Coexistence of B-cell Chronic Lymphocytic Leukemia (B-CLL) and Myelodysplastic Syndrome (MDS) is rare condition(1). A 76-year-old female patient presented with pruritic and hyperemic rashes in her whole body, was diagnosed with MDS concurrent with B-CLL as a result of determined leucocytosis(White blood cell count: 52.200/mm3; 57% lymphocytosis, 33% monocytosis) in the complete blood count. She also had a history of receiving chemoradiotherapy for cervical cancer in her past medical history. A biopsy was performed from her rashes and histopathological findings showed chronic lymphocytic vasculitis. Cases of lymphocytic cutaneous vasculitis associated with hematological malignancies have been reported. Coexistence of B-CLL and MDS is an independent entity from the management of CLL, but receiving chemotherapy for a carcinoma is a risk factor for developing MDS. So, we aimed to present a case, who has a risk factor for developing MDS and skin involvement of B-CLL together, with literature and emphasize that two different hematological malignancies that develop simultaneously or at different times in the same patient may coexist. This rare condition should be considered in lymphocytosis and blast association.
Early T-cell Precursor Acute Lymphoblastic Leukemia (ETP-ALL) is a subtype of T-ALL/LBL which is derived from thymic cells at the early T-cell precursor (ETP) differentiation stage that have the potential to differentiate into multiple lineages, including lymphoid and myeloid. ETP-ALL accounts for 15% of childhood T-ALL and 10-30% of adult T-ALL. It has characteristic immunophenotypic expression of CD7, a lack of CD1a and CD8, weak expression of CD5 (with <75% positive blasts), and positive expression of one or more stem cell or myeloid markers including CD117, HLADR, CD13, CD33, CD11b or CD65. We here in report two cases of ETP-ALL with brief review of literature.
Aim: The aim of this study was to evaluate gene frequencies of human platelet alloantigens among major ethnic groups in Rivers-State, Nigeria.
Study Design: A cross-sectional study.
Place and Duration of Study: Rivers State University Medical Centre, Port Harcourt, Safety Molecular Pathology Laboratory, Enugu State, Justcare clinical laboratory Port Harcourt Rivers State and University of Port Harcourt Teaching Hospital Port Harcoourt, between October 2019 and March 2020.
Methodology: The subjects consisted of apparently healthy individuals who were of Rivers State origin totaling 104 persons aged 17 to 42 years. They were under-graduate and post-graduate students of Rivers State University, Port Harcourt, Nigeria. Five major ethnic groups were considered which included Ikwerre, Ogoni, Ijaw, Etche and Ogba. Their demographic information was collected using a sample register and a questionnaire. Samples were collected from the antecubital vein. 10ml of blood was collected, 5ml was transferred into EDTA sample bottle (Ethylene diamine tetracetic acid) while 2ml was dispensed into plain bottle and labeled accordingly. Serological testing including HIV (RVS) screening, HBsag, HCV and VDRL were all done immediately after samples were collected. The remaining sample was analyzed using genotyping of Human Platelet Antigens by High Resolution Melting Curve Analysis Polymerase Chain Reaction (HRM-PCR). The melt curve analysis was done using the MicPCR software while the frequency analysis was done using Number Cruncher Statistical Software (NCSS) Version 13. Graph Pad Prism Version 8.0.2 was used to determine the statistical significance between the various HPA genotypes and the ethnic groups and p-values of <.05 were considered to be statistically significant. Results were presented in percentages, mean+/- standard deviation and in tables
