Dynamic Characteristics of Blood Platelet Count in COVID-19 Patients

Background and purpose: Coronavirus disease 2019 (COVID-19) was spreading all over the world. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) primarily invades and infects the lungs of humans leading to COVID-19. Mild to severe clinical symptoms such as fever, cough, and shortness of breath were existed in those patients. One of the most common changes in these patients was abnormal blood routine. However, uncertainty remains regarding the dynamic characteristics of platelet in COVID-19 patients due to limited data. Therefore, we aimed to analyze the association between dynamic characteristics of blood platelet and disease severity, and to identify new monitoring indicators to treat the COVID-19 patients. Methods: In this cohort study, 398 COVID-19 patients treated in the Shenzhen Third People’s hospital from December 16, 2019 to March 26, 2020 were collected and participated. All data of participants including the clinical characteristics, imaging and laboratory information were collected. All patients included in our study were classified as four groups (mild, common, severe, and critical types) regarding clinical symptoms and relevant severe failures based on the Diagnosis Criteria. Platelet count was examined at the baseline and every 3–5 days during hospitalization. Results: The platelet count varied with clinical classifications. The platelet count in mild type was normal without significant fluctuation. While the blood platelet count of most common and severe patients had obvious fluctuations, showing as a dynamic change that first rose and then fell to the level at admission, which was consistent with the trend of lung inflammation. Bone marrow smears further showed that bone marrow hyperplasia was normal in mild, common and severe type patients, and megakaryocytes and their platelet-producing functions were not abnormal. Conclusions: Our results suggested that the dynamic changes of platelet count might be a predictor of lung inflammation alteration for COVID-19 patients. The changes in platelet count might be a responsive pattern secondary to lung inflammation. The function of bone marrow may be slightly affected by SARS-CoV-2 infection.

A Suspected Case of Idiopathic Thrombocytopenic Purpura - A Case Report

Objectives: This study demonstrated the positive effect of herbal medication on a suspected idiopathic thrombocytopenic purpura (ITP) patient-a 57-year-old male with suspected ITP and a decreased platelet count.Methods: The patient was treated with an herbal medicine named Nokyongdaebo-tang, and its effect was measured with periodic platelet blood tests.Results: Before taking the herbal medicine, the patient’s blood platelet count was 98 K/μl, but following treatment, the blood platelet count increased to 201 K/μl and maintained a continuously elevated level.Conclusion: The results indicated that herbal medication may improve the blood platelet count of suspected ITP patients.

Clinical Decision Support System for Detection of Dengue

Dengue fever is caused due to the mosquito (Aedel aegypti) bite. The symptoms of this fever are similar to other fevers such as Malaria, Chikungunya and Zika. A common sign of Dengue fever is the sharp fall of blood platelet count, amongst other a host of other confusing symptoms, which makes Dengue difficult to diagnose, especially by an inexperienced physician. The purpose of this study is to outline a decision support system (DSS) which would come to the aid of detection of Dengue fever by carrying out an analysis of AHP and fuzzy AHP (FAHP) methodology. The data of confirmed Dengue as diagnosed by a physician is picked up, examined independently using AHP and FAHP approach, the results obtained are then compared with the diagnosis report of an expert doctor. The outcome is encouraging and indicates that expert systems can be leveraged for the diagnosis of Dengue and can be a useful tool for non-expert physicians

Assessment of Coagulopathy, Inflammation and LDH Activity in SARS-CoV-2-infected Patients

