The Prognostic Significance of Established Hematological Parameters and Inflammatory Biomarkers in Assessing Dengue Infection Severity and Progression among Patients Ages 5 to 14 in a Tertiary Government Hospital in Pampanga, Philippines

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S103-S104
Author(s):  
J R Cai ◽  
I B Camacho ◽  
E M Caras ◽  
J A Carayugan ◽  
K H Carmona ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Hematological Parameters ◽  
Dengue Infection ◽  
Prognostic Significance ◽  
Absolute Lymphocyte Count ◽  
Warning Signs ◽  
Inflammatory Biomarkers ◽  
Severe Dengue ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Introduction/Objective Dengue virus (DENV) is an arthropod-borne virus which imposes a significant burden on the health system in most tropical and subtropical countries. In 2009, WHO classified Dengue into Dengue Without Warning Signs (DNWS), Dengue With Warning Signs (DWWS), and Severe Dengue (SD). This study aims to establish the prognostic value of predetermined hematological parameters and inflammatory biomarkers in assessing severity and progression of dengue infection among ages 5-14. Methods/Case Report A retrospective study was conducted to evaluate the Complete Blood Count, Inflammation biomarkers, and severity of dengue patients (5-14 of age). The diagnosis must be serologically confirmed by a positive NS1/IgM. Results (if a Case Study enter NA) A total of 36 patients participated in the study, having 18 from each groups of DWWS and SD. The mean age of Dengue cohort was 13.9 years with 59% (19/36) being male. Laboratory findings reveal SD to have lower platelet count (<100.00x109/L) during day 1-3 (p<0.001). Low WBC count (<4.00x109/L), Relative Eosinophil (<2.00%), and Absolute Lymphocyte count (<1.52x109/L) were evident on days 1-3 among DWWS and SD cases (p=0.023; p=0.045; p=0.033). Low relative neutrophil (<0.45%) was a constant finding in both clinical types throughout disease progression. SD group had significantly higher Neutrophil to Lymphocyte ratio (NLR) values among SD cases on days 4-6 (p<0.001). In contrast, Platelet to Lymphocyte ratio (PLR) was significantly lower among DWWS cases on days 4-6 (p=0.020). Monocyte to Lymphocyte (MLR) ratio had poor discriminative power (p=0.560). Conclusion The findings highlight decreased platelet, WBC, relative eosinophil, and absolute lymphocyte count to be common among Dengue patients. NLR and PLR were found to be good predictors of dengue severity during the initial phase of infection. Evaluating these values may aid clinicians in early diagnosis of severe dengue. However, larger samples are needed to further validate the predictive values of these parameters.

The atypical lymphocyte count: a novel predictive factor for severe thrombocytopenia related to dengue

2020 ◽  
Vol 114 (6) ◽  
pp. 424-432
Author(s):  
Visula Abeysuriya ◽  
Clarice Shi Hui Choong ◽  
Basuru Uvindu Thilakawardana ◽  
Primesh de Mel ◽  
Malka Shalindi ◽  
...  
Keyword(s):  
Platelet Count ◽  
Predictive Factor ◽  
Lymphocyte Count ◽  
Characteristic Curve ◽  
Dengue Infection ◽  
Severe Dengue ◽  
Full Blood Count ◽  
Severe Thrombocytopenia ◽  
Atypical Lymphocyte ◽  
Predictive Values

Abstract Background Early identification of patients at risk of severe dengue disease (DD) is critical to guide its management. We evaluated whether the atypical lymphocyte count (ALC), generated from the Sysmex automated full blood count analyzer, is predictive of severe thrombocytopenia secondary to Dengue infection. Methods We prospectively collected data on patients admitted with DD between December 2017 and October 2018. ALC data were extracted from the Sysmex XS500i analyzer from day 1 to day 7 of admission. Clinical data were obtained from patients' medical records. Results We enrolled 256 patients with DD. A negative correlation between ALC on admission and platelet count on day 5 to day 7 (Spearmen's correlation; day 5:-0.485, day 6:-0.428 and day 7:-0.344) (p=0.001) was observed. Based on receiver operator characteristic curve analysis, we found that an ALC of >0.5x103/L had 90% sensitivity and 70% specificity for severe thrombocytopenia (platelet count <50x109/L) on day 5. The positive and negative predictive values were 74.4 and 91.2%, respectively (power 84.7). Conclusions We propose that ALC on admission may be a novel negative predictive factor for severe thrombocytopenia on day 5 to day 7 of DD. Further studies are required to validate our findings and evaluate whether ALC is predictive of other complications of DD.

