Complete Blood Count Peculiarities in Pregnant SARS-CoV-2-Infected Patients at Term: A Cohort Study

Background: During viral outbreaks, pregnancy poses an increased risk of infection for women. Methods: In a prospective study, all patients admitted for delivery at term to Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, between 1 April 2020 and 31 December 2020 were included. There were 457 patients, divided into two groups: group 1, SARS-CoV-2-positive patients (n = 46) and group 2, SARS-CoV-2-negative patients (n = 411). Among other tests, complete blood count was determined upon admittance, and the following values were studied: white blood cell count, lymphocytes, neutrophils, red blood cell count, hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, mean corpuscular volume, red blood cell distribution width, hematocrit, platelet count, mean platelet volume, platelet distribution width, plateletcrit, and platelet large cell ratio. Results: in pregnant SARS-CoV-2-infected patients at term, there was a significant decrease in white blood cell, neutrophil, and lymphocyte count, and an increase in mean corpuscular hemoglobin concentration, compared to healthy pregnant women at term, although all still within normal limits. None of the other components of the complete blood count or fetal outcomes studied was significantly influenced by SARS-CoV-2 infection in pregnant patients at term.

725. Complete Blood Count Values Vary in Degree of Change with Day of Fever in Children with Dengue Fever

Background Dengue fever (DF) is an acute viral disease which can lead to severe illness, including dengue hemorrhagic fever, marked by thrombocytopenia and hemolytic anemia, as well as end-organ damage. Despite the well-known presentation and prevalence, changes in hematologic markers across the DF course have not been well-described in children. We sought to investigate the association of clinical laboratory values over time with dengue disease progression and outcome in a pediatric population in the Dominican Republic. Methods Pediatric participants were enrolled at Hospital Infantil Dr. Robert Reid Cabral in Santo Domingo, Dominican Republic, in a prospective, observational case-based study. Laboratory values, including complete blood count (CBC) indices and dengue titer results, were collected over the course of hospital stay. Using linear mixed models, we assessed whether 13 different CBC values and time trajectories differed by dengue status, including age and sex as covariates. To account for multiple testing, p≤0.0033 was considered significant. Results A total of 575 children ages 0 to 211 months met inclusion criteria; 51.8% (n=298) were male, and the median (IQR) age was 59 (14-93) months. Eighty-two percent (n=472) of participants had DF. CBC values across days 1 to 10 of fever in those with and without DF are depicted in Figure 1. Those with DF showed levels dropping more quickly across days of fever for hematocrit and hemoglobin (p≤ 0.002), with a more rapid decline in those with severe DF (p < 0.0001). Those with DF had levels increasing more quickly for mean corpuscular hemoglobin concentration (MCHC), monocyte number, and white blood cell counts (p ≤ 0.003), with those with severe DF having a more rapid increase (p < 0.001). The direction of the change across time differed by DF status for mean corpuscular volume and red blood cell distribution width (RDW) (p ≤ 0.0003), with those with severe DF showing an increase in RDW across day of fever (p= 0.0004). Figure 1. CBC values across day of fever in dengue (blue) and non-dengue (purple) patients. The graph above depicts the following CBC values across day of fever in dengue (blue) and non-dengue (purple) patients: a) white blood cell (WBC) count, b) platelet count, c) monocyte number, d) hemoglobin, e) mean corpuscular hemoglobin concentration (MCHC), and f) mean corpuscular volume (MCV). Values with an asterisk (*) represent significant values (p < 0.0033). Conclusion The trajectory of CBC measures differs between those with and without DF, despite similar clinical presentations. These laboratory differences may facilitate a better understanding of the clinical course of DF and may aid in earlier identification of DF in resource-limited settings. Disclosures Elizabeth P. Schlaudecker, MD, MPH, Pfizer (Grant/Research Support)Sanofi Pasteur (Advisor or Review Panel member)

Effect of gender on hematological parameters in growing Ouled Djellal sheep of semi arid zones of Northeastern Algeria

