RESUMEN
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to substantial morbidity and mortality worldwide. Hematological abnormalities are common in COVID-19 patients and play a significant role in disease pathogenesis and prognosis. OBJECTIVE: This study aimed to longitudinally monitor hematological parameters in COVID-19 patients and investigate their predictive value for disease severity and prognosis. METHODS: A prospective longitudinal design was employed to enroll 121 adult patients diagnosed with COVID-19 based on positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test results. Baseline demographic and clinical data were collected, and hematological parameters, including complete blood count (CBC) indices, inflammatory markers, and coagulation profiles, were measured at predefined time points during hospitalization or outpatient visits. Follow-up assessments were conducted longitudinally to monitor the disease progression and clinical outcomes. RESULTS: This study revealed dynamic changes in hematological parameters over the course of COVID-19. Hemoglobin levels showed a decrease from baseline (mean ± SD: 12.5 ± 1.8 g/dL) to the peak of illness (10.2 ± 2.0 g/dL), indicating the development of anemia during the acute phase of infection. White blood cell counts demonstrated an initial increase (8.9 ± 3.2 × 10^9/L) followed by a decline (5.4 ± 1.9 × 10^9/L) as the disease progressed, suggesting an early inflammatory response followed by immune suppression. The platelet counts fluctuated, with a decrease observed during the acute phase (190 ± 50 × 10^9/L) and subsequent recovery during convalescence (240 ± 60 × 10^9/L). Inflammatory markers, such as C-reactive protein and interleukin-6, were elevated, peaking at 120 and 150 pg/mL, respectively, indicating systemic inflammation. Coagulation profiles showed abnormalities suggestive of COVID-19-associated coagulopathy, including elevated D-dimer levels (mean ± SD: 3.5 ± 1.2 µg/mL) and prolonged prothrombin time (15.8 ± 2.5 seconds). Longitudinal analysis of hematological parameters revealed associations between disease severity and clinical outcomes, with certain abnormalities correlating with an increased risk of complications and a poor prognosis. CONCLUSION: This study highlights the importance of monitoring hematological parameters in COVID-19 patients for risk stratification, prognostication, and guiding therapeutic interventions.
RESUMEN
BACKGROUND: Recent studies have found that there is a strong association between ischemic heart disease (IHD) and hypertension (HTN) with spirometric indices. AIMS: To study the prevalence of obstructive airway disease (OAD) in non-smoker subjects with IHD and HTN and to compare them with healthy population. SETTINGS AND DESIGN: This was a prospective, case-control, and observational study. SUBJECTS AND METHODS: A total of 100 patients (cases) (n = 100) admitted in medicine department were recruited for this study. Controls (n = 100) were apparently healthy age- and sex-matched without HTN and IHD, recruited from March 2007 to July 2008. All eligible subjects were subjected to spirometric examination on a turbine-based spirometer (MIR spirolab-II) according to ATS/ERS guidelines. Forced expiratory volume/forced vital capacity (FEV(1)/FVC) ratio <70% was used to make a diagnosis of OAD. STATISTICAL ANALYSIS USED: All analyses were carried out using Statistical Software Package for Social Sciences trial version (SPSS 10 version). RESULTS: Out of 100 cases, 18 were with FEV(1)/FVC ratio <70% (OAD) and 82 had >70% FEV(1)/FVC ratio. Out of 100 controls, 2 were with FEV(1)/FVC ratio <70% (OAD) and 98 had >70% FEV(1)/FVC ratio. Eleven patients out of 66 from the case population with HTN had FEV(1)/FVC ratio <70% (Odds ratio 8.044). Prevalence of OAD in the hypertensive individuals was 16.66%. Twelve patients out of 62 from the case population with IHD had FEV(1)/FVC ratio <70% (Odds ratio of 9.333). Prevalence of OAD in the IHD individuals was 19.35%. In multiple correlation results for case population, when pulmonary function test variables were correlated with various dependant (age) and independent variables [HTN, IHD, height, weight, body mass index (BMI)], they were significantly reduced (P = 0.00017). In multivariate analysis (MANOVA), spirometric variables like FEV(1), FEV(1)/FVC%, FVC, forced expiratory flow (FEF) 25-75%, and peak expiratory flow rate (PEFR) were compared with factors like IHD, HTN, and covariates like age and BMI. We found that systolic blood pressure (SBP; P = 0.005), diastolic blood pressure (DBP; P = 0.05), height (P = 0.05), weight (P = 0.042), and IHD (P = 0.0001) were strongly associated with reduced pulmonary functions like FEV(1), FEV(1)/FVC%, and FVC. The presence of IHD and HTN were independently associated with the presence of OAD. CONCLUSIONS: This study highlights the increased prevalence of OAD amongst patients with IHD and HTN. Patients with IHD and HTN should routinely undergo inexpensive investigations like spirometry to detect the presence of underlying OAD.
RESUMEN
We describe a case of ruptured aneurysm of the left coronary sinus of Valsalva diagnosed by transthoracic two-dimensional echocardiography. A very few cases with ruptured left sinus of Valsalva have been reported. We are reporting a rupture of the left sinus of Valsalva into the main pulmonary artery in a 40-year-old male diagnosed by transthoracic echocardiography.