The patho-physiology of COVID19 is still not clear. This study investigated the status of coagulation, LDH activity, and inflammation in SARS-CoV-2 infected patients. One hundred and thirty-four newly diagnosed COVID19 infected patients (age ranged65-82years) attending Mullingar Regional Hospital, Mullingar, Republic of Ireland, volunteered to participate in this study. They all presented with a pulmonary disorder, pyrexia, vomiting, body pains, etc. SARS-CoV-2 confirmatory test was done with RT-PCR molecular test using Cepheid Genexpert System. The data of another 121 plasma samples of apparently normal, non-COVID19 infected individuals taken before the emergence of COVID19 served as controls. Levels of blood platelets was determined in the participants using Siemen ADVIA 2120 Haematological System, and plasma D-dimer was determined in the participants using Star Max-Stago–Automatic Coagulation Analyzer LDH activity, plasma ferritin, and C-reactive protein (CRP) were determined in the participants using Beckman AU680-Chemistry Analyser. SARS-CoV-2 –infected patients showed significantly (p<0.001) higher levels of D-dimer (1522.95+1395.45ng/ml), CRP (125.3+116.4mg/l), ferritin (488.5+514.9pg/l), and LDH activity (574.4+446.7iu/l) compared to controls (78.8+18.1ng/ml, 2.4+1.7mg/l, 61.3+58.2pg/l, 304.1+76.6iu/l respectively). The blood platelet count did not show significant (p>0.05) change in the COVID19 patients (252.2 x 109+101 x 109) compared to controls (256.4 x 109+63.2 x 109). Elevated LDH activity could indicate tissue breakdown in the SARS-Cov-2 infected patients. Hyper-coagulation and inflammation are imminent in the COVID19 patients. Adjuvant anticoagulant and anti-inflammatory therapies may be useful as part of therapeutic regimen in the SARS-CoV-2 infected patients. Keywords: COVID19, Coagulopathy, CRP and ferritin, LDH.

Cardiorespiratory and haematologicalparameters of healthy french bulldogs

Brachycephalic dogs have a normal lower jaw and a receded upper jaw, and these dogs are predisposed to nostril stenosis, elongated palate, tracheal hypoplasia and hyperthermia due to heat stress. Giventhese characteristics, these dogs are more predisposed to respiratory and cardiovascular disorders. The popularity of brachycephalic dogsthathave a greatertendency for cardiorespiratory disorders, such as French bulldogs,has increased recently; however, studies on the cardiorespiratoryand haematological parameters in this breedare lacking. Thus, the present study sought to evaluatethe cardiorespiratory and haematological parameters of healthy French bulldogs to standardize normal values forthisbreed. Thirty-six French bulldogs wereused without predilection for age or sex, and the following parameters were evaluated: temperature (T), heart rate (HR), respiratory rate (RR), erythrogram, leukogram, total plasma protein, plasmatic fibrinogen, blood platelet count, urea, creatinine, alkaline phosphatase (AP) and alanine aminotransferase (ALT). The mean and standard deviation wereas follows: T°C (38.3±0.4), HR (111.1±27.0) beats per minute, RR (54.8±32.5) breaths per minute, erythrocyte count (7.3±1.2x106), haemoglobin (16.9±2.8 g/dL), haematocrit (48.9±7.7%), MCV (67.6±2.4fL), MCH (23.3±0.7 pg), MCHC (34.6±0.8%), RDW-CV (9.3±0.9; 9.2-12.0%), total leukocytes (11009.7±2907.3/mm3), band neutrophils (250.0±260.4/mm3), segmented neutrophils (7094.4±2307.3/mm3), eosinophils (589.7±561.3/mm3), lymphocytes (2020.8±1457.5/mm3), monocytes (987.6±528.4/mm3), total plasma protein (6.9±0.5 g/dL), plasmatic fibrinogen (274.1±96.5 mg/dL), blood platelet count (366.4±88.5/mm3), urea (35.2±12.6 mg/dL), creatinine (0.8±0.2/mg/dL), AP (49.1±25.8U/L),ALT (36.2±12.3U/L). The haematological parameters and heart rate were within the normal values for the species, but the respiratory rate values (54.8±32.5 breaths per minute)were greater than the normal averageof10 to 30 breaths per minute. We conclude thatthehaematological parameters and heart rateof healthy French bulldogs arewithin the normal limit for dogs; however, the respiratory rate is above referencevalues, reinforcing the notion that dogs of this breed, although healthy,exhibitan increasedrisk of respiratory disorders