Ouled Djellal sheep is the most dominant breed in Algeria due to its adapta-tion to harsh steppe environment. Hematological parameters are good indi-cators of animal health, but their values are breed-specific, and they are affected by age and gender. Therefore, this study aimed to determine the hematological profile of healthy Ouled Djellal lambs and ewe lambs reared traditionally under semi-arid zones of Algeria during the growing peri-od. Blood samples were taken from twenty-four Ouled Djellal lambs (12 males, 12 females) at 42, 63, 84 and 105 days of age to evaluate the count of White Blood Cells, Lymphocyte, Monocyte, Granulocyte, Red Blood Cell and total Platelet, the percentage of Lymphocyte, Monocyte and Granulocyte, Hemoglobin concentration, Hematocrit, Mean Corpuscular Volume, Mean Corpuscular Hemoglobin and Mean Corpuscular Hemoglobin Concentration by usual known methods. Both male and female lambs did not show signifi-cant variations in mean values of White Blood Cells, Lymphocyte count, Red Blood Cells, Hemoglobin, Mean Corpuscular Hemoglobin concentration, per-centage of Monocyte, Monocyte count, Gran percentage and Granulocyte count from 42ͭ ͪ day to 105ͭ ͪ days. Mean values of percentage of Lymphocyte, Hematocrite in lambs, Mean Corpuscular Hemoglobin in ewe lambs, and Mean Corpuscular Volume, Platelets levels in both lambs and ewe lambs indicated also variations during this period of growth. Significant Pearson's correlations were found between some hematological parameters in Ouled Djellal lambs and/or ewe lambs. Therefore, these findings provide usual val-ues, which can be considered for assessing the physiological, nutritional and health status of these animals.

Daily water regime and sample sampling affect blood and urine parameter value change in healthy individuals

Background Homeostasis is a mechanism for maintaining a stable inner environment in healthy participants. Blood and urine biomarkers are indicators of the subject health status. Biomarkers apply for early diagnosis, prognosis, and treatment. Understanding the effect of pre-analytical factors on biomarker range is significant for the data quality of bio-specimens, reproducibility, and minimizing potential results errors. Water as a necessary element for the normal functioning of living beings and sampling frequency as pre-analytical factors influences the homeostatic range of parameters. The purpose of the study is to examine the effect of 9-day fluid intake and 2-time sampling on concentration changes of 7-urine (freezing point depression, potassium, sodium, chloride, urea, creatinine, urate) and 17-blood (urea, creatinine, urate, glucose, C-reactive protein, leukocytes, erythrocytes, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean platelet volume, thrombocytes, potassium, sodium, and chloride) variables. Methods Parametric and non-parametric test apply to data processing with SPSS software v23.0. Results The group of 23 healthy subjects was divide based on water intake (test: more than 1800 ml; control: less than 2000 ml) and gender (female: 10(43%); male: 13(57%)). The mean value of the amount of fluid consumed for the test group is 2183.33 ml, while the control is 1395.83 ml. Investigated parameters, freezing point depression, sodium, potassium, creatinine urea and urate in urine, urea, urate, glucose, hematocrit, and thrombocyte in blood show a significant difference (P < 0.01) between the first and second sampling. The difference between water intake after first sampling (P < 0.01) observes for freezing point depression, sodium, urate, and (P < 0.05) for potassium (P < 0.05), chloride (P < 0.05), creatinine (P < 0.05), urate, urea in urine and potassium (P < 0.01), and chloride (P < 0.05) in blood. Difference between gender exists for urea (P < 0.05) in urine after second sampling and urate (P < 0.01), glucose (P < 0.01/0.05), hematocrit (P < 0.01/0.05) after the first and second sampling, and mean corpuscular hemoglobin concentration (P < 0.01) after secondary sampling in blood samples. Conclusion Water intake increases the blood and urine biomarker range after the first and second sampling. Further studies should include a larger number of participants to get precise reference limits in a healthy population. Compare health and disease states to draw practical clinical conclusions.

