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Background and objectives: In patients with coronavirus disease 2019 (COVID-19), white blood cell (WBC) abnormalities have been found worldwide with significant inter-regional differences. In the present study, we evaluated WBC parameters concerning COVID-19 positivity and severity.
Methods: In this cross-sectional study, total WBC count, absolute count of each type of WBC, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) were compared between 150 COVID-19 patients and 150 non-COVID-19 patients presenting with COVID-19-like symptoms. Also, COVID-19 patients were divided into severe and non-severe cases.
Results: The severity of the disease had no significant association with age or gender (p>0.05). Total WBC count, absolute neutrophil count, absolute monocyte count, and NLR were significantly lower (p<0.05), while LMR was significantly higher in COVID-19 patients compared to non-COVID-19 patients (p<0.05). Total WBC count, absolute neutrophil count, and NLR were significantly higher (p<0.05), while absolute eosinophil count and absolute lymphocyte count were significantly lower (p<0.05) in severe COVID-19 patients compared to non-severe patients.
Conclusions: Age is not a predictive factor for the severity of COVID-19. Routine WBC parameters are useful in predicting the severity of the disease in COVID-19 patients and can be used as prognostic indicators. Routine WBC parameters can also be used for repeat RT-PCR testing in COVID-19 suspected patients.

 

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Gauri Metkar , Shalaka Saraf
Background: Snakebite is a potentially life-threatening emergency that can be treated effectively. Snake envenomation can cause hematologic and coagulation abnormalities. In this respect, tests such as prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) are commonly used. The present study aimed to determine the value of coagulation parameters in the prognostication of snakebite patients.
Methods: This prospective descriptive observational study examined the coagulation parameters, including PT, INR, and aPTT, in consecutive cases of snake envenomation admitted to a tertiary health care hospital from October 2019 to August 2021. The correlation of coagulation parameters with each other and with prognostic indicators (ie, the number of days spent in the intensive care unit [ICU], the requirement of anti-snake venom [ASV], fresh frozen plasma [FFP], and the total number of blood products) was studied.
Results: A total of 58 patients with snakebite were studied. The majority were males (69%). The highest proportion of patients belonged to the age group of 16-40 years (60%). The correlation of coagulation parameters with each other was statistically significant. The correlation of coagulation parameters with prognostic indicators (ie, the total number of ASV vials administered, the total number of days in the ICU, the total number of FFP units administered, and the total number of blood components administered) was statistically significant.
Conclusion: Coagulation parameters (PT, INR, and aPTT) are essential laboratory investigations for treatment monitoring and can be used effectively for the prognostication of snakebite patients. In cases where the coagulation profile of snakebite patients shows abnormalities, conducting repeated coagulation studies at intervals of 12 hours can contribute to improved prognostication.