Neutrophil Lymphocyte Ratio, Monocyte Lymphocyte Ratio, Platelet Lymphocyte Ratio in Covid-19 Patients.

BACKGROUND: Covid-19 is a pandemic viral infection with high pathogenicity and contagiousness. Our aim is to evaluate the preliminary hematological findings analyzed during admission in order to determine the diagnostic value of hematological parameters in Covid-19 patients and to reveal their relationship with the severity of the disease. METHODS: Our study includes a total of 169 patients, whose diagnosis was confirmed and 93 of whom were treated in the ward, 76 of whom were treated in the Intensive Care Unit (ICU), and 67 control patients. Neutrophil-to-lymphocyte ratio (NLR), monocyte-lymphocyte (MLR) ratio, platelet-lymphocyte ratio (PLR), mean platelet volume/platelet count ratio (MPV/PLT) data on admission were analyzed retrospectively and compared. RESULTS: ICU patients had significantly higher values of NLR, MLR, PLR, and MPV/PLT (p < 0.001 for each) but had lower values of lymphocyte count and hemoglobin (p < 0.001 for each) compared to that of ward patients. According to the results of ROC analysis, the diagnostic values of NLR, MLR, PLR, and MPV/PLT parameters were statistically significant (p < 0.05). CONCLUSIONS: According to the results of our study, abnormal routine peripheral blood examination results were detected in Covid-19 patients. NLR, MLR, and PLR can be considered as independent, reliable biomarkers for assessing disease severity, hospitalization, and clinical classification in Covid-19. Therefore, it was concluded that fast, cost-effective, easily accessible admission hemogram parameters are reasonably important to predict the prognosis of Covid-19 patients.

Serum Vitamin D, Zinc Levels and the Relationship between them in Children and Adolescents.

BACKGROUND: Along with vitamin D deficiency, a common global health problem in developed and developing countries, zinc deficiency also remains one of the most common micronutrient deficiencies-related public health problems in some parts of the world. Determination of vitamin D and Zn status is important for the growth, development, and health of school-age children, as well as their intellectual achievement and academic performance. In this study, we aimed to evaluate serum 25(OH)D and Zn levels and the relationship between them in a nationally representative sample of Turkish children and adolescents. METHODS: A total of 541 children and adolescents aged 1 - 16 years were included in our study whose vitamin D and zinc test levels were measured and who applied to the Basaksehir Cam and Sakura City Hospital Pediatric Outpatient Clinic. Cases were examined by dividing them into subgroups according to their vitamin D levels (≤ 15 ng/mL deficiency; 15 - 20 ng/mL insufficiency; ≥ 20 ng/mL sufficiency) and age (< 5 years preschool; 5 - 10 years middle childhood; 11 - 16 years adolescence). RESULTS: The levels of 25(OH)D were lower than 20 ng/mL in 33% of the children. There was deficiency in 80 (15%) and insufficiency in 99 (18%) cases. A statistically significant difference was found in 25(OH)D and Zn levels in groups separated by 25(OH)D level and age (p < 0.001). A positive significant correlation was found between serum 25(OH)D and Zn levels (r = 0.468; p < 0.001). A negative correlation was found between 25(OH) D levels and age (r = -0.261; p < 0.001) and body mass index (BMI) (r = -0.308; p < 0.001). CONCLUSIONS: In our study, we found high levels of vitamin D deficiency and insufficiency and a significant positive correlation between serum 25(OH)D and Zn levels in the pediatric population. Based on this possible contribution, we think that providing vitamin D support to children of all ages, including adolescents, and thus improving zinc levels may be beneficial in protecting from diseases that lead to morbidity and mortality as a result of reducing the rate of growth and development retardation, regulating of bone development, and contributing to the development of the immune system.

Analysis of Ischemia-Modified Albumin (IMA) and Coagulation Parameters in Patients with SARS-CoV-2 Pneumonia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a systemic disease which causes an increased inclination to thrombosis by leading to coagulation system activation and endothelial dysfunction. Our objective in this study is to determine whether ischemia-modified albumin (IMA) can be used as a new marker in patients with COVID-19 for evaluating the increased coagulation risk, pneumonic infiltration, and thus, prognosis. METHODS: Our study included 59 patients with COVID-19 compatible pneumonic infiltration on lung computed tomography (CT) who applied to and were hospitalized in the Internal Diseases Outpatient Clinic, then followed up and treated, as well as 29 healthy individuals with a negative COVID-19 rRT-PCR test without any additional disease. Hemogram, coagulation, routine biochemistry, and serum IMA activity parameters were studied. RESULTS: In our study, the higher serum IMA level in COVID-19 patients with pneumonic infiltration compared to that of the healthy control group was found to be statistically significant. No significant correlation was found between the serum IMA levels and the coagulation and inflammation parameters in the 59 COVID-19 patients included. CONCLUSIONS: Serum IMA levels in COVID-19 patients with pneumonic infiltration on CT were found to be higher than in the control group. Examination of biochemical parameters, especially thrombotic parameters that affect prognosis such as IMA, can be a guide in estimating pneumonic infiltration.