scholarly journals COVID-19 mortality prediction model, 3C-M, built for use in resource limited settings - understanding the relevance of neutrophilic leukocytosis in predicting disease severity and mortality

2021 ◽  
Author(s):  
Niharika Agarwal ◽  
Devika Dua ◽  
Ritika Sud ◽  
Madhur Yadav ◽  
Aparna Agarwal ◽  
...  
Keyword(s):  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Hematological Parameters ◽  
Severe Disease ◽  
Absolute Lymphocyte Count ◽  
Mortality Prediction ◽  
Clinical Severity ◽  
Total Leukocyte Count ◽  
Lymphocyte Ratio

In this study, a combination of clinical and hematological information, collected on day of presentation to the hospital with pneumonia, was evaluated for its ability to predict severity and mortality outcomes in COVID-19. Ours is a retrospective, observational study of 203 hospitalized COVID-19 patients. All of them were confirmed RT-PCR positive cases. We used simple hematological parameters (total leukocyte count, absolute neutrophil count, absolute lymphocyte count, neutrophil to lymphocyte ration and platelet to lymphocyte ratio); and a severity classification of pneumonia (mild, moderate and severe) based on a single clinical parameter, the percentage saturation of oxygen at room air, to predict the outcome in these cases. The results show that a high absolute neutrophil count on day of onset of pneumonia symptoms correlated strongly with both severity and survival in COVID-19. In addition, it was the primary driver of an initial high neutrophil-to-lymphocyte ratio (NLR) observed in patients with severe disease. The effect of low lymphocyte count was not found to be very significant in our cohort. Multivariate logistic regression was done using Python 3.7 to assess whether these parameters can adequately predict survival. We found that clinical severity and a high neutrophil count on day of presentation of pneumonia symptoms could predict the outcome with 86% precision. This model is undergoing further evaluation at our centre for validation using data collected during the second wave of COVID-19. We present the relevance of an elevated neutrophil count in COVID-19 pneumonia and review the advances in research which focus on neutrophils as an important effector cell of COVID-19 inflammation.

scholarly journals Increased levels of pentraxins protein and cytokines bear good association in patients with severe dengue infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Goutam Patra ◽  
Bibhuti Saha ◽  
Sumi Mukhopadhyay
Keyword(s):  
Dengue Infection ◽  
Clinical Manifestations ◽  
Blood Parameters ◽  
Warning Signs ◽  
Severe Dengue ◽  
Disease Manifestation ◽  
Mild Disease ◽  
Tnf Α ◽  
The Status ◽  
The Tropics

AbstractDengue is an arboviral infection with high rates of morbidity and mortality throughout the tropics and sub-tropics. This work studied the status of pentraxin (CRP/SAP) protein, ferritin, TNF-α and IL-1β levels in Dengue patients of different pathophysiological manifestations. Accordingly, clinically confirmed Dengue cases (n = 97) were enrolled and subsequently blood parameters were studied by Haematology cell counter and Biochemistry Autoanalyser. CRP, SAP, ferritin, TNF-α and IL-1β ELISA were done in all the samples by using standard ELISA kits. Statistical Analysis was done in all the experiments. The levels of CRP (p < 0.0001), SAP (p < 0.0001), ferritin (p < 0.0001), TNF-α (p < 0.0001) and IL-1β (p < 0.0001) were high in patients with Severe Dengue as compared to Dengue without warning signs. High levels of SGOT, SGPT and decreased platelet counts were found in severe patients as compared to Healthy donor. CRP/SAP as well as TNF-α/IL-1β were independently associated with both dengue severity and overall disease manifestation. Statistically significant increased CRP, SAP, ferritin, TNF-α and IL-1β titres were correlated in patients with severe clinical manifestations as compared to mild disease forms of dengue. Elevated levels of pentraxin, TNF-α/IL-1β in blood during dengue infection could act as an early predictor in Severe Dengue infection.

