Red cell distribution width, platelet distribution width, and plateletcrit as indicators of prognosis in COVID-19 patients - A single-center study
Kovuri UmadeviNagarjunachary RajarikamMotrapu LavanyaMohd Imran AliFarida BegumSeshava Puri Smitha Vadana
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Background: COVID-19 is still present in the world, though the extent varies by region and country. According to the World Health Organization, there have been over 617 million confirmed cases of COVID-19 and over 13 million deaths worldwide since the pandemic began on March 10, 2023. Aims and Objectives: This is a study conducted with the aim of providing biomarkers to predict COVID-19 disease progression and mortality based on red cell indices and platelet indices which are commonly measured as part of a complete blood count (CBC). Materials and Methods: A prospective study was conducted during the peak of the second wave of COVID-19 from March 2021 to June 2021. The study included 540 patients who were admitted to the Government General Hospital, Nizamabad, and had tested positive for COVID-19 by RT-PCR. Red Blood Cell (RBC), Hematocrit (HCT), Red cell indices like Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Red Cell Distribution width (RDW) and Platelet indices like Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), Platelet–Large Cell Ratio were taken from CBC analyzer Sysmex XN-1000 and analyzed statistically. The patients were then followed up for a period of 14 days to track their outcomes. Results: In the data, majority were male n=334 (62%) and n=280 (38%) were female. 70.37% (n=380) were survivors and 29.63% (n=160) were non-survivors. Red blood cell, red cell indices such as RDW-CV and RDW-SD, and platelet indices such as PCT and PDW were significantly higher in non-survivors compared to survivors with P<0.05. Conclusion: Non-survivors had significantly higher levels of RDW-CV, RDW-SD, PCT, and PDW compared to survivors. These parameters in combination can be useful for predicting COVID-19 mortality at early stage in forthcoming waves.Keywords:
Mean platelet volume
Mean corpuscular hemoglobin
[Objective] To examine the effects of nano-CaCO3 on hematological and cardiovascular systems in an occupational population. [Methods] A total of 129 workers from a nano-CaCO3 plant of Shanxi Province were selected as an exposure group, and 60 staff of a hospital in the same county were selected as a control group. General information of the participants were collected by questionnaires, and routine physical examinations were performed. [Results] The prevalence rate of hypertension was 30.23%, and the abnormal rates of heart rate and electrocardiogram(ECG) were 17.83% and 44.96% respectively in the exposure group, which were significantly higher than those in the control group(13.33%, 6.67%, and 6.67% respectively, P 0.05). The abnormal rate of hemoglobin, number of red blood cells, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width coefficient of variation, percentage of lymphocytes, percentage of neutrophilic granulocyte, total bilirubin, and indirect bilirubin in the exposure group were significantly higher than those in the control group(P 0.05). The results of multiple linear regression analysis showed that nano-CaCO3 exposure was positively associated with lymphocytes, mean corpuscular hemoglobin concentration, mean platelet volume, platelet distribution width, total bilirubin, and indirect bilirubin. Length of service was negatively associated with hemoglobin and hematocrit. Exposure and length of service were positively associated with mean corpuscular volume and mean corpuscular hemoglobin. The results of logistic regression analysis showed that the nano-CaCO3 exposure was a major risk factor for hypertension and abnormalities of the ECG(OR=5.118, P 0.05; OR=17.736, P 0.05). [Conclusion] Nano-CaCO3 could influence the hematological and cardiovascular systems of occupationally exposed populations.
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Hematological parameters play a key role in assessing the disease states and physiological status of birds, however the reliable information of hematological reference values for Lohmann silver in the pre- and post-laying periods is limited. Thus, the aim of this study was to research the effect of age on hematological parameters and provide reliable reference intervals for commercial Lohmann silver layer. Blood samples were obtained from 231 laying hens at different ages (5-37 wk) with 4-wk sampling intervals. A total of 12 hematological parameters including leucocytes (WBC, 109/L), red blood cell (RBC,1012/L), hemoglobin (HGB, g/L), hematocrit (HCT,%), mean corpuscular volume (MCV, fL), mean corpuscular hemoglobin (MCH, pg), mean corpuscular hemoglobin concentration (MCHC, g/L), red cell distribution width (RDW,%), platelet count (PLT,109/L), mean platelet volume (MPV, fL), platelet volume distribution width (PDW), plateletcrit (PCT, fL) were determined with a reference value advisor. One-ANOVA and Tukey test were utilized to test for significant differences of each parameter between ages. Our findings showed that these parameters were significantly affected by age, except for HCT in the pre-laying period. And reference intervals for all parameters except MCH, MCHC, MCV, MPV, and PDW in the pre-laying period were higher than that in the post-laying period. The results of this study may serve as indispensable information when diagnosing the health of Lohmann silver layer.
