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Background and objectives: Coronavirus disease 2019 (COVID-19) is a global health problem. Laboratory professionals are at a higher risk of contracting the disease during the COVID-19 pandemic. This study was conducted to examine lab professionals' perceptions and satisfaction with organizational processes during the COVID-19 outbreak.
Methods: This cross-sectional survey was carried out on 53 medical laboratory professionals working at laboratories in Tripoli (Libya) between November 2020 and January 2021. Data were collected via face-to-face questionnaire. Responses to questions were scored based on a five-point Likert scale (1=strongly disagree, 2= disagree, 3=neutral, 4=agree and 5=strongly agree). Data were presented as frequency and percentages using the Microsoft Excel 2016.
Results: Most participants were female (81.2%) and with less than five years of work experience (39.6%). The majority of respondents (79.3%) had a bachelor’s degree. Most healthcare workers (75.5%) were unaware whether the lab would provide medical care if they were tested positive for COVID-19, while 13.2% of them perceived that they will get free medical care. Owing to social distancing, 20 subjects (37.7%) felt that their social activities have been altered during break time.  Only 3.7% of the participants believed that their motivation level decreased due to the COVID-19 outbreak.
Conclusion: The outcomes of this study provide laboratorians’ perspective in the COVID-19 crisis as well as specific lessons for future unpredicted crises.

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Introduction: COVID 19 pandemic caused by SARS-COV2 virus has taken a toll all over the world. The susceptibility of various diseases like Helicobacter Pylori, Hepatitis B virus and Norwalk Virus and even SARS Corona Virus 1 have been associated with ABO blood groups. However, very limited data is available regarding the COVID 19 susceptibility and ABO blood groups. Methods: In the present report we investigated 500 admitted patients who were RTPCR positive for corona virus. Significant Tests were applied to study association of blood groups vis a vis disease severity, ICU admissions and assisted ventilation. Results:  We found out that Type A blood group is more susceptible to severe COVID 19 infection, even though maximum patients were of type B blood group. We also found that type A blood group needed more ICU admission and assisted ventilation then non type A groups and difference was statistically significant. Conclusion: Patients with type A blood group COVID 19 patients with type A blood group might require more vigilant surveillance and aggressive treatment measures. Further studies are required to validate the disease susceptibility.

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Background and objectives: The outbreak of coronavirus disease 2019 (COVID-19) has become a global health emergency. The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) NSP13 helicase plays an important role in SARS-CoV-2 replication and could serve as a target for the development of antivirals. The objective of the study was to perform homology modeling and docking analysis of SARS-CoV-2 NSP13 helicase as a drug target.

Methods: The structure and function of SARS-CoV-2 NSP13 helicase were predicted by in-silico modeling studies. The SWISS-MODEL structure assessment tool was used for homology modeling and visual analysis of the crystal structure of the protein. The validation for structure models was performed using PROCHECK. Model quality was estimated based on the QMEAN and ProSA. The MCULE-1-Click docking and InterEvDock-2.0 server were used for protein-ligand docking.
Results: The SARS-CoV-2 NSP13 helicase model corresponded to probability confirmation with 90.9% residue of the core section, which highlights the accuracy of the predicted model. ProSA Z-score of -9.17 indicated the good quality of the model. Inhibitor N-(3-(carbamoylamino) phenyl) acetamide exhibited effective binding affinity against the NSP13 helicase. The docking results revealed that Lys-146, Leu-147, Ile-151, Tyr-185, Lys-195, Tyr-224, Val-226, Leu-227, Ser-229 residues exhibit good binding interactions with inhibitor ligand N-(3-(carbamoyl amino) phenyl) acetamide.
Conclusion: Hence, the proposed inhibitor could potently inhibit SARS-CoV-2 NSP13 helicase, which is thought to play key roles during viral replication. The results of this study indicate that N-(3-(carbamoylamino) phenyl) acetamide could be a valuable lead molecule with great potential for SARS-CoV-2 NSP13 helicase inhibition.