Results: The results showed that HPA-4 and HPA-5 a/a and b/b were the highest among Etche (20.0% each), followed by HPA-2 and HPA-3 at 16% each for b/b and HPA-1 a/a and a/b had 10.0% and 6.7% respectively, and HPA-1 b/b, HPA-2 a/b and HPA-3 a/a had 3.3% respectively. The HPA pattern for Ijaw was highest at HPA-4 a/a (15.7%), followed by HPA-5 b/b (15.3%) and the least was HPA-2 b/b (11.4%). The pattern for Ikwerre was highest for HPA-5 b/b (20.0%) and least for HPA-4 b/b and HPA-2 a/a (0.8% each). The HPA pattern for Ogba was highest for HPA-5 b/b (20.0%) and least for HPA-3 a/a and HPA-2 a/a (0.0% each), while the pattern for Ogoni is highest for HPA-5 b/b (19.1%) and least for HPA-5 a/b and HPA-3 a/b (0.9%). The HPA alleles showed that HPA-1 a/b was highest. 42 (40.4%), followed by HPA-1 a/a 34 (32.7%) and HPA-1 b/b 28 (26.9%), and the least was 3% for HPA-2 a/b. The highest for HPA-2 was b/b, 60 (57.7%) and the least is a/a, 2 (1.9%), while the highest for HPA-3 was also b/b, 75 (72.1%) and the least was a/a 3 (2.9%). Also, HPA-4 a/a allele is the highest in its category, 85 (81.5%) and the least was a/b 9 (8.7%), while b/b, 102 (98.1%) was the highest for HPA-5 and there was none for a/b and a/a alleles.
Conclusion: The HPA alleles showed that HPA-1 a/b was highest. The highest for HPA-2 and HPA-3 was b/b. HPA-4 a/a allele was the highest in its category, while b/b was the highest for HPA-5. HPA-4 and HPA-5 a/a and b/b were the highest among Etche. The HPA pattern for Ijaw was highest at HPA-4 a/a. The pattern for Ikwerre was highest for HPA-5 b/b. The HPA pattern for Ogba was highest for HPA-5 b/b, while the pattern for Ogoni was highest for HPA-5 b/b.
Aims: Inflammatory, immunological, oxidative stress status and antioxidant homeostasis in HIV-Infection and ageing were studied to determine if their relationships were logistic in humans.
Study Design: The effect of HIV disease/antiretroviral therapy on Inflammatory, immunological, oxidative stress status and antioxidant homeostasis was assessed by juxtaposition with similar indices in HIV seronegative healthy young (20-35years) adults (CTRL) and HIV seronegative elderly (65-86 years) subjects (ELD65+).
Place and Duration of Study: Subjects include One hundred (100) HIV seropositive individuals, 50 on ART and 50 ART-Naive and One hundred (100) seronegative individuals comprising fifty (50) healthy younger adults and Fifty (50) elderly (≥65yrs) individuals attending the Federal Medical Centre Owerri between August and December 2020.
Methodology: Venous blood was collected into an EDTA vacutainer and plain vacutainer plain from each participant for inflammation indices (ESR, CRP) using Westergren and Finecare CRP rapid quantitative test kit, Oxidative stress index (erythrocyte lipid peroxidation as thiobarbituric acid reactive substances (TBARS), antioxidant index (glutathione(reduced) using spectrometric method were determined on subjects. Enzyme-.linked immunosorbent assay (ELISA) was used to determine interleukin-6 (IL-6). The data generated were analysed by one-way analysis of variances (ANOVA) using Statistical Package for Social Sciences (SPSS) version 21; Relationship existing between parameters were analysed using table curve 2D (Systat USA).
Results: Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) Interleukin-6 (IL-6) and thiobarbituric acid reactive substances (TBARS) were all significantly higher in seropositive young adult subjects (P<0.05) than the seronegative young adult control subjects. Glutathione (GSH) was significantly reduced in the seropositive young adult subjects (P<0.05) than the seronegative young adult control subjects. In all the parameters measured, Naïve and ART subjects were similar in trend to ELD65+ subjects suggesting immune ageing. The antioxidant parameter GSH had an inverse relationship with the inflammatory (ESR, CRP and IL-6) and oxidative stress (TBARS) parameters. This relationship was logistic and followed a logistic dose-response relationship and a sigmoidal association.