Evaluation of the analytical performance of the PC100 platelet counter

Introduction Platelet count can be altered in various diseases and treatments and measuring it may provide better insight into the expected outcome. So far, quantification of platelet count is done within laboratory conditions by using established hematology analyzers, whereas a point-of-care device could be used for this purpose outside of the clinical laboratories. Aim Our aim was to assess the closeness of agreement between a newly developed point-of-care PC100 platelet counter and two reference methods (Sysmex® XP-300, Sysmex® XN-9000) in measuring platelet counts in whole blood and platelet-rich-plasma (PRP). Method Whole blood was obtained from 119 individuals, of which 74 were used to prepare PRP samples. Whole blood platelet count was measured by the two reference methods and the PC100 platelet counter. PRP was prepared from the whole blood and platelet count was adjusted to the range of 250–3600 × 103/μl and measured with the PC100 platelet counter and Sysmex® XP-300. Results A median difference of − 1.35% and − 2.98% occurred in whole blood platelet count between the PC100 platelet counter and the Sysmex® XP-300 and Sysmex® XN-9000, respectively. A strong linear correlation (r ≥ 0.98) was seen in both cases and regression equations indicated neither a constant nor a proportional bias between the methods. Direct comparison of the two reference methods revealed a median difference of − 1.15% and a strongly linear relationship (r = 0.99). Platelet count in PRP resulted in a median difference of 1.42% between the PC100 platelet counter and the reference method, Sysmex® XP-300. While the difference between two methods increased with concentration of platelets in PRP, a strong linear relationship remained throughout the whole measuring interval indicated by the high correlation coefficient (r = 0.99). Assessment of the predicted bias at predefined platelet counts showed that the bias in platelet counts falls within the acceptance criterion for both whole blood and PRP measurements. Conclusions Our results show that the PC100 platelet counter can be used interchangeably with the reference methods for determining platelet counts.

Chronic Immune Thrombocytopenia and Hashimoto’s Hypothyroidism in an Adolescent: Presentation and Implications

Immune thrombocytopenia (ITP) is a disorder characterized by immune-mediated destruction of thrombocytes leading to peripheral blood platelet count of <100 × 10^9/L. Primary ITP is a terminology used in the absence of other causes or disorders that may be associated with thrombocytopenia, i.e., isolated thrombocytopenia. The term secondary ITP is used if such diseases coexist. We present here a case of a 14-year-old female diagnosed with immune thrombocytopenia. When her evaluation was not strongly supportive of primary ITP, she was screened and proved to have a concomitant Hashimoto thyroiditis. Contrary to the popular belief about secondary ITP in adult population, treatment of our patient’s hypothyroidism did not improve her platelet’s count, and the patient needed multiple immunosuppressive medications to improve her condition.

Different presentations of thrombocytopaenia in children

Thrombocytopaenia is defined as a blood platelet count of less than 100,000/μL. Thrombocytopaenia can either be isolated or associated with the clinical picture of various disease entities. The paper presents three cases of children who developed thrombocytopaenia secondary to other diseases: a 3-month-old infant with thrombocytopaenia induced by cytomegalovirus infection; a 10-year-old girl with autoimmune lymphoproliferative syndrome and thrombocytopaenia observed at the time of diagnosis; and a girl aged nearly 2 years, later diagnosed with myelodysplastic syndrome based on bone marrow biopsy results. The topic discussed by the authors is extremely important in the daily work of general practitioners and paediatricians, as appropriate selection of patients with thrombocytopaenia who should be referred to specialists for an extended diagnostic work-up plays a crucial role in the therapeutic management.

DHA from microalgae Schizochytrium spp. (Thraustochytriaceae) modifies the inflammatory response and gonadal lipid profile in domestic cats

The present study aimed to evaluate the inflammatory response, oxidative status and fatty acid deposition in reproductive tissues of cats supplemented with the dried microalgae Schizochytrium spp. (Thraustochytriaceae) as a DHA source. Thirty-seven cats (males, n 21; females, n 16; 11·5 (sd 0·5) months of age) were divided by sex into five groups. Treatment diets contained algae biomass at 4·0, 8·0, 12·0 or 16·0 g/kg replacing poultry fat (n-6 source). Cats were fed the respective diet for 62 d and neutered on day 58. Blood samples were collected at the beginning of the experiment (day 1), before neutering (day 58) and 4 d after surgery (day 62) for analysis of inflammation and oxidative markers. Acute-phase protein levels were altered (P < 0·01) in the postoperative period, without any treatment effect (P > 0·05). PGE2 concentrations after surgery were reduced linearly (R2 0·8706; P = 0·002) with microalgal inclusion. Blood platelet count was reduced (P = 0·001) after the surgery regardless treatment, but it was higher in the DHA group compared with control (P < 0·001). The DHA deposition (testicles, R2 0·846; ovaries, R2 0·869) and the n-6:n-3 ratio (testicles, R2 0·859; ovaries, R2 0·955) in gonads had a pattern which fitted a quadratic model. DHA from Schizochytrium spp. modifies PGE2 response after the surgery in cats. The physiological roles of the DHA in the reproduction of cats were not investigated, but its gonadal deposition after supplementation was observed.