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Background and objectives: In coronavirus disease 2019 (COVID-19), elevated serum levels of C-reactive protein (CRP), a marker of systemic inflammation, are commonly observed. We aimed to investigate the associations between CRP test results and clinical characteristics in patients with COVID-19.
Method: In this cross-sectional study, data from 399 patients with COVID-19 were collected through a census method. The patients were divided into a CRP-positive group (n=335) and a CRP-negative group (n=64). Demographical data, laboratory findings, clinical characteristics, and history of some underlying diseases were compared between the two groups. All analyses were carried out in SPSS (version 21).
Results: The frequency of hypertension was 40.1% among the study population, 42.4 % among CRP-positive patients, and 28.1% among CRP-negative patients. Diabetes and heart disease were the most common comorbidities among the patients. Dyspnea (60.4%), fever (52.7%), fatigue (45.4%), and dry cough (40.1%) were the most commonly observed symptoms. The mean duration of hospitalization was 8.14±6.18 days, and the mean duration of intensive care unit stay was 9.09±9.41 days. Moreover, CRP positivity was significantly associated with hypertension, immunosuppressive therapy, and higher duration of hospitalization (p<0.05).
Conclusion: Pre-existing hypertension, diabetes, and heart disease with the coincidence of some clinical symptoms are associated with higher levels of CRP in COVID-19 patients, which results in longer hospitalization.

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Background and objectives: Pandemics have serious adverse impacts on public health, economy, social structure, and overall growth and development of a nation. Such impacts can be mitigated by timely introduction of effective vaccination programs. This was successfully achieved in India. This study was performed to compare the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) responses after first and second dose of coronavirus disease 2019 (COVID-19) vaccination.
Methods: This cross-sectional study included 60 people who were vaccinated with the AstraZeneca vaccine at Karnataka Institute of Medical Sciences, Hubballi, India. The subjects were divided into two groups. Group I included 30 people who had received a single dose of the vaccine, and group II included 30 people who had received two doses of the vaccine. Exclusion criteria included having a history of influenza like illness/severe acute respiratory infection/proven COVID-19 infection in past 6 months. The antibody response was measured by the Anti-SARS-CoV-2 IgG test using the VITROS Anti-SARS-CoV-2 IgG Reagent Pack.
Results: We observed that 97% of the subjects had reactive IgG antibodies after receiving two doses of the vaccine, whereas only 83% of the subjects developed antibodies after a single dose of the vaccine. A positive correlation was observed between the development of reactive antibodies and the duration between the first dose and the second dose (r=0.24).
Conclusion: Based on the results, the two-dose vaccination with the AstraZeneca vaccine is beneficial over the single-dose vaccination for protection against COVID-19. Moreover, increasing the duration between doses might improve the antibody response.

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Background and objectives: The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, a newly emergent coronavirus, first recognized in Wuhan, China in December 2019. Early identification of laboratory indicators helps in distinguishing severe patients from mild to moderate counterparts and can facilitate medical interventions, thereby lowering the mortality rate. The present study was done to evaluate the role of hematological parameters and basic coagulation parameters in the assessment of the severity of COVID-19.
Methods: This retrospective observational study was done at a tertiary care institute from May 2020 to May 2021. Hematological and coagulation profile was studied in 200 confirmed COVID-19 cases. Data related to age, gender, and clinical features were retrieved from patients’ records. Laboratory findings such as complete blood count neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and coagulation parameters in different categories were compared.
Results: The majority of patients were males (59.5%) and with mild illness (52.5%). Moderate and severe illness was present in 30% and 17.5% of cases, respectively. The frequency of anemia, leucopenia, and thrombocytopenia was 62.5%, 6%, and 5.5%, respectively. Overall neutrophilia was seen in 40.5% of cases, whereas lymphopenia was seen in 39% of cases. Coagulation parameters were also much deranged in moderate and severe cases as compared to mild cases.
Conclusion: The hematopoietic and hemostatic systems are significantly affected by COVID-19. Careful evaluation of laboratory parameters assists clinicians in formulating a tailored treatment approach and in predicting disease severity.
 

