and food management were completed. The prevalence of H. canis infections in dogs was 8.1% (8/98). There were three main changes in the hematological status: thrombocytopenia, anemia and hyperproteinemia, mainly related to percentage of leukocyte infection ≥5%, and also to the presence of clinical signs such as mucopurulent secretion, lymphadenomegaly, dry skin, pale mucous membranes, and lean or cachectic body score.

RESUMO: A hepatozoonose é causada por protozoários do gênero Hepatozoon. Em cães, a infecção ocorre principalmente por Hepatozoon canis, sendo escassas as descrições de prevalências desta infecção na região Nordeste do Brasil, sobretudo no Semiárido. Com isso, o trabalho objetivou determinar a prevalência da infecção por Hepatozoon canis em cães da zona rural do município de Sousa, Paraíba, Brasil, como também determinar possíveis sinais clínicos e aspectos epidemiológicos relacionados à esta infecção. Foram avaliados 98 cães da zona rural do município de Sousa, independentemente da raça ou sexo, com idade superior a quatro meses. Foram realizados exames clínicos e colhidas amostras de sangue sistêmico e periférico para a pesquisa do parasito em esfregaços sanguíneos e hemogramas. Além disso, foram preenchidos questionários epidemiológicos acerca do manejo sanitário e alimentar dos animais. A prevalência de cães positivos para H. canis foi de 8,1% (8/98). Foram observados três principais alterações no quadro hematológico, sendo trombocitopenia, anemia e hiperproteinemia, principalmente relacionadas ao percentual de leucócitos infectados ≥ 5%, e também à presença de sinais clínicos, como secreção mucopurulenta, linfadenomegalia, pelos ressecados, mucosas hipocoradas e escore corporal magro ou caquético.

Hematological Changes in HCV Patients Treated with Different Sofosbuvir-Based Regimens

Introduction: Treatment of HCV with direct acting antiviral agents (DAAs) with the different regimen dramatically changed the outcomes of the disease beside its eradication. In the same time hematological concerns as anemia, thrombocytopenia, and leucopenia were a major factor before initiation, or during treatment with the antiviral drugs.Aim: To demonstrate hematological changes during and after treatment with different regimen of DAAs.Methods: Follow up the hematological changes before, during and after treatment for 100 patients with chronic HCV treated with five different sofosbuvir-based regimen; using interferon, ribavirin, simeprevir and daclatasvir.Results: There are no similar linear changes regarding anemia, leucopenia or thrombocytopenia, however, combination therapy using sofosbuvir with simeprevir or daclatasvir significantly increase platelets count, WBCs, and hemoglobin level during and after end of treatment, versus regimens uses sofosbuvir with ribavirin and or interferon that showed significantly decreased hematological values during and after treatment.Conclusion:Sofosbuvir-based regimen has favorable hematological changes in patients with chronic HCV infection during and after treatments especially with sofosbuvir and daclatasvir

Hematological Profile And Serum Potassium Level In Patients Of Chronic Renal Failure At A Tertiary Health Care Center

Background: Chronic Kidney Disease (CKD) can be defined as an estimated glomerular Filtration Rate (eGFR) of less than 60 ml/min/1.73 m2for a minimum period of three months. CKD is commonly associated with various hema-tological abnormalities especially anemia. Aim: The present study was planned to assess the hematological variations in CKD patients as compared to healthy subjects. Method: Fifty patients diagnosed with CKD were enrolled for the study. Fifty age and sex-matched healthy subjects constituted the control group. Blood samples were collected for all subjects enrolled in the study and subjected to analysis including complete blood count (CBC) using five parts cell counter and renal function test (RFT), including urea, creatinine using dry chemistry, and potassium using direct ion-selective electrode method. Result: On comparison of the hematological profile, it was observed that all enrolled CKD patients were anemic with hemoglobin (Hb) less than 13g/dL in males and less than 12 g/dL in females. The mean Hb levels were as low as 7.50 ± 1.55 g/dL (P< 0.0001). Correspondingly, total RBC count of CKD patients was also low. It was also observed that platelet count was slightly low among CKD patients. However, the mean level was compara-ble with control group (P=NS). On further analysis, it was observed that among fifty CKD patients, 46% (n=23) suf-fered from severe anemia i.e. Hb < 7 gm/dL, whereas 48% had moderate anemia i.e. Hb between 7-9.9 gm/dL. How-ever, only 12 % (n=6) CKD patients suffered from thrombocytopenia i.e. platelets count < 1.50 lack/cmm. Conclu-sion: Hematological abnormalities may lead to several associated morbidities and may pose a challenge for mainte-nance of overall health status for CKD patients. Hence, there is need to monitor hematological profile of CKD patients specially those on dialysis so that any abnormality can be detected and managed accordingly.