Conclusion: We conclude that Erythrocyte sedimentation rate, C-reactive protein, Interleukin-6 (IL-6), Glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) are useful parameters to assess immune ageing, and are related logistically in humans.
Aims: To determine the relationships between ischaemic cardiac injury (ICI) evidenced by ischaemic electrocardiogram (ECG) with raised cardiac troponin T (cTnT), pain intensity and frequency in children with sickle cell anaemia (SCA).
Study Design: Case-control.
Place and Duration of Study: Department of Paediatrics, University of Calabar Teaching Hospital over a 6-month period.
Methodology: Children with SCA aged 4 – 17 years with vaso-occlusive painful crises (VOC) were enrolled. Cases were those with ICI while controls were those without ICI. VOC was diagnosed by history and examination with Faces Pain Scale – Revised. Electrocardiography and cTnT estimation were done. Cut-off level (97.5th percentile) of cTnT was obtained from age and sex-matched healthy children with haemoglobin genotype-AA. Serum cTnT analysis was by electrochemiluminescence immunoassay. Ischaemic ECG assessment was according to World Heart Federation criteria.
Results: Fifty-six children with SCA participated among who 27(48.2%) were cases and 29(51.8%) controls. Ischaemic ECG (71.4%) and elevated cTnT (57.2%) were significantly related (P=.01). All cases had severe pain (P=.02) and accounted for >50% of those with chest pain (P=.25). Controls had more < 3 pain episodes per annum than cases while frequent VOC (≥3 pain episodes per annum) occurred more in the cases though the differences were not statistically significant.
Conclusion: Severe pain with frequent VOC is associated with ICI even in the absence of chest pain in children with SCA. Regular electrocardiography and cTnT measurement will identify at-risk children for adequate management.
Pregnancy is a physiological condition that is associated some changes in haematological and immunological parameters. This study evaluated the levels of some systemic inflammatory and haematological parameters in pregnant women in Port Harcourt, Nigeria. A total of 275 pregnant women of age 20 to 70 years and 87 apparently healthy non-pregnant control subjects were involved in this study. Five millilitres (5ml) of blood were collected from the subjects into EDTA bottle for the evaluation of the parameters. ELISA technique was used in the determination of soluble transferrin receptor while Sysmex automation was used for the determination of the other parameters. The mean value of parameters for the study subjects were Hb( 9.05± 1.22g/dl), sTfR( 21.16± 9.11nmol/L), NLR (2.69 ± 0.91), PLR (8.78 ± 2.97), while for control subjects were Hb( 12.19± 0.66g/dl), sTfR( 18.21± 3.77nmol/L), NLR (2.86 ± 0.11), PLR (9.62 ± 2.79). The mean sTfR levels in pregnant women was significantly lower (p=0.001) than in control subjects. The pregnant women also had significantly lower values of Hb (p=0.0001), and PLT (p=0.017). According to trimesters, the levels of sTfR significantly increased with trimester (p=0.002), while that of PLR significantly increased in the second trimester (p=0.006). However, there were no significant differences in the levels of Hb (p=0.185) and NLR (p=0.70) among the trimesters. The results indicate that the pregnant women did not have levels of parameters that may indicate negative outcomes of pregnancy. It is recommended that systemic parameters be monitored among pregnant women in order to help in their medical management.
Aims: To assess the hemoglobin levels and nutritional status of selected elderly people.
Study Design: Cross-sectional observational study.
Place and Duration of Study: Ushayer Hatra village, Mohanpur, Rajshahi, Bangladesh and Institute of Nutrition and Food Science, University of Dhaka, over an one month period.
Methodology: Sixty elderly participants (40 males, 20 females; age range 60-95 years) were included, all being non-hospitalized, non-smoker, non-alcoholic and no one having any history of recent major blood loss. Hb analysis was done by Cyanmethemoglobin method. Anthropometric measurements (height, weight and mid upper arm circumference) were taken following standard measurement guidelines of the World Health Organization. Socio-economic data were collected using a pre-tested questionnaire.
