Predictive value of immature granulocyte count and other inflammatory parameters for disease severity in COVID-19 patients C oronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection, was declared a pandemic by the World Health Organization in March 2020 [1]. Since the first case, identified in late 2019, COVID-19 has affected over 145.2 million people around the world and caused more than 3.08 million deaths as of April 24, 2021 [2]. COVID-19 infection may be asymptomatic or have clinical manifestations that range from mild to severe, but understanding the signs upon presentation remains complex [3]. Greater disease severity is associated with poor outcomes and Objectives: This study was designed to compare the immature granulocyte (IG) count, IG-to-lymphocyte ratio (IGLR), complete blood count (CBC) values, and inflammatory parameters of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), ferritin level, and CRP-to-albumin ratio (CAR) measured at hospital admission in patients with coronavirus disease 2019 (COVID-19) and non-COVID-19 patients and to compare these parameters between subgroups according to disease severity. In addition, these parameters were evaluated for predictive value related to the severity of COVID-19. Methods: The data of adult patients admitted with a suspected COVID-19 infection confirmed with real-time polymerase chain reaction testing of nasal and pharyngeal swab specimens were included in this retrospective study. Outpatient COVID-19-positive patients were enrolled in the mild group, hospitalized patients were classified in the moderate group, and patients admitted to the intensive care unit were categorized in the severe group. Results: A total of 1213 COVID-19-positive patients and 1034 COVID-19-negative patients were included in the study. The IGLR, NLR, PLR, CRP, CAR, and ferritin levels were significantly higher, and the leukocyte, IG, neutrophil, lymphocyte, monocyte, basophil, and eosinophil levels were significantly lower in the COVID-19-positive group than the COVID-19-negative group (p<0.05 for all). The severe group had higher median IG, IGLR, neutrophil, NLR, PLR levels than the mild, moderate, and COVID-19-negative groups (p<0.05 for all). Receiver operating characteristic analysis revealed an area under the curve value for IGLR, CAR, CRP, IG, NLR, and ferritin of 0.868, 0.860, 0.834, 0.848, 0.845, 0.841, and 0.827, respectively, which differentiated severe COVID-19 patients from mild and moderate COVID-19 patients. Conclusion:The results suggest that the IGLR may be useful to distinguish severe COVID-19 patients at the time of admission. Further exploration is warranted to fully determine the potential value of the IGLR in disease monitoring.
Background/aim: Lead can cause morphological and functional changes in heart, and inflammation and endothelial dysfunction in vasculature. Endocan, as a novel indicator of endothelial dysfunction, has been used for cardiovascular diseases. This study investigated the relationship between lead exposure, endocan levels, and diastolic functions. Materials and methods: A total of 51 lead-exposed workers without a known cardiovascular disease or risk factors and 54 healthy controls were enrolled. All participants underwent transthoracic echocardiography. Blood lead and serum endocan levels were analyzed. Results: Baseline demographic and clinical characteristics were found to be similar between groups. Median blood lead (32 vs 1.5 µg/dL, P < 0.001) and serum endocan levels (67 vs 57.1 pg/mL, P = 0.02) were significantly higher in the lead-exposed group. Serum endocan level showed a positive correlation with blood lead levels (r = 0.404, P = 0.003) in lead-exposed workers. Serum endocan level was an independent risk factor for increased E/E' ratio (β = 0.704, P = 0.002) and left atrial volume index (β = 1.158, P = 0.011) and higher level of lead in blood was an independent risk factor for increased E wave (β = 8.004, P = 0.022) in lead-exposed workers. Conclusion: Worsened diastolic functions may be seen in the course of lead exposure. Due to sharing a similar mechanism, a higher serum level of endocan may be a valuable laboratory clue for impaired diastolic function in this population.
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