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Hypocellular acute myeloid leukemia (AML) is an infrequent and challenging entity, and superinfection with coronavirus disease 2019 (COVID-19) could further complicate its diagnosis and management. It is characterized by low bone marrow cellularity, prominent cytopenias, and in many cases, clinically simulate aplastic anemia and hypoplastic myelodysplastic syndrome. We report a case of hypocellular AML-M2 in a 65-year-old male who was found to be COVID-19-positive. The cause of hypoplasia of bone marrow in such cases is still ambiguous and could be due to infiltration by blasts or co-infections. The cause of hypoplasia must be determined for proper management, which requires analysis of more such cases.
 

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Background and objectives: Coronavirus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical manifestations of COVID-19 vary from asymptomatic to acute respiratory distress syndrome. In severely-ill patients, neutrophil count is significantly increased. This study aimed to evaluate absolute neutrophil count (ANC) in patients with COVID-19 and healthy individuals.
Methods: This retrospective, cross-sectional study was carried out on patients admitted to the outpatient department of OBGY Rural Hospital (Maharashtra, India) from April 2021 to June 2021. A peripheral venous blood sample (3 ml) was taken from 143 patients with COVID-19 and 143 healthy controls. The blood samples were analyzed using a fully automated blood cell counter for the estimation of complete blood count. A peripheral blood smear was prepared and stained with Leishman stain for evaluation of morphological changes.
Results: The ANC of COVID-19 patients was significantly higher than that of healthy control subjects (p=0.00001). Toxic granules (48.9%) were the most common morphological neutrophil abnormality, followed by hypolobation, hypogranulation, Pseudo-Pelger-Huet anomaly (20.9%), and shift to left with the presence of immature myeloid series cells.
Conclusion: High ANC along with morphological changes in neutrophils could be used as a simple and inexpensive surrogate marker of COVID-19 and its severity.

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Background and Objectives: The outbreak of coronavirus disease 2019 (COVID-19) has become a public health emergency. This study aimed to investigate a possible correlation between COVID-19 severity and mortality and serum levels of ferritin and C-reactive protein (CRP).
Methods: This retrospective descriptive study was conducted on 75 COVID-19 patients hospitalized in a tertiary care hospital in Central Karnataka (India) from April 2021 to June 2021. Demographic details as well as clinical and laboratory parameters were retrieved from hospital records.
Results: Of 75 patients, 50 were survivors and 25 were non-survivors. Serum ferritin levels were significantly associated with mortality (p<0.040). There was no significant association between CRP level and COVID-19 severity or mortality (p>0.05).
Conclusion: This study revealed that serum ferritin levels can be used as a prognostic marker for COVID-19 patients.

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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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Background and objectives: Mucormycosis is a complication in post-coronavirus disease 2019 (COVID-19) patients in India. This study was done to evaluate the prognostic value of clinical, histopathologic findings, microbiological features, and biochemical parameters such as D-dimer, lactate dehydrogenase, and serum ferritin in post- COVID-19-patients with rhino-orbital mucormycosis.
Methods: This retrospective observational study was carried out on biopsies taken from 50 post-COVID-19 patients suspected of mucormycosis. The biopsy specimens were processed and stained with hematoxylin and eosin, periodic acid–schiff, and Wright-Giemsa. In addition, 10–20% potassium hydroxide wet mount and culture on sabouraud dextrose agar were performed to detect Mucor. The biochemical parameters were measured using ARCHITECT ci8200 chemistry analyzer.
Results: Overall, 30 cases (60%) were positive for fungal elements, and growth of Mucor spp. was found in 28 cases (56%). In histopathology, 70% of cases (n=35) showed broad, aseptate, ribbon-like hyphae with wide-angled branching diagnostic of mucormycosis. There seemed to be a site-wise overlap between the nasal/maxillary sinus and rhino-orbital/rhino-cerebral variety. There was no difference between the patients in terms of gender. The most common risk factor was diabetes mellitus (observed in 80% of cases). In patients with invasive mucormycosis, inflammatory biomarkers such as serum ferritin, serum lactate dehydrogenase, C-reactive protein, and D-dimer were greater than the normal range, whereas procalcitonin was within the reference range.   
Conclusion: It can be concluded that raised metabolic markers, direct 10% KOH examination and histological features including angioinvasion as well as rhino-orbital and cerebral extension might assist doctors in diagnosis, progression, and survival rate.