Results: The mean (±SD) Hb content was higher in males than females (11.87 (±1.50) g/dL in males and 10.16 (±1.04) g/dL in females) and the difference was highly statistically significant (P < .0005). Low Hb levels (<13 g/dL in males and <12 g/dL in females) in 67.5% male and 95.0% female participants were observed. The mean BMI of males and females were 21.76 kg/m2 and 22.58 kg/m2 respectively. Fifty percent female and 57.5% male participants were in normal body weight (BMI=18.5-24.9 kg/m2). The Mean value of MUAC were 27.13 cm in males and 25.14 cm in females. Based on MUAC, 90.0% male and 75.0% female participants had normal nutritional status (MUAC ≥ 23.5 cm in males and ≥ 22 cm in females). The association between BMI and MUAC categories of the participants were found to be statistically significant in both groups (P =.049 and .001 in male and female groups respectively).
Conclusion: Most of the study participants had low hemoglobin levels but normal nutritional status. However, further studies with considerable sample size are required to determine the prevalence of anemia and malnutrition among the elderly people of Bangladesh.
Fleurya aestuans popularly called West Indian Wood Nettle is known for its therapeutic potential as it has been long used by herbalists in managing many diseases. The haematinic efficacy of the leaves of this plant was examined in this study. A total of 43 rats were procured, 13 rats were used for lethal dose (LD50) studies while the remaining 30 rats were grouped into six groups of five rats each and allowed to acclimatize for two weeks. Groups 1 served as control and were administered 2ml/kg of the extract vehicle, group 2 served as negative control, groups 3 and 4 served as test group and were administered with 50 mg per body weight of Fleurya aestuans leaf extract and 200 mg per body weight of same extract, while group 5 and 6 were administered with 0.23 ml per body weight of bioferon and 100 mg per body weight of Kaempferol respectively. Phenyl hydrazine was used to induce the anaemia in all the groups; the extract was prepared and administered orally using oral gavage. Blood samples were collected through ocular puncture after 14 days and analysed for haematological parameters using standard manual methods. Results showed that the extract significant (P < 0.05) enhanced the low levels RBC counts, Hb concentration, PCV, SOD, CAT and GSH levels but reduced the abnormally elevated levels of MCV, MCHC, MDA, WBC and Platelets counts. The oral administration of Fleurya aestuans leaf extract could be useful both in boosting blood parameters and combating diseases irrespective of the anaemia and leukocytosis caused by phenylhydrazine therapy.
Leachates contain deleterious constituents that may cause contamination of ground and surface water leading to serious risks to the ecosystem and human health. The exposure of the environment to dumpsite leachate may occur in different ways, such as uncontrolled overflow, rainfall and infiltration. This study therefore, attempts to determine the possible effects of (Eliozu) dumpsite leachates on some haematological parameters in Wistar rats. 25 Wistar rats weighing between 180g and 250g were divided into five groups of 5 animals each. Groups are as follows: Group 1: received 1ml of commercial bottle water, Group 2: received near-by borehole water, Group 3: received 10% of leachate concentrations, Groups 4 and 5: received 50% and 100% of leachate concentrations every 24 hours for 90 consecutive days. At the end of the gavaging of the leachates, blood samples were collected for heamatological parameters analysis using automated method. Results obtained shows a significant (p<0.001) reduction in some hematological parameters compared with control. Paradoxically, the mean corpuscular volume (MCV), red blood cell distribution width-standard deviation and red blood cell distribution width-coefficient of variation show significant increase (p<0.001) compared with the control. There were also significant decreases in weights of the experimental animals while compared with the control group. Eliozu dumpsite leachates demonstrated some toxicological potentials on Red Blood Cells (RBCs) and RBC indices; White Blood Cells (WBCs) and WBC Differentials in Wistar rats. We recommend further studies in this regard.