Nilai Mean Corpuscular Hemoglobin Concentration, Mean Corpuscular Volume dan Mean Corpuscular Hemoglobin Darah Sapi Bali yang Dipelihara Berbasis Organik

Telah dilakukan penelitian untuk mengetahui nilai hematologi MCHC (Mean Corpuscular Hemoglobin Concentration), MCV (Mean Corpuscular Volume) dan MCH (Mean Corpuscular Haemoglobin) darah sapi bali yang dipelihara berbasis organik. Sistem pemeliharaan berbasis organik adalah manajemen pemberian pakan yang berasal dari lingkungan serta tidak menggunakan pestisida atau zat kimia lainnya. Nilai MCV, MCH dan MCHC darah sapi bali diukur dengan Veterinary hematology analyzer. Hasil penelitian menunjukan, nilai dari MCHC sebesar 39,17%/dl, MCV sebesar 48,44 fl dan nilai dari MCH sebesar 18,69pg. Dapat disimpulkan rerata nilai tersebut masih dalam batas normal nilai indeks eritrosit sapi pada umumnya.

Rapid Gardos Hereditary Xerocytosis Diagnosis in 8 Families Using Reticulocyte Indices

Gardos channelopathy (Gardos-HX) or type 2 stomatocytosis/xerocytosis is a hereditary hemolytic anemia due to mutations in the KCNN4 gene. It is rarer than inherited type 1 xerocytosis due to PIEZO1 mutations (Piezo1-HX) and its diagnosis is difficult given the absence of a specific clinical or biological phenotype. We report here that this diagnosis can be sped up using red blood cell (RBC) indices performed on an ADVIA 2120 (Siemens®) analyzer, which measures reticulocyte mean corpuscular volume (rMCV) and mean corpuscular hemoglobin concentration (rMCHC). We studied reticulocyte indices in 3 new and 12 described patients (8 families) with Gardos-HX, 11 subjects presented the recurrent p.Arg352His mutation, 4 cases (two families) carried a private KCNN4 mutation. They were compared to 79 described patients (49 families) with Piezo1-HX. Surprisingly, in Gardos-HX cases, rMCV revealed to be smaller than MCV and rMCHC higher than MCHC, in contrast with normal or Piezo1-HX RBC. Consequently, ΔMCV (rMCV-MCV) was −0.9 ± 5 fL vs. 19.8 ± 3 fL (p &lt; 0.001) in Gardos compared with Piezo1-HX and ΔMCHC (rMCHC-MCHC) was 18.7 ± 13 vs. −50 ± 8.7 g/L (p &lt; 0.001). A threshold of 8.6 fL for ΔMCV and −5.5 g/L for ΔMCHC could discriminate between Gardos and Piezo1-HX with 100% sensitivity and specificity, regardless of age, mutation or splenectomy status. Consequently, we showed that reticulocytes indices are useful to suggest Gardos-HX on blood count results, allowing to rapidly target these patients for gene analysis. In addition, these parameters may prove useful as a ‘functional tool’ in interpreting new KCNN4 variants.

Cogongrass (Imperata cylindrical L.) Roots Ethanol Extract to Improve Hematological Profile in Carbon Tetrachloride-Injection Mice Model

