Evaluation of hematological parameters and inflammatory markers in children with COVID-19

Background: We attempt to compare preoperative inflammatory markers among children with medulloblastoma and pilocytic astrocytoma and establish their diagnostic efficacy to distinguish these tumors. Methods: Children (<18 years) with biopsy-proven medulloblastoma and pilocytic astrocytoma operated at our institute from January 2012 to January 2018 were enrolled in this study. The hematological parameters were compared between the two groups and with healthy controls. Children with a history of disease or medications that may confound these parameters were excluded from the study. Receiver operator characteristic curves were made to assess the diagnostic accuracy of markers found to be significant. Results: Patients with medulloblastoma were found to have higher neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR), platelet-lymphocyte ratio (PLR), and platelet counts compared with pilocytic astrocytoma. Absolute lymphocyte count (ALC) was significantly lower in medulloblastoma group as compared to healthy controls but not with pilocytic astrocytoma. NLR and dNLR demonstrated maximum diagnostic accuracy in distinguishing patients with medulloblastoma from healthy controls and pilocytic astrocytoma. Using a cutoff of 2.45 for NLR distinguishes medulloblastoma from healthy controls as well as pilocytic astrocytoma with a sensitivity of 75.5% and specificity of 66.7%. Similarly, dNLR cutoff of 1.47 distinguishes medulloblastoma from healthy controls with a sensitivity of 83% and specificity of 76% and a cutoff of 1.53 distinguishes medulloblastoma from pilocytic astrocytoma with a sensitivity of 81.1% and specificity of 81.8%. Combination of NLR and dNLR performed only marginally better than individual variables with area under the curve being 0.856 for medulloblastoma versus healthy controls and 0.86 for medulloblastoma versus pilocytic astrocytoma. Conclusion: NLR and dNLR can be used as a preoperative predictive marker in medulloblastoma. There is decreased ALC in patients with medulloblastoma contributing to raised NLR and dNLR suggestive of systemic immunosuppression.

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Effects of cold water immersion on circulating inflammatory markers at the Kona Ironman World Championship

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0602 ◽

2021 ◽

Author(s):

Jenna M Bartley ◽

Rebecca L Stearns ◽

Colleen Munoz ◽

Julie K. Nolan ◽

Shlomit Radom-Aizik ◽

...

Keyword(s):

Muscle Damage ◽

Inflammatory Markers ◽

Immune Cell ◽

Cold Water ◽

Water Immersion ◽

Hematological Parameters ◽

Cold Water Immersion ◽

World Championship ◽

Leukocyte Counts ◽

Muscle Damage Markers

Cold water immersion (CWI) purportedly reduces inflammation and improves muscle recovery post exercise, yet its effectiveness in specific contexts (ultraendurance) remains unclear. Thus, our aim was to study hematological profiles, systemic inflammation, and muscle damage responses to a specific post race CWI (vs. control) during recovery after the Ironman® World Championship, a culmination of ~100,000 athletes competing in global qualifying Ironman® events each year. Twenty-nine competitors were randomized into CWI or control (CON) group. Physiological parameters and blood samples were taken pre race (BASE), after intervention (POST), and 24 (+1DAY) and 48 hours (+2DAY) following the race. Muscle damage markers (plasma myoglobin, serum creatine kinase) were elevated at POST, +1DAY, and +2DAY, while inflammatory cytokines IL-6, IL-8, and IL-10 and total leukocyte counts were increased only at POST. CWI had no effect on these markers. Numbers of the most abundant circulating cell type, neutrophils, were elevated at POST more so in CWI (p<0.05, vs. CON). Despite that neutrophil counts may be a sensitive marker to detect subtle effects, CWI does not affect recovery markers 24- and 48-hours post race (vs. CON). Overall, we determine that our short CWI protocol was not sufficient to improve recovery. Novelty: • Ironman World Championship event increased circulating muscle damage markers, inflammatory markers, and hematological parameters, including circulating immune cell sub-populations that recover 24-48 hours after the race. • 12-min CWI post ultraendurance event affects the absolute numbers of neutrophils acutely, post race (vs. CON), but does not impact recovery 24- and 48-hours post race.