Background: Aplastic anaemia (AA) is an uncommon condition characterized by pancytopaenia and loss of haemopoietic stem and progenitor cells in the bone marrow. Without treatment, it is inexorably fatal. However with the availability of current definitive treatment options, patients’ clinical outcome is improving globally.
Objective: To determine the prevalence and outcome of aplastic anaemia in children and adults, over a five-year period, at University of Uyo Teaching Hospital (UUTH), Uyo, Nigeria.
Methods: This was a prospective study. We reviewed the cases of acquired aplastic anaemia managed in our hospital over a period of five years. Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 23.
Results: A total of twelve cases were treated for aplastic anaemia during the period under review, giving an annual incidence of 2.4 cases per year. The ages of the patients ranged from 12 to 56 years (mean 27.8 12.3 years) with a male to female ratio of 2.1. At presentation, they had a haemotocrit of 14.583.11, white cell count of 2.380.44, absolute neutrophil count of 0.300.17, platelet count of 18.426.35, reticulocyte count of 0.930.67. Nine (75%) patients had severe AA while three (25%) patients had very severe AA at diagnosis. Management consisted of transfusion support with unbanked packed red cells and platelet concentrate, antibiotics, antifungal and antiviral agents, cyclosporin and methylprednisolone. The patients were all blood transfusion dependent. None of the patients benefited from bone marrow transplantation and anti-thymocyte globulin. The mean survival was 10.582.19 months with a mortality rate of 0.24%.
Conclusion: There is compelling need for the Federal Government to ensure that bone marrow/stem cell transplantation centres are available and accessible nationwide, and to make drugs such as cyclosporin and anti-thymocyte globulin affordable or free to reduce the high mortality associated with the condition.
Rita Bokemposila, Clément L. Inkoto, Alexis Kazamwali, Gaston Mwema, Christian Lobinga, Louise Malonga, Jean Claude Malenga, Thérèse Mbeza, Jean Lambert Gini Ehungu, Koto-Te-Nyiwa Ngbolua, Pius T. Mpiana
International Journal of Research and Reports in Hematology,
Neonatal infection (NI) remains a public health problem of concern because of its frequency and severity, which is related to the immuno-incompetence of the newborn and the risk of mortality, which is in the order of 10% to 30%. According to the World Health Organization (WHO), 30 to 40% of these newborn deaths are due to neonatal infections of bacterial origin. The present work was initiated with the aim of establishing the leukocyte profile of sick newborns with hyperthermia or hypothermia, in neonatology services for a better management of the newborn. The cross-sectional study was conducted in Kinshasa, capital of the Democratic Republic of the Congo (DRC) of a period from January 01 to December 31, 2018 with a sample consisting of 218 newborns from 0 to 29 days admitted in the neonatology service. The software Microsoft Excel 2010 and SPSS for Windows version 22.0 served us in the encoding and analysis of data. The results obtained in this study presented the cells of the white lineage, then explained the infections in neonatology while examining the pathological variations of the different types of white blood cells. This study also showed that there is a lack of concordance between the clinical (181 or 83% of newborns) and biological (126 newborns with infection or 57, 8%) with statistically significant evidence.
Aim: The aim of this study was to assess the influence of gender and subjects’ condition on haemostatic parameters in sickle cell anaemia and control subjects.
Study Design: This study is a cross-sectional observational study.
Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020.
Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. Out of the four hundred and fifty (450) subjects, 269 (59.78%) were males and 181 (40.22%) were females. The subjects were further grouped into three based on the subjects’ condition, which include steady state (n=150), vaso-occlusive crisis (n=150); and the control (n=150). There were 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and was calculated using Cochrane formula. Five milliliters (5ml) of venous blood sample was withdrawn. The haemostatic parameters (vWF, FVIII, D-dimer, L-arginine, fibrinogen, ADAMTS13) were assayed quantitatively with Bioassay Technozym kit using Microplate Reader (Labtech microplate auto ELISA plate reader, an IS0 13485:2003 CE and WHO compliance Co., Ltd. Shanghai International Holding Corp. GmbH; Europe) calibrated to a wavelength of 450 nm with strict adherence to the manufacturer's instructions, while PT and APTT were analyzed with Fortress reagent and Uniscope SM801A Laboratory using water bath. Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values <0.05 were considered statistically significant.