scholarly journals Clinical profile of dengue fever in children: analysis of 2017 outbreak from Central Kerala, India

2018 ◽  
Vol 5 (6) ◽  
pp. 2265 ◽  
Author(s):  
Senthil Kumar K. ◽  
Rajendran N. K. ◽  
Ajith Brabhukumar C.
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Warning Signs ◽  
Clinical Profile ◽  
Severe Dengue ◽  
High Morbidity ◽  
Care Hospital ◽  
High Grade Fever

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.

scholarly journals A clinical corelation study of dengue fever with hepatic dysfunction in children and their outcome

2021 ◽  
Vol 8 (4) ◽  
pp. 706
Author(s):  
Srividya G. M. ◽  
Poornima Lakshmi
Keyword(s):  
Hepatic Dysfunction ◽  
Total Bilirubin ◽  
Complete Blood Count ◽  
Dengue Infection ◽  
Liver Function Tests ◽  
Significant Rise ◽  
Warning Signs ◽  
Severe Dengue ◽  
Serum Total Bilirubin ◽  
Life Threatening

Background: The study was hepatic dysfunction in childhood dengue infection and to study clinical co-relation like severity, clinical features, and outcome.Methods: Dengue sero positive patients of 100 were admitted during the study period and examined for hepatomegaly and jaundice and subjected to complete blood count, liver function tests, ultrasound abdomen, PT, APTT, HBsAg, HCV, Widal and analysed.Results: All patients presented with fever, most commonly occurred in age group of 5 to 7 years, hepatomegaly was the commonest clinical sign seen, thrombocytopenia was seen in 88% of cases, serum total bilirubin was raised in 10% of subjects with severe dengue infection. Serum SGOT was raised in 74 % of patients with dengue. When compared between the groups, rise in SGOT occurred in 74% of patients with probable dengue, 98% with warning signs and 100% in severe dengue. SGPT was raised in 58% of patients with dengue infection. When compared between the groups, rise in SGPT occurred in 42% of patients with probable dengue, 66% with warning signs and 81% in severe dengue. SGPT was raised in 28% of patients with dengue infection. When compared between the groups, rise in SGOT occurred in 9.5% of patients with probable dengue, 32% with warning signs and 82% in severe dengue. Prothrombin time was raised in 11% of patients. When compared between the groups, rise in PT occurred in 6.4% with warning signs and 72% in severe dengue. When compared between the groups, rise in APTT occurred in 6.4% of patients with warning signs and 72% in severe dengue. When compared between the groups fall in serum protein occurred in 12.7% with warning signs and 54.5% in severe dengue. 2 cases of severe dengue expired, in which the enzyme levels were highly elevated.Conclusions: Significant rise of liver enzymes helps in recognition of severe forms of dengue infection. As hepatic dysfunction in dengue is transient and reversible, early identification of the same should help to reduce life threatening complications. This can help to reduce the morbidity and mortality due to dengue infection.al population.  

Pretreatment Absolute Lymphocyte Count and Neutrophil-to-lymphocyte Ratio Are Prognostic Factors for Stage III Breast Cancer

2021 ◽  
Vol 41 (7) ◽  
pp. 3625-3634
Author(s):  
KOSHO YAMANOUCHI ◽  
SHIGETO MAEDA ◽  
DAIKI TAKEI ◽  
YOICHI KOGA ◽  
MANPEI YAMASHITA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stage Iii ◽  
Lymphocyte Ratio ◽  
Stage Iii Breast Cancer

Absolute Lymphocyte Count, Platelet-to-Lymphocyte Ratio, and Overall Survival in Eribulin-treated HER2-negative Metastatic Breast Cancer Patients