Alterações hematológicas, hemostáticas e bioquímicas induzidas pela clofazimina e claritromicina, em doses única e múltiplas, em ratos / Hematological, hemostatic and biochemical alterations induced by clofazimine and clarithromycin, in single and multiple doses, in rats

Claritromicina e clofazimina têm sido utilizadas no tratamento da hanseníase, tuberculose e infecções causadas pelo complexo Mycobacterium avium. Como os dados sobre a toxicidade de esquemas terapêuticos que incluem estes fármacos são escassos, este estudo teve como objetivo determinar os efeitos adversos destas terapias, por meio da avaliação dos parâmetros hematológicos, hemostáticos e bioquímicos. Os fármacos foram administrados em ratos machos Wistar, em monoterapia, em regime de doses única e múltipla. Claritromicina provocou aumento de leucócitos mono e polimorfonucleares. Ambos os fármacos inverteram a proporção entre células mono e polimorfonucleares e provocaram aumento do número de células polimorfonucleares e células em degeneração. Clofazimina e claritromicina prolongaram o tempo de protrombina e claritromicina também prolongou o tempo de tromboplastina parcial ativa. Claritromicina causou aumento de bilirrubinas total e direta e, ambos os fármacos, elevaram os níveis plasmáticos de gama-glutamiltransferase. Portanto, clofazimina e claritromicina induzem alterações hematológicas, hemostáticas e hepáticas.

Clarithromycin and clofazimine have been used to treat leprosy, tuberculosis and infections caused by the Mycobacterium avium complex. Since there is a scarcity of data on the toxicity of therapeutic regimens that include these drugs, this study had the aim of determining the adverse effects of these therapies, through evaluation of hematological, hemostatic and biochemical parameters. The drugs were administered to male Wistar rats, as monotherapy, in regimens of single and multiple doses. Clarithromycin caused increases in the numbers of mononuclear and polymorphonuclear leukocytes. Both of the drugs inverted the proportions between mononuclear and polymorphonuclear cells and increased the numbers of polymorphonuclear cells and degenerating cells. Clofazimine and clarithromycin prolonged the prothrombin time and clarithromycin also prolonged the activated partial thromboplastin time. Clarithromycin caused increases in total and direct bilirubin. Both of the drugs increased the plasma levels of gamma-glutamyltransferase. Therefore, clofazimine and clarithromycin induce hematological, hemostatic and hepatic changes.

Investigations on the role of insulin and scorpion antivenom in scorpion envenoming syndrome

Acute myocardiopathy in alloxan treated experimental dogs and rabbits was induced by subcutaneous (SQ) injection of scorpion venom from Mesobuthus tamulus concanesis, Pocock. Envenoming resulted in an initial transient hypertension (180-320 mm Hg.) followed by hypotension. Simultaneous administration of venom and species-specific scorpion antivenom (SAV) prevented hypertension and hypotension. Hypotension did not occur when SAV was given 60 min after envenoming. Blood glucose, triglycerides, cholesterol, amylase, insulin, glucagon, cortisol, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet count, red blood cell (RBC) count, hemoglobin (Hb), 2,3-diphosphoglycerate (2,3-DPG), and glutathione levels were increased 60 and 90 min after envenoming. Total white blood cell (WBC) count was reduced 60 min and increased 90 min after envenoming. Simultaneous administration of venom and SAV did not alter Hb, MCHC, and packed cell volume (PCV) levels, or ECG, and cardiovascular, biochemical, metabolic, and hormonal changes. Hematological parameters were reversed when SAV was given 30 and 60 min after envenoming. PCV, Hb, and MCHC values returned to normal 120 min after SAV. Alloxan-treated dogs showed increased blood glucose, cholesterol, glucagon, cortisol levels; reduced glycogen content of liver, cardiac and skeletal muscles; and reduced insulin levels and insulin/ glucagon ratio (I/G ratio). Envenoming in the alloxan pre-treated dogs further increased these levels and reduced tissue glycogen content, insulin levels, and I/G ratio. Administration of 4 U of insulin to alloxan pre-treated envenomed rabbits caused a biochemical and clinical improvement and increased glycogen content of all tissues in comparison with the values from those administered with SAV to alloxan pre-treated envenomed animals. SAV administration to envenomed alloxan pre-treated rabbits did not cause clinical or biochemical improvement. Severe scorpion envenoming causes an autonomic storm with a massive release of catecholamines and other counter-regulatory hormones; changes in insulin secretion resulting in fuel energy deficits producing multi-system-organ-failure (MSOF); and death. Administration of either insulin or SAV (through the release of insulin) appears to be the physiological basis for the control of the metabolic support to control the adverse effects triggered by counter-regulatory hormones.