Carbon tetrachloride (CCL4) is widely used in industry, toxic to the environment and humans, and most often used as a model of acute liver damage and liver fibrosis in experimental animals. Liver damage can deteriorate the hematological profile. The roots of cogongrass (Imperata cylindrica L.) have been used as traditional medicine due to its antioxidant activity. This study was conducted at the Faculty of Medicine, Universitas Padjadjaran, from January to March 2019. The study aimed to investigate whether the cogongrass roots ethanol extract (CGRE) can ameliorate the disturbance in the hematological profile in acute CCl4-injected mice. CGRE in dose 150 and 200 mg/kgBW was given orally to mice for four weeks before intraperitoneal injection of CCl4 1 mL/kgBW in olive oil (1:1 v/v). After 48 hours, mice were sacrificed, and the whole blood was drawn for hematological analysis. As a result, mean corpuscular volume (MCV) was reduced in CCl4-induction mice treated with CGRE in dose 150 mg/kgBW (49.25±3.06 vs 43.38±2.13 fl, p<0.05). This condition was followed by the improved hematocrit (Hct) and mean corpuscular hemoglobin concentration (MCHC). Platelet and platelet crit (Pct) levels were tended to decrease in CCl4-induction mice treated with CGRE in dose 150 mg/kgBW. In conclusion, CGRE dose 150 mg/kg BW can improve MCV, Hct, MCHC, platelet, and Pct in CCl4-injection mice. The antioxidant level in CGRE might facilitate it. EKSTRAK ETANOL AKAR ALANG-ALANG (IMPERATA CYLINDRICAL L.) MEMPERBAIKI PROFIL HEMATOLOGI PADA MENCIT YANG DIINJEKSI CARBON TETRACHLORIDECarbon tetrachloride (CCL4) banyak digunakan pada industri, bersifat toksik bagi lingkungan dan manusia, serta sering digunakan pada hewan coba untuk kerusakan liver akut dan fibrosis. Kerusakan liver dapat menyebabkan gangguan profil hematologi. Akar alang-alang (Imperata cylindrica L.) telah digunakan sebagai obat tradisional karena memiliki aktivitas antioksidan. Penelitian ini dilakukan di Fakultas Kedokteran Universitas Padjadjaran pada bulan Januari hingga Maret 2019. Tujuan penelitian ini adalah meneliti apakah ekstrak etanol akar alang-alang dapat memperbaiki gangguan profil hematologi pada mencit yang diinjeksi CCL4 secara akut. Ekstrak etanol akar alang-alang (EEAA) dosis 150 dan 200 mm/kgBB diberikan per oral kepada mencit selama empat minggu sebelum injeksi intraperitoneal CCl4 1 mL/kgBB yang dilarutkan dalam minyak zaitun (1:1 v/v). Setelah 48 jam, mencit dikorbankan dan diambil darahnya untuk pemeriksaan hematologi. Sebagai hasil, mean corpuscular volume (MCV) menurun pada mencit yang diinduksi CCl4 dengan perlakuan EEAA 150 mg/kgBB (49,25±3,06vs 43,38±2,13 fl, p<0,05). Keadaan ini diikuti dengan perbaikan hematokrit (Hct) dan mean corpuscular hemoglobin concentration (MCHC). Kadar platelet dan platelet crit (Pct) cenderung menurun pada mencit yang diinduksi CCl4 dengan perlakuan EEAA 150 mg/kgBB. Sebagai simpulan, EEAA dosis 150 mg/kgBB dapat memperbaiki MCV, Hct, MCHC, platelet, dan Pct pada mencit yang diinjeksi CCL4. Kemungkinan difasilitasi oleh antioksidan pada EEAA.

Lower Mean Corpuscular Hemoglobin Concentration is Associated with Favorable Prognosis of Resected Pancreatic Cancer.

Objective: This study was designed to explore the value of mean corpuscular hemoglobin concentration (MCHC) for overall survival (OS) in resectable pancreatic cancer (PC). Background: Systemic inflammatory response are important factors that promotes the occurrence and metastasis of malignant tumors. MCHC are suggested to be relevant to the prognosis of several malignancies. Such as lung cancer, head and neck cancers. However, there are few studies to explore the correlation between them and PC. Methods: The present study included totally 544 patients with PC who underwent radical resection between March 2011 and May 2019. These patients were classified into a training set (n=195) and a validation set (n=349). Kaplan-Meier curve method and Cox proportional hazard regression model were employed to analyze prognosis. Results: Survival curve showed that OS were significantly favorable for resectable PC patients with low preoperative MCHC (P=0.015). Multivariate analysis suggested that MCHC (hazard ratio [HR], 1.266; 95% confidential interval [CI], 0.895-1.792; P=0.028) were independent prognostic factors for resectable PC patients. Conclusion: Low MCHC was positively correlated with OS in resectable PC, which could be used to predict the prognosis.