Comparative analysis of clinical and biological characteristics of COVID-19 patients: A retrospective cohort study.

Background: Coronavirus disease (COVID-19), caused by a betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly evolved into a pandemic since it was first reported in December 2019. thus, SARS-CoV-2 has become a major global public health issue. Objective: The objective of this work is to compare demographics, comorbidities, clinical symptoms, biology and imaging findings between severe and non-severe COVID-19 patients and to identify clinical and biological risk factors and biomarkers for the development of severe COVID-19 as well as predictive thresholds for severity in order to best rationalize management and decrease the morbidity and mortality caused by this condition. Patients and methods: This is a single-center retrospective study, from June 25 to December 31, 2021, on 521 patients at the level of the unit COVID-19 of the central laboratory of the Mohammed VI University Hospital Center Oujda, then classified into two groups according to the severity of the disease. Results: Out of a total of 521 patients, a severe group including 336 cases (64.5%) and a non-severe group with 185 cases (35.5%). Hypertension, diabetes and obesity were noted in the majority of patients. Severe COVID-19 cases had higher C-reactive protein, procalcitonin, D-dimer, ferritin, elevated white blood cell count, and lower lymphocyte count than non-severe cases with a significant difference between the two groups. The areas under the curve (AUC) for C-reactive protein, procalcitonin and D-dimer were 0.886, 0.708, and 0.736 respectively. The optimal thresholds predictive of severity were 105 mg/l for C-reactive protein, 0.13 ng/ml for procalcitonin, 7420/µl for white blood cell count, and 0.55 mg/l for D-dimer. Conclusion: Comparison of the proportion of clinical, biological and radiological data between severe and non-severe cases of COVID-19, as well as identification of biomarkers for the development of severe form in the present study, will allow optimal streamlining of management with rapid triage of patients.

Value of hematological parameters for predicting patients with severe coronavirus disease 2019: a real-world cohort from Morocco.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute respiratory syndrome coronavirus 2. The clinical manifestations and the evolution of patients with COVID-19 are variable. In addition to respiratory involvement, COVID-19 leads to systemic involvement and can affect the hematopoietic system. This study aimed to evaluate the prognostic value of hematological and hemocytometric parameters in predicting the severity of patients with COVID-19. METHODS: We performed a retrospective study at Mohammed VI university Hospital from 1 March to 11 November 2020. We collected demographic characteristics and hematological findings of incident COVID-19 cases. RESULTS: A total of 245 patients were included in our study. We found that the rate of lymphopenia was significantly reduced in patients who were severely affected by COVID-19. Additionally, the rate of neutrophilia, the neutrophil side fluorescence light signal, monocyte fluorescent intensity, monocyte size, the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio, and the lymphocyte-to-monocyte ratio were significantly elevated in patients who were severely affected by COVID-19. CONCLUSIONS: These results are consistent with the literature regarding the predictive value of these markers. A prospective validation in a large population with a longer follow-up is required.

Visceral leishmaniasis associated with macrophage activation syndrome: Case report and literature review.

BACKGROUND: The combination of visceral leishmaniasis (VL) and macrophage activation syndrome (MAS) makes the diagnosis difficult due to their similar clinical presentation, with a poor prognosis especially since the treatment is still poorly codified.We report the case of a 17-month-old female patient from Berkane, presenting for a 3 months history of anarchic fever with anemic syndrome made up of pallor and hemorrhagic syndrome made up of epistaxis. Physical examination revealed a temperature of 39 ° C, lower limbsedema, paleness of skin and mucous membranes, gingival petechiae, bleached hair, and hepatosplenomegaly. CASE PRESENTATION: The complete blood count showed pancytopenia with deep aregenerative normochromic normocytic anemia at 3 g/dL, leukocytes were at 4860/mm 3 with neutropenia at 680/mm 3 and thrombocytopenia at 12.000/mm3, the blood smear was without abnormality. These anomalies were associated with a hypoalbunemia, hypertriglyceridemia, hyperferritinemia, lactate dehydrogenase (LDH) level was at 337 IU/L, low prothrombin time (PT) at 56 % and fibrinogen level at 1 g/L. The direct Coombs test was positive. Examination of the myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis. A diagnosis of visceral leishmaniasis associated with MAS was made.The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution and good therapeutic tolerance. CONCLUSION: The association of VL and MAS remains rare and should be evoked even in non-endemic areas since late diagnosis worsens the prognosis and may even be responsible for the death of patients despite an aggressive treatment.