Objective: COVID-19 virus involves respiratory as well as other body systems including cardiovascular, gastrointestinal, neurological, immunological and hematopoietic system. Patient of covid-19 pneumonia presents with wide range of hemostatic abnormalities. These hemostatic abnormalities in COVID-19 are related with disease progression, severity and mortality. The Objective of our study is to evaluate the role of hematological parameters in determination of COVID-19 disease severity. Material and method: This was a retrospective study, conducted in Department of Pathology and Department of medicine, FMH college of Medicine and Dentistry from May 2020 to July 2020. Total of 101, confirmed cases of covid-19 disease, both genders between 17 and 75-year age were included. Hematological parameters were compared in mild, moderate, severe and critical disease group. Continuous variables were analyzed by using non parametric, Kruskal Wallis test while categorical variables were analyzed by chi-square test. Results: Out of 101 patients, 20.8%, 51.8%,19.8% and 7.9% were in mild, moderate, severe and critical group respectively. Median (IQR) values of WBCs (p-value 0.004), ANC (p-value 0.002), NLR (p-value 0.001), D-dimer level (p-value 0.001), ferritin (0.0001), LDH (0.0001) were significantly increased in patients with critical disease. Median (IQR) values of APTT (p-value 0.003) and CRP (p-value 0.0001) were suggestively higher in patients with severe disease. Other parameters like Hemoglobin, MCV, HCT, ALC, Platelet count, prothrombin time did not show statistically significant association with severity of disease. Conclusion:The study concluded that Leukocytosis, neutrophilia, elevated Neutrophil to lymphocyte ratio, APTT, D-dimer, LDH and serum ferritin and CRP are associated with severity of covid-19 disease.

No abstract

Background The first case of Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, China in 2019. In the first half of 2020, this disease has already converted into a global pandemic. This study aimed to find that treatment of patients with COVID-19 pneumonia with Tocilizumab or steroids was associated with better outcomes. Objectives: To analyze the effectiveness of Tocilizumab in moderate to severe Covid-19 patients based on predefined assessment criteria . Study Settings : Single-center, Fatima Memorial Hospital, Lahore. Study design Quasi-experimental. Duration of study From May 12, 2020 to June 12, 2020. Patients & Methods: Sample size and technique Sample size was 93; 33 patients were kept in the experimental group, given Tocilizumab, 8 mg/kg intravenously or 162 mg subcutaneously, and the rest of the 60 patients were given corticosteroids, methylprednisolone 80 mg/day. Consecutive sampling. Failure of therapy was labeled when patients were intubated or died, and the endpoints were failure-free survival which was the primary endpoint, and overall survival secondary at the time of discharge. Results A total of 93 patients were enrolled, the Tocilizumab (TCZ) group (case) and Corticosteroid (CS) group (Control). The median age was 58 years (IQR-21), 37 (39.8%) patients with diabetes mellitus, 11 (11.8%) in the TCZ group, and 26 (28%) in the CS group. On the whole, the total median hospital stay in days was 7 with IQR (4), a total of 83 (89.2%) patients recovered successfully and discharged, 27 (29%) in the TCZ group and 56 (60.2%) in the CS group. Total 10 (10.8%) patients died, out of which 6 (6.5%) belonged to the TCZ group and 4 (4.3%) belonged to the CS group The median Oxygen requirement with IQR was 8 (9) in both the groups and in total as well, p-value (0.714). Conclusions Tocilizumab is a quite effective treatment option for critically sick patients of Covid-19 by reducing their oxygen requirement drastically and so the ICU stay, median hospital stay and so the mortality as well. Clinicals trials registration UIN # NCT04730323

to June 2020. After approval from institution's review board, confirmed cases of Covid-19 by PCR were selected. Their CRP levels were obtained from medical record. CRP levels were compared in the following groups of patients: mild group, moderate group, severe group. Data was analyzed using the SPSS version 25.0. Results: Out of 115 patients of covid 19 disease included in our study, 11 were in mild group, 19 in moderate and 85 in severe group. Mean CRP of patients in mild group was 3.6±1.0 mg/L, while mean CRP was 117.9±58.1 mg/L in moderate and 134±71.9 mg/L in severe group (p<0.001). Out of 85 (73.9%) severe group patients,15(17.6%) were shifted to mechanical ventilation and out of them 4(26.6%) expired. Mean CRP of ICU patients was 148±82.1 (p-value= 0.008) and 124.2±60.2 in expired patients. Conclusion: We conclude that higher level of CRP at presentation is an independent predictor of Covid 19 disease severity.