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Retrospective Analysis of Hematological Parameters in Covid Positive Pregnancy

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i4.4873 ◽

2021 ◽

Vol 12 (4) ◽

pp. 2389-2394

Author(s):

Sivasundari Maharajan ◽

Nimrah Amthul ◽

Dhanvarsha Sumaldha

Keyword(s):

Inflammatory Markers ◽

Hematological Parameters ◽

College Hospital ◽

Acute Phase Reactants ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Clinical Scenarios ◽

Study Population ◽

Physiological Changes In Pregnancy ◽

In Pregnancy

The newly identified SARS-CoV-2 virus and its ongoing implicated COVID-19 pandemic started off as pneumonia of unknown aetiology in Wuhan, China, in December 2019. Certain laboratory values that may be considered deranged in non pregnant states are normal physiological changes in pregnancy. An understanding of the normal haematological and immunologic parameters in pregnancy is necessary for the interpretation of COVID-19 severity. Considering the COVID-19 infection is still new, little is known about the clinical course of the disease in pregnancy. This is a retrospective observational study undertaken in the Department of Obstetrics and Gynaecology, Saveetha Medical College Hospital, Chennai, India, from April to November 2020. Out of the 50 women in the study, 19 women were anaemic with haemoglobin <11, accounting for 38% of the study population. A neutrophil to lymphocyte ratio greater than 4.5 was observed in 44% of the population. Thrombocytopenia was present in 12% of the population. D-dimer greater than 1000 was found in 12% of the study population. All of our patients were asymptomatic, had good maternal and fetal outcomes even though derangement of inflammatory markers were noted. The immunological changes of pregnancy make pregnant women more susceptible to pathogens. Though our patients had instances suggestive of critical prognosis like an increased neutrophil-lymphocyte-ratio and affirmative acute phase reactants and inflammatory markers, they were asymptomatic (category BNH) and stable in room air. However, further analysis of laboratory parameters and their correlation to clinical scenarios in the second wave of COVID19 infection is warranted.

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Curcumin Effect on Rats Hepato-Renal Functions, Hematological Parameters, and Inflammatory Markers in Comparison with Celecoxib and Prednisolone

Zagazig Veterinary Journal ◽

10.21608/zvjz.2021.96979.1157 ◽

2021 ◽

Vol 49 (4) ◽

pp. 390-399

Author(s):

Saydat Abd-El Megid ◽

Eman Osman ◽

Tarek Khamis ◽

Ahmed Arisha ◽

doaa Abdel-Fattah

Keyword(s):

Inflammatory Markers ◽

Hematological Parameters ◽

Renal Functions

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Translation from SCD Mouse to Man: Chronic Administration of Tucaresol Reduces RBC Sickling and Improves Hematological Parameters, but Does Not Impact Inflammatory Markers in SCD Model Mice

Blood ◽

10.1182/blood.v128.22.3644.3644 ◽

2016 ◽

Vol 128 (22) ◽

pp. 3644-3644

Author(s):

Kelly Marie Knee ◽

Reema Jasuja ◽

Amey Barakat ◽

John J. Kelly ◽

Joseph C. Nneji ◽

...

Keyword(s):