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저장된 혈액은 저장 병변이 발생하기 때문에 정확한 전혈구검사를 위해서는 보관 시간에 따른 다양한 혈구들의 변화에 대한 검증이 선행되어야 한다. 본 연구는 자동혈구분석기(ProCyte Dx)를 활용하여 개의 혈액 샘플 저장 시간에 따른 혈구지표의 변화를 조사하여 저장 유효시간을 결정하기 위해 수행하였다. 혈액 시료는 10마리의 비글에서 채혈하였으며, 채혈 후 저장시간 경과별(0, 2, 4, 8, 24, 48, 72, 96시간)로 백혈구계, 적혈구계, 혈소판계의 혈구 지표를 분석하였다. 채혈 후 저장 시간별 혈구 지표 변화를 분석한 결과, 백혈구계 혈구에서는 96시간까지 시간경과에 따른 저장병변이 관찰되지 않았다. 하지만 적혈구계의 HCT (hematocrit)와 MCV (mean corpuscular volume)는 8시간부터 유의하게 증가하였고, MCHC (mean corpuscular hemoglobin concentration)는 4시간부터, RDW (red cell distribution witdh)는 72시간부터 유의적으로 감소하였다. 또한 PLT (platelet)의 농도는 8시간부터 유의한 감소를 보였다. 이상의 결과를 종합해보면, 개 혈액 내 혈구조성의 정확한 진단을 위해서는 채혈 후 2시간 이내에 분석하는 것이 적합하며, 백혈구계의 경우에는 96시간까지 시간경과에 따른 변화없이 안정적인 분석이 가능한 것으로 판단된다.
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Abstract Introduction Defining accurate age‐ and sex‐specific reference intervals (RIs) for hematology parameters, especially for the pediatric population, is important for making an appropriate clinical diagnosis. To address gaps, we established age‐specific RIs for 11 hematologic parameters in Iranian children younger than 30 months for the first time. Methods Fresh whole blood samples collected from a total of 344 participants (males: 158 and females: 186) ages 3 days to 30 months, with a mean age of 12.91 ± 7.15 months, were recruited from healthcare centers in Mashhad, Iran. Hematologic parameters, including complete blood count (CBC), were analyzed on the Sysmex auto‐analyzer system (KX‐21 N). RIs were calculated with 90% confidence intervals using the direct method based on CLSI Ep28‐A3 and C28‐A3 guidelines. Results None of the CBC parameters required sex partitioning. Of 11 CBC parameters, six required age partitions of 3 days–<4 months, 4–<10, 10–<15, and 4–<30 months. Five parameters (i.e., white blood cell count, mean corpuscular hemoglobin concentration, mean platelet volume, red cell distribution width, and platelet distribution width) did not demonstrate age‐specific changes. RIs of red blood cell count and hematocrit, as well as hemoglobin, increased with age, while mean corpuscular volume, mean corpuscular hemoglobin, and platelet count, decreased with age. Conclusion In this study, we established RIs for 11 hematology parameters in young children. Age partitioning was required for six parameters demonstrating marked changes during the early period of growth and development and necessitating the use of pediatric‐specific reference standards.
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Background Adaptation, including changes in blood properties, to whole-body cryostimulation may depend on many factors, including body mass. Aim This study investigates whether hematological parameters change similarly in a group of people with obesity and a group of men with normal body weight after 10 and 20 cryostimulation treatments. Methods In our non-randomized trial, the participants were divided into two groups based on their body fat percentage: 14 men with a high (HBF = 29.35%) and 10 with a normal percent of body fat (NBF = 11.40%) and subjected to 20 whole body cryostimulation treatments (-120°C for 2–3 minutes). Blood samples were taken before the first and after the 10 th and 20 th cryostimulation. The following parameters were determined: red blood cells (RBC), hemoglobin concentration (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelets (PLT), red blood cell distribution width (RDW-SD), mean platelet volume (MPV), white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMPH), monocytes (MONO), eosinophils (EO) and basophiles (BASO). Results Statistically significant differences were found in red blood cells parameters such as RBC, HCT, MCV and MCHC. Time influence was noted for HCT, MCV and MCHC. Two-way ANOVA showed a significant correlation (for time and group) for 2 paramateres: RBC and MCV. For platelet parameters statistically significant differences were found for PLT (group influence) and MPV (time and group interaction). In white blood cells parameters statistically significant differences in levels of LYMPH were noted. Higher levels were observed for HBF group. Conclusions All observed changes were within the reference range, but hematological markers changed unevenly in people who are obese and non-obese. Therefore, it appears that an amount of fat tissue could be a factor causing the differences in adaptation to low temperature. It is suggested that 20 whole body cryostimulation sessions restore the state of homeostasis disturbed after 10 sessions. Trial registration ACTRN 12619000524190 .