The Relationship of Hematological Parameters and C-reactive Protein (CRP) With Disease Presence, Severity, and Response to Systemic Therapy in Patients With Psoriasis.

OBJECTIVES: Systemic inflammation has an important role in psoriasis, which is a chronic disease with an increasing prevalence and is associated with comorbidity. Our aim is to investigate the relationship of hematological parameters and C-reactive protein (CRP) with the presence and severity of the disease in patients with psoriasis. It is also to investigate whether it can be used as a biomarker in monitoring the response to systemic treatment. MATERIALS AND METHODS: This retrospective study was conducted with the participation of 139 psoriasis patients receiving biological therapy (BT) and conventional therapy (CT) and 140 healthy controls. Demographic, clinical, and laboratory data of patients and controls were examined and all parameters were compared with the psoriasis area severity index (PASI) score. In addition, the changes in these parameters before the treatment and in the third month of the treatment were examined in the patient groups who received BT and CT. RESULTS: White blood cell (WBC), neutrophil, monocytes, platelet (PLT), plateletcrit, red blood cell, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) monocyte-lymphocyte ratio (MLR), red cell distribution width (RDW), CRP and erythrocytesedimentation (ESR) levels were higher compared to the healthy control group in psoriasis patients (p<0.05). Baseline PASI values were positively correlated with WBC, neutrophils, monocytes, NLR, MLR, and CRP. WBC, neutrophil, NLR, CRP, and ESR levels decreased in all patients in the third month of treatment (p<0.05). WBC, PLT, neutrophil, and NLR in patients receiving BT; while WBC, neutrophil, NLR, CRP, and ESR levels decreased in patients receiving CT, RDW levels increased (p<0.05). Adalimumab; NLR and basophil, methotrexate; WBC, NLR, neutrophil, and ESR levels caused a significant decrease (p<0.05). CONCLUSION:  The fact that increased WBC, neutrophils, monocytes, NLR, MLR, and CRP levels are associated with the severity of psoriasis indicates that these parameters reflect systemic inflammation in psoriasis. In addition, the decrease in these parameters after BT and CT suggests that they can be considered simple and reliable markers that can be used as a complement to the PASI score in assessing disease severity and response to treatment.

Serum levels of NLRC4 and MCP-2/CCL8 in patients with active Crohn's disease.

Crohn's disease (CD) is characterized by malfunction of immune-regulatory mechanisms with disturbed intestinal mucosal homeostasis and increased activation of mucosal immune cells, leading to abnormal secretion of numerous pro- and anti-inflammatory mediators. MCP2/CCL8 is produced by intestinal epithelial cells and macrophages, and is a critical regulator of mucosal inflammation. NLRC4 is expressed in phagocytes and intestinal epithelial cells and is involved in intestinal homeostasis and host defense. However, no study to date has assessed the circulating levels of NLRC4 and MCP2/CCL8 in patients with CD. The study was aimed to investigate the serum levels of MCP2/CCL8 and NLRC4 in patients with active CD. Sixty-nine patients with active CD and 60 healthy participants were included in the study. Serum levels of NLRC4 and MCP2/CCL8 were determined using an enzyme-linked immunosorbent assay. The median serum NLRC4 levels were lower in the patient group than in the controls (71.02 (range, 46.59-85.51) pg/mL vs. 99.43 (range 83.52-137.79) pg/mL) (P < 0.001). The median serum levels of MCP2/CCL8 were decreased in patients with CD (28.68 (range, 20.16-46.0) pg/mL) compared with the controls (59.96 (range, 40.22-105.59) pg/mL) (P < 0.001). Cut-off points of NLRC4 (<81 pg/mL) and MCP2/CCL8 (<40 pg/mL) showed high sensitivity and specificity for identifying active CD. In conclusion, this is the first study to examine circulating levels of MCP2/CCL8 and NLRC4 in patients with active CD. Our results suggest that serum NLRC4 and MCP2/CCL8 levels may be involved in the pathogenesis of CD and may have a protective effect on intestinal homeostasis and inflammation. Serum levels of MCP2/CCL8 and NLRC4 could be used as a diagnostic tool and therapeutic target for CD.