2021 ◽  
Vol 1 (5) ◽  
pp. 435-441
Author(s):  
YOICHI KOYAMA ◽  
SAORI KAWAI ◽  
NATSUKI UENAKA ◽  
MIKI OKAZAKI ◽  
MARIKO ASAOKA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Lymphocyte Count ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Absolute Lymphocyte Count ◽  
Breast Cancer Patients ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background/Aim: To investigate the utility of peripheral blood biomarkers – absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) – for predicting outcomes in eribulin-treated patients with metastatic human epidermal growth factor receptor type 2 (HER2)-negative breast cancer. Patients and Methods: ALC, NLR, and PLR were retrospectively obtained from pre-treatment blood sampling results of 120 patients and stratified according to means. Univariate and multivariate analyses were performed to investigate the association of clinicopathological factors, including these values, with overall survival (OS) and progression-free survival (PFS). Results: The ALC, NLR, and PLR cut-off points were 1,285/μl, 3.3, and 235, respectively. No biomarkers were associated with PFS. However, univariate analysis showed ALC (p=0.044) and PLR (p=0.044) to be significantly associated with OS. Conclusion: ALC and PLR can predict eribulin efficacy in terms of OS, reflecting the antitumour immune response in the microenvironment and indicating eribulin’s effectiveness.

Baseline neutrophil-to-lymphocyte ratio and absolute lymphocyte count in patients with HER2-negative breast cancer treated with eribulin may predict overall survival.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13005-e13005
Author(s):  
Shigeto Maeda ◽  
Keisei Anan ◽  
Kenichiro Koga ◽  
Sayaka Kuba ◽  
Hiroshi Yano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Overall Survival ◽  
Lymphocyte Count ◽  
Group Performance ◽  
Absolute Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Rank Test ◽  
Lymphocyte Ratio ◽  
Log Rank Test

e13005 Background: In Japan, eribulin has been approved for inoperative or recurrent breast cancer, following treatment with an anthracyclines and a taxanes. We reported the efficacy and safety of eribulin as a first-line to third-line treatment in patients with advanced/metastatic breast cancer (MBC) previously treated with anthracylinsanthracyclines and taxanes (Breast 2017). Briefly, the main inclusion criteria were as follows: no history of eribulin administration; an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 2,; human epidermal growth factor receptor 2 (HER2)-negative,; 20–75 years; ≥4 weeks from the last dose of chemotherapy, or ≥2 weeks from the last dosing of endocrine or radiation therapy; measurable lesion based on Response Evaluation Criteria in Solid Tumors (RECIST) ver. 1.1; sufficient organ function; life expectancy of ≥3 months; and no significant abnormalities on electrocardiogram. Patients in this clinical trial were enrolled between December 1, 2011, and November 30, 2013. Eribulin was administered intravenously at a dose of 1.4 mg/m2 during a 2-5 min infusion on days 1 and 8 every 3 weeks. In contrast, baseline neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC) were reported to predict progression-free survival (PFS) or overall survival (OS). However, these reports were mainly retrospective analysis. Therefore, retrospective evaluation of NLR/ALC in a prospective clinical trial is important to understand the association between NLR/ALC and OS/PFS. Methods: Of 47 prospectively enrolled patients in a previous trial, 45 patients were retrospectively evaluated for baseline NLR/ACL and at the time of 3 cycles of eribulin. The association between NLR/ALC and OS/PFS was also were analyzed for association with OS/PFS. The Kaplan-Meier method was used to estimate the OS/PFS distribution. The cut-off values for baseline NLR and ALC were set at 3 and 1500 /ul, respectively. Results: The median OS of patients with a baseline NLR < 3 was significantly longer than that of patients with a baseline NLR ≥ ≧3 (769 days vs. 409 days; log-rank test p = 0.0333). The median OS of patients with a baseline ALC ≥ ≧1500 was also significantly longer than that of patients with a baseline ALC < 1500 (964 days vs.vs 427 days; log-rank test p = 0.0425). Association between baseline NLR/ALC and PFS were not seen, and also association between at the time of 3 cycles of NLR/ALC and OS/PFS were not seen neither. Conclusions: Baseline NLR and ALC in the patients with HER2- negative breast cancer who plan to treat eribulin may predict overall survival. Clinical trial information: UMIN000007121.

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