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Objective To establish the reference range of venous blood cells of healthy aged people by means of investigation on the reference range of venous blood cells of healthy adults and the aged.Methods The parameters of 3 302 venous blood samples from the healthy adults and the aged were analyzed by applying SymexKX-21N hematology analyzer,and the test results were statistically analyzed with SPSS10.0 software.Results The reference range of the healthy aged people(males and females):WBC(3.57-9.00)×10~9/L and(3.52-8.39)×10~9/L;RBC(3.78-5.42)×10~(12)/L and (3.44-4.83)×10~(12)/L;hemoglobin(Hb) 121.40-168.10 and 107.90-147.90 g/L;hematocrit (HCT) 36.62%-49.18%and 32.82%-44.03%;mean corpuscular volume(MCV) 85.10-100.60 and 84.70-100.60 fL;mean corpuscular hemoglobin(MCH) 28.54-34.48 and 28.20-34.10 pg; mean corpuscular hemoglobin concentration(MCHC) 322.00-357.00 and 320.00-352.00 pg/L; coefficient of variation of red blood cell distribution width(RDW-CV) 12.13%-15.10%and 10.20%-17.12%;platelet(PLT)(70.00-240.00)×10~9/Land(77.00-262.00)×10~9/L;mean platelet volume(MPV) 9.77-15.37 and 9.51-15.55 fL;platelet distribution width(PDW) 11.44%-27.77%;platelet hematocrit(PCT) 1.10-2.73 and 1.13-2.99 mL/L;large platelet ratio (P-LCR) 24.35%-70.14%.The differences of the parameters(WBC,RBC,Hb,HCT,MCHC, PLT and PCT) were statistically significant between senile males and senile females(P0.01),while the other parameters weren't(P0.05);the differences of parameters(WBC,MPV,PDW and PLCR) were not significant between adults and the ageds(P0.05),while the other parameters were (P0.05).There were also significant differences(P0.05) between the test results and the repor- ted date about the blood cell parameters of adults and the ageds.Conclusion The reference range of the healthy ageds is different from that of adults;therefore it is necessary to establish the laboratory reference range of venous blood cells of the elderly in this region scientifically and rationally.
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Lung cancer is one of the most commonly diagnosed diseases in both men and women and the leading cause of cancer-related death worldwide. This study aims to investigate the effect of lung cancer on the role of some hematological criteria in patient serum. There were fifty (50) lung cancer patients (males and females) and forty (40) healthy subjects in the present study. The levels of some hematological parameters that include erythrocyte indices [red blood cell (RBCs) count, hemoglobin (Hb), hematocrit (HCT), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and red cell distribution width (RDW)], leukocyte indices [total white blood cell (WBCs) count, neutrophil percentage (%), lymphocyte percentage (%)], and thrombocyte indices [platelet count and mean platelet volume (MPV)] was recorded. In general, the levels of all hematological criteria in the serum of lung cancer patients were significantly different (p<0.05) from those of the control groups. In conclusion, hematological measurements can provide important prognostic information for patients with lung cancer, and they are simple and readily available at medical centers.
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To investigate the changes of peripheral hemogram in the children of slight and moderate lead poisoning. 3 170 children were divided into two groups based on blood lead level(BPb):normal group(BPb100μg/L)and lead poision group(BPb≥100μg/L).Peripheral hemogram,included hemoglobin(HGB),erythrocyte(RBC),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),leucocyte(WBC),platelet(PLT),mean platelet volume(MPV)and platelet distribution width(PDW)were measured in both groups. In poision group,WBC and PLT were significant lower( P 0.01),while MPV and PDW were significant higher( P 0.01) than normal group. There was no significant difference in HGB,RBC,HCT,MCV,MCH and MCHC( P 0.05) in both groups. [Conclusions] Slight and moderate lead poison could cause WBC and PLT level decreased in children, and HGB and RBC level were not obvious change.
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Objective: Elevated blood glucose may be affect complete blood count parameters. In this study, we compared the hemogram parameters of healthy individuals and cases with impaired glucose tolerance.
Method: We examineted 134 patients with impaired glucose tolerance and 30 healthy cases. Patients files were evaluated retrospectively and the levels of hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, red blood cell, red cell distribution wide, mean platelet volume, platelet distribution wide, leukocycte, neutrophil, lymphocycte, platelet, and hemoglobin