Background: Total Hemoglobin(Hb) measurement is one of the most common and important parameter that is investigated in the laboratory. This non invasive method allows pain free continuous online patient monitoring with minimum risk of infection and facilitates real time data monitoring allowing immediate clinical reaction to the measured data. The objective of the study is to test the efficacy of pulse co-oximeter .Methods: Present study is a prospective comparative study. A total of 261 patients enrolled for the study after their consent. Non invasively measured SpHb values and invasively measured Hb values were then compared by using Bland Altman statistical analysis .Result: Pulse co-oximeter recorded/displayed SpHb in 90.8% patients and did not display SpHb in 9.2% of patients. Out of which 73-75% patients Hb showed variation of less than or equal to 2gms and 20-24% patients Hb showed variation of more than 2 gms. On Bland Altmann comparative analysis of SpHb and Hb revealed bias and limits of agreement was 0.2+3.3gm/d and 95% of the measurements fell within two standard deviation of the mean difference and P value < 0.001 represents good correlation between SpHb and Hb of Lab1 and Lab 2. Conclusion:Pulse co-oximeter can be used as a screening tool for Hb measurement . It determines Hb instantly and non invasively with 73-75% of the values show variation of less than or equal to 2gms. Further studies are needed to determine financial aspects and needs upgradation in terms of accuracy of the instrument.
Background: Clinical status and concurrent comorbidities of COVID-19 patients largely determine the need for their admittance to ICUs, similarly, several laboratory parameters like D-dimer, LDH, serum ferritin, CRP, and IL-6 may facilitate the assessment of disease severity and rational triaging. Therefore, their role in the management of COVID-19 patients has to be assessed. Materials and methods: Prospective study was done on patients who were tested positive for COVID-19 infection and admitted to various centers under the Vijayanagara Institute of Medical Sciences, India. Patients were divided into mild, moderate, and severe cases. Demographic data and serum levels of biomarkers like D-dimer, LDH, ferritin, CRP, and IL-6 were collected in these patients, and data were statistically analyzed. Results: A total of 164 cases were included in this study, of which, 62 were mild, 47 moderate, and 55 were severely infected COVID-19 patients. There was male predominance in patients infected with COVID-19. The median age of presentation was 53, 60, and 57 years in mild, moderate, and severe cases respectively. Median was also derived for D-dimer, LDH, serum ferritin, CRP, and IL-6 in mild, moderate, and severe cases. Changes in D-dimer, LDH, and serum ferritin levels in mild, moderate, and severe cases showed statistical significance(p<0.05). Conclusions: D-dimer helps in the early identification of mild, moderate, and severe cases and can be used for the vigilant monitoring of patients. LDH and serum ferritin helps in the identification of oxygen-dependent and oxygen-independent patients. The role of CRP and IL-6 in the management of COVID-19 patients has to be further investigated.
Background: It is known as in other viral infections, severe acute respiratory syndrome coronavirus 2 infections, can be associated with haematological changes and often has the potential to optimize the monitoring of the infectious process and their severity. Hence, we took up this study to analyze clinico-haematological profiles in coronavirus disease-2019 patients and to compare haematological changes between mild, moderate, and severe cases. Materials and methods: The study included the patients who were tested positive for coronavirus disease-2019 infection and the patients were classified into mild, moderate and severe cases. The demographic data and the laboratory haematological parameters were collected and statistically analysed. The median values were compared between mild, moderate, and severe cases using non-parametric tests, Kruskal-Wallis test with posthoc Mann-Whitney, and the p-value was calculated using Chi-square test for statistical significance. Results: Data was collected for 276 patients, of which 167 patients were mild cases, 50 were moderate and 59 were severe. The median was derived for all the haematological parameters in mild, moderate, and severe groups which showed an increasing trend in total leucocyte count, absolute neutrophil count, neutrophil to lymphocyte ratio, and a decreasing trend in absolute lymphocyte count and statistically significant with p-value <0.05. Conclusions: Coronavirus disease-2019 infection is associated with changes in haematological parameters, as the severity of the disease progresses total leucocyte count, absolute neutrophil count, and neutrophil to lymphocyte ratio increase but absolute lymphocyte count decreased. High neutrophil to lymphocyte ratio and lymphopenia are valuable early risk stratification parameters.
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