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Background: Although public health interventions have slowed the spread of SARS CoV 2 infections, the worldwide pandemic of COVID 19 is progressing. Thus, effective and safe vaccination against SARS CoV 2 is an important tool for controlling the COVID 19 pandemic. Now in the early stages of COVID 19 vaccination, vaccinated individuals are interested in using antibody tests to confirm vaccination success and estimate the time of protection. Here, we assessed anti spike IgG responses in the general population 2 weeks after the second dose of the Sputnik V vaccine.
Methods: This study included blood samples of 67 individuals without a previous SARS CoV 2 infection taken 14 days after the second dose of the Sputnik V vaccine. Anti spike IgG responses were assessed with an enzyme linked immunosorbent assay (ELISA).
Results: Anti spike IgG was detected in 55 (82.1%) of 67 samples 14 days after the second dose of the Sputnik V vaccine. Antibody levels were significantly lower in males than in females, and 9 (75%) of 12 seronegative individuals were males.
Conclusion: Vaccination resulted in detectable anti spike IgG in 82.1% of individuals, and gender may be an important factor in the humoral response.

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Background: COVID-19 is a respiratory disease pandemic and a major global health problem that can cause acute respiratory distress syndrome (ARDS). Previous studies have shown an inverse link between toxoplasmosis and COVID-19. This study aimed to evaluate the association between COVID-19 and toxoplasmosis infection.
Methods: In this cross-sectional descriptive study, samples were taken from 360 patients, 50% of whom were men and 50% were women. Of the patients, 180 were determined to be COVID-19-positive by the ELISA kit, and 180 were in the control group. Some demographic characteristics, such as sex, age range, and occupation, were also recorded.
Results: This study was conducted on 180 COVID-19-positive patients, of whom 26.7% were in the 16-30-year age group, 25.1% were self-employed, and 31.7% had anti-Toxoplasma gondii antibodies. Among the 180 control patients, 21.1% had antibodies for T. gondii. Of the 57 patients who were co-infected with both COVID-19 and toxoplasmosis, men had higher infection rates (63.2%) than women (36.8%). There was a significant relationship between co-infections with COVID-19 and toxoplasmosis with occupation, but not with age.
Conclusion: The study found that people with toxoplasmosis infection have a 1.73 times higher risk of contracting COVID-19. The findings suggest that infectious agents could be a predisposing factor, possibly due to changes in cytokine levels.

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Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic, clinical, laboratory, and imaging risk factors. We aimed to determine the best outcome predictors and their trends during 30 days of hospitalization.
Methods: This retrospective study was conducted on moderate to severe hospitalized COVID-19 patients from 26 January 2020 to 13 January 2021. The length of stay in the hospital was considered as the time interval between admission and discharge, and the patient's final condition was defined as either dead or alive. Demographic, clinical, and laboratory data were collected from the hospital information system. The generalized additive model and the Cox regression model were used to model data.
Results: Of the 1520 hospitalized COVID-19 patients, 232 (15.26%) died and 1288 survived or reached the end of 30 days of hospitalization. We selected demographic, clinical, and 131 independent laboratory variables. Blood urea nitrogen (BUN) had a nearly double average in the dead group (44.603 [± 25.408] mg/dL) than the survived group (21.304 [± 13.318] mg/dL), and the lymphocyte (Lymph) count showed the opposite trend. The estimated hazard ratio (HR) of these 2 factors was higher than 1 and was statistically significant. In daily stay trends, the hazard function of them also increased rapidly after 15 days.
Conclusion: Blood urea nitrogen and complete blood count provide strong predictive clues about the prognosis of hospitalized COVID-19 patients, and rapid dynamic changes in the second week can predict a poor outcome in these patients.