Clinical Trials ◽

Small Molecule ◽

Clinical Data ◽

Inflammatory Markers ◽

Hematological Parameters ◽

Oxygen Affinity ◽

Polymerization Process ◽

Hematological Markers ◽

Long Term Treatment ◽

Hb S

Abstract Sickle cell disease is a hematological disorder with significant unmet need that affects approximately ten million people worldwide. Currently, treatment for SCD is limited to a single approved drug, Hydroxyurea, and palliative treatments such as hydration and pain management. The limited treatment options have led to considerable interest in developing new therapies for SCD. One strategy for a disease-modifying treatment for SCD is stabilization of the oxygenated form of hemoglobin (OxyHb) by a small molecule allosteric modulator (Zaugg et. Al, JBC, 1977). One such compound, Tucaresol was advanced into clinical trials on the strength of the pre-clinical data, however a SCD mouse model was unavailable when the trial was initiated. The renewed interest in stabilizing OxyHb with a small molecule presents an opportunity to use Tucaresol as a mechanism for understanding the translation between effects seen in an animal model and clinical endpoints in patients. In this study, we treated Townes SCD mice with Tucaresol for 15 days, to evaluate its effect on hematology, oxygen affinity, sickling and markers of inflammation in vivo. These results are compared to the clinical data reported in the original trials. Tucaresol is a substituted benzaldehyde derived from a class of molecules known to preferentially bind to hemoglobin and stabilize the oxygenated state by formation of a Schiff base linkage at a site on the a-chains (Rolan et. Al, Br. J. Clin. Pharm., 1995). Earlier molecules acting by this mechanism had been shown to reduce Hb S polymerization and RBC sickling in vitro, and it was theorized that long-term treatment with such molecules would impact hemolysis and occurrence of vaso-occlusive crisis (VOC) (Beddell et. Al, Br. J. Pharmac. 1984). Preclinical studies demonstrated Tucaresol modification of Hb S delays the polymerization process and inhibits RBC sickling. In clinical trials, Tucaresol positively impacted hematological markers including hemoglobin and reticulocyte counts, and reduced the percentage of irreversibly sickled cells. However, trials of Tucaresol were halted due to a significant immune response and specific inflammatory markers were not measured during the trial. To study these effects in Townes SCD model, mice were dosed with Tucaresol at 30 mg/kg twice a day, for fifteen days. The dose was selected to be consistent with clinical dosing regimens. Blood was collected prior to study start from individual animals to obtain baseline levels for hematological parameters and soluble cell adhesion molecules in plasma. Blood was sampled at day 3 and day 10 of dosing to understand drug exposure and accumulation. At this dose, Tucaresol demonstrated a steady state achieved by day 10 and the blood concentration ranged from 0.5-1.6 mM on day 15. Following two week dosing with Tucaresol, we observed a 50% increase in hemoglobin, and 24% increase in mean corpuscular hemoglobin concentration (MCHC), relative to vehicle treated animals. Reticulocytes, a clinical indicator of hemolytic anemia, are highly elevated in SCD patients and mice, also showed a 47% decrease in Tucaresol treated relative to vehicle treated animals. Oxygen affinity measurements showed a decrease in P50 and P20 values for treated animals, indicating increased oxygen affinity, consistent with the proposed mode of action of Tucaresol- stabilization of the oxygenated state. The percentage of sickled erythrocytes was also decreased by 38% in Tucaresol treated SCD mice when compared to vehicle controls. The decrease in sickling is consistent with the clinical observation of a 52% (mean) decrease in irreversibly sickled cells. In contrast to the improvement seen with hematological parameters, inflammatory markers remained either unchanged or slightly elevated after 15 days of treatment with Tucaresol. Plasma levels of sICAM-1 and sVCAM-1 were unchanged while sE-Selectin was elevated. In summary, in this short course of treatment of SCD mice, Tucaresol had an impact on the hematological markers that was consistent with effects observed in the clinic, but did not modulate the inflammation response. All experiments were within guidelines and were reviewed and approved by Pfizer institutional animal care and use committee. Disclosures Knee: Pfizer Inc: Employment. Jasuja:Pfizer: Employment. Barakat:Pfizer: Employment. Kelly:Pfizer: Employment. Singh:Pfizer Inc: Employment. Janz:Pfizer: Employment.

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Selected Blood Inflammatory and Metabolic Parameters Predicted Successive Bilateral Sudden Sensorineural Hearing Loss

Disease Markers ◽

10.1155/2019/7165257 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Xueyuan Zhang ◽

Yinlun Weng ◽

Yaodong Xu ◽

Hao Xiong ◽

Maojin Liang ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Inflammatory Markers ◽

Hematological Parameters ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Metabolic Parameters ◽

Female Ratio ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Objectives. To explore whether peripheral inflammatory, metabolic, and hemostatic parameters could predict the pathogenesis of successive bilateral sudden sensorineural hearing loss (SSNHL). Methods. This study reviewed 33 patients with successive bilateral SSNHL and 215 patients with unilateral SSNHL. Clinical characteristics and hematological parameters were compared, including the inflammatory markers (like neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR)) and metabolic features (including hypertension, triglyceridemia, dyslipidemia, and hyperglycemia), as well as hemostatic indices (including prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen). Results. In the successive bilateral SSNHL group, older average onset age (48.67±15.36 vs. 42.71±13.58, p<0.05), higher male to female ratio (18 : 15 vs. 112 : 103, p>0.05), and poorer therapeutic efficacy (12% vs. 59%, p<0.01) were observed than those in the unilateral SSNHL group. Compared to the unilateral SSNHL group, NLR, MLR, and PLR in the successive bilateral SSNHL group were significantly higher (NLR: 5.72±2.23 vs. 4.45±2.82, p=0.01; MLR: 0.25±0.15 vs. 0.17±0.11, p<0.01; PLR: 190.70±69.79 vs. 148.18±65.67; p<0.01); the LDL level was significantly higher; yet, the HDL level was significantly lower (LDL: 3.79±0.53 vs. 3.49±0.74; HDL: 1.33±0.32 vs. 1.44±0.26; p<0.05 for both); fibrinogen was significantly higher (4.03±0.47 vs. 3.70±0.65; p<0.01). Logistic regression analysis demonstrated that the risk factors for successive bilateral SSNHL included age, NLR, MLR, PLR, LDL, HDL, diabetes, and fibrinogen. However, only NLR, MLR, PLR, diabetes, LDL, and HDL independently predicted successive bilateral SSNHL. Conclusion. Selected blood inflammatory markers combined with metabolic parameters were positively correlated with successive bilateral SSNHL.

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