Results: The results showed that There was significant variability in the haemostatic parameters by subjects’ condition. The comparison of HbF and haemostatic parameters showed significant (p<0.05) increase and decrease in VOC and steady state respectively compared with the control group. Subject condition as an independent factor predicts significantly high 72.91% and 86.00% for ADAMTS13 and for vWF activations respectively compared to other factors.
Conclusion: Subjects with SCA, particularly during VOC, undergo significant haematologic alterations that increase their risk of developing coagulation activation-related complications. Thus, though selected markers of coagulation were significantly different between the subject conditions, they were often significantly higher in the SCA.
Aim: This study aimed to evaluate the anti-nuclear antibodies and differential leucocytes count in ABO typed women with spontaneous abortion (SA) in Yenagoa, Bayelsa State, Nigeria.
Study Design: Cohort cross-sectional study.
Place and Duration of Study: Scanex Diagnostics No 58a Nikton Road, Kpansia. Yenagoa, Bayelsa State, Nigeria, between January, 2018 and August, 2018.
Methodology: A total of 150 females were recruited; 50 with unexplained history of SA (UHSA) and 50 with unexplained recent SA (URSA) formed the test groups while 50 apparently healthy females who have children, with no recent or history of abortion were used as control. 5ml of venous blood was collected using standard venipunture technique from each participant, out of which (2mls) was dispensed into ethylene-diaminetetraacetic acid (EDTA) bottles, and was used for DLC by manual spread technique and ABO testing, using the tile method. The remaining 3ml of blood was used to analyse ANAs by the ELISA Assay technique.
Results: The study participants, UHSAURSA and Control showed that the age group of 31-35years have the majority of spontaneous abortion of 18(36%), 13 (26%) and 12(24%) respectively. In the Blood group study, majority of blood group were B; 4 (40%), 3(22.2%), 1 (16.6%) and O 7 (22.5%), 3 (8.1%), 3 (9.6%) respectively. Out of the 9 blood group B, URSA subjects only 3 of them tested positive for ANAs, out of 10 blood group B UHSA subjects only 4 of them tested positive for ANAs & out of the 6 blood group B control participants only 1 of them tested positive for ANAs; out of the 37 blood group O URSA subjects only 3 of them tested positive for ANAs, also out of the 31 blood group O UHSA subjects, only 7 tested positive for ANAs and out of the 6 blood group O control participants only 1 tested positive for ANAs. Out of the 50 subjects with URSA, only 6 tested positive for ANAs, also out of the 50 UHSA subjects only 11 tested positive for ANAs and out of the 50 control participants only 4 tested positive for ANAs. The mean ANAs value (0.13 ± 0.11 and 0.20 ± 0.03) in URSA and UHSA were significantly lower (p<.05) compared to the control (0.07± 0.01) (p=.001) subjects. Also, the mean monocyte value (3.12±1.70and2.54±1.71) in URSA and UHSA were significantly higher (p<.05) when compared to the control (2.20±1.48) (p=.020) subjects respectively. There was no significant (p>0.05) difference between the mean neutrophil, lymphocytes and eosinophil values (54.56 ± 10.25 and 56.28 ± 11.12; 41.62 ± 11.15 and 40.56 ± 11.25; 0.32 ± 0.94 and 0.62 ± 1.01) in the same order when compared to that of the control (56.10 ± 10.56; 41.08 ± 10.58; 0.52 ± 0.88) (p=.67; p=.89; p=.27) subjects in the same order.
Conclusion: Age, ANAs, ABO and monocyte could be responsible for unexplained SA. It is recommended that ANAs, Blood group and DLC be adequately checked in early pregnancy, for this shall further aid the prediction and prevention of spontaneous abortion.
Aim: Platelet additive solutions (PAS) platelet collection methods, in which less donor plasma is used, are becoming more common in order to reduce the reactions occurring in patients. In our study, we aimed to evaluate the platelet quality in apheresis platelet suspensions (I) collected with PAS-III and to examine the frequencies of other transfusion reactions, especially allergic reactions related to platelet transfusion (II).
Materials and Methods: In our study, the results of routine use of apheresis platelet sets between July 2019 and March 2021 were evaluated retrospectively.
Results: All of the PAS-III added apheresis platelet concentrates collected in our center, whose quality control was performed in different time periods (100 platelet concentrates) were included. Platelet counts and pH values were examined on the 1st and 5th days of these apheresis platelet concentrates, which were stored in our blood bank at 20-24°C with agitation.
In our study, mean platelet counts measured on days 1 and 5 in 65% PAS-III/35% plasma apheresis platelet suspensions were found to be 3.44 x 1011 and 3.0 x 1011, while pH values were determined as 6.83 and 6.62 on days 1 and 5, respectively. Also, no allergic or any other transfusion reaction was detected.
Conclusion: In conclusion, in our study, apheresis platelet concentrates suspended in 65% PAS-III/35% donor plasma were associated with (I) better donor comfort and (II) reduction in the frequency and/or severity of transfusion reactions originating from donor plasma.
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes novel coronavirus disease 2019 (COVID-19), is spreading rapidly around the world. Thrombocytopenia in patients with COVID-19 has not been fully studied. To date no published works in Sudan describe thrombocytopenia among COVID-19 patients.
Objective: To study the prognostic value of thrombocytopenia in COVID-19 Pneumonia.
Methods: A prospective cross-sectional study enrolled 140 COVID-19 patients in Gezira Isolation Centers during the period from November 2020 to February 2021. Data regarding demographics, clinical presentation, laboratory investigation, mode of oxygen therapy and outcomes were collected. Thrombocytopenia defined when platelets counts less than 150 x 103 cell/cumm.
Results: Among 140 patients, 86(61%) were males and 54(39%) were females, their mean age was 66.5±13.5 years. In outcomes, 91(65%) patients were recovered and 49(35%) were deceased. The mean of platelets count was 246±124 x 103 cell/cumm and 38(27.1%) patients had thrombocytopenia, among them 37(26.4%) patients had platelet count ranged from 51-149 x 103 cell/cumm and one (0.7%) patients had platelet count below 50 x 103 cell/cumm. Thrombocytopenic patients were significantly older than those without thrombocytopenia (70.9±9.1 years vs 64.8±14.4 years; P. value= 0.017). Also, thrombocytopenic patients were more tended to have hypertension (63.2% vs 44.1%; P. value= 0.025), diabetes mellitus (DM; 63.2% vs 43.1%; P. value= 0.024), renal disease (65.8% vs 16.7%; P. value= 0.001), and lung disease (10.5% vs 0%; P. value= 0.041). Moreover, thrombocytopenic patients were more inclined to receive mechanical ventilation (100%) and CPAP (81.8%) more than those without thrombocytopenia (P. value < 0.001). Thrombocytopenia was significantly correlated with mortality (67.3% vs 5.5%; P. value < 0.001). The AUC of thrombocytopenia (platelets count below 140 x 103 cell/cumm) in detecting mortality was 0.830 (95% CI: 0.748-0.913; P. value <0.001), with sensitivity of 86.8% and specificity of 84.3%.
Conclusion: The frequency of thrombocytopenia in Sudanese COVID-19 patients was high. The development of thrombocytopenia was significantly associated with old age, DM, hypertension, renal diseases and lung disease and invasive ventilation. Moreover, thrombocytopenia was significantly correlated with mortality