Introduction:Real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assays were established to detect severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). However, due to the high rate of false negative results, additional tests as computed tomography (CT) scans of the chest and blood chemistry are required to properly diagnose COVID-19 infection. Abnormal morphological changes of peripheral blood cells as granulocytic dysmorphism and abnormal reactive lymphocytes have been described in some cases. The aim of the present study was to investigate the morphological changes affecting all peripheral blood cells of COVID-19 patients, in order to find any specific abnormalities that could help in the early diagnosis and/ or prognosis.Methods: Peripheral blood smears of 113 COVID-19 patients and 50 non-COVID-19 controls were examined for morphological changes in the period between October 2020 and January 2021 (second wave). We set a score value in which every morphological abnormality was given one point in each examined blood smear. Score, neurophil/lymphocyte (N/L) ratio, and blood chemistry were compared to the severity and outcome of the disease.Results: Significant morphological changes were found when compared to control blood smears. Various abnormalities as pyknotic cells, broken cells, pseudo Pelger-Huët, abnormal lymphocytes, abnormal monocytes, and leukoerythroblastic reaction were found. Cases with higher scores had unfavorable outcomes (p = .005). High interleukin-6 (IL-6) levels were correlated to pyknotic cells (p = .003). Conclusion:The blood picture of COVID-19 patients revealed various morphological changes that are not detected with the same frequency and variability in other viral infections. The prominent morphological changes can be predictive of an undesirable outcome of the disease.
Background: Reducing the hazards of the early-onset neonatal sepsis (EONS) is a priority justifying the further investigation for potential biomarkers for its early diagnosis. Purpose: We aimed to investigate the diagnostic value of presepsin, procalcitonin, lactoferrin, interleukin (IL)-6, and IL-8 for the early diagnosis of EONS. Methods: A prospective comparative study, including 30 cases with highly suspected EONS and 30 matched controls, was conducted. Besides the complete blood count and blood culture, C-reactive protein, procalcitonin, presepsin, IL-6, IL-8, and lactoferrin were measured at the admission and after 72 hours. Results: At the time of the admission, presepsin, procalcitonin, C-reactive protein, and IL-8 were significantly higher in the sepsis group. The levels of presepsin, procalcitonin, and IL-8 significantly decreased after 72 hours of the admission. Presepsin, procalcitonin, IL-8, and IL-6 showed a high diagnostic ability for sepsis at admission with area under the curve of 0.934, 0.798, 0.775, and 0.751, respectively. The cutoff values of presepsin, procalcitonin, IL-8, and IL-6 were 821 pg/mL, 2.3 ng/mL, 54 pg/mL, and 24 pg/mL, with a sensitivity of 88.9%, 72.2%, 83.3%, and 94.4% and specificity of 85.7%, 80.9%, 71.4%, and 52.4%, respectively. Lactoferrin had the lowest diagnostic ability with area under the curve of 0.558. Implications for Practice: Presepsin was the most accurate biomarker followed by procalcitonin, IL-8, and IL-6 regarding the early diagnosis and management of EONS. The combination between these biomarkers is highly recommended. Implications for Research: Further studies are needed to investigate the diagnostic ability of the combination of these biomarkers.
Delirium and its relation to biochemical markers have been considered a study question in several research works. The relation between S100B levels and delirium is still a matter of discussion. Objective: To compare the serum level of S100B in patients with and without delirium and to detect the relation between S100B and delirium subtypes. Method: A case control study was conducted on 114 elderly (60 years and older) selected from the geriatric acute care unit at Ain Shams University Hospitals. They were classified into two groups; 58 elderly cases who had delirium diagnosed by Confusion Assessment Method and 56 controls. Then delirium was reclassified according to the subtypes of delirium into Hyperactive: 46 patients, hypoactive: 2 patients, and Mixed: 10 patients. Serum S100B levels were determined by ELISA. Results: Cases were significantly older than controls (72.4 ± 9.4 versus 66.9 ± 5.3 years respectively) (P < 0.001). S100B levels were higher in cases (32.4 ± 9.8 pg/ml) than controls (30 ± 9.3 pg/ml) but the difference was not statistically significant (P = 0.19). There was no significant difference in S100B levels between the different subtypes of delirium. Conclusion: Delirious patients had higher S100B levels than controls but the difference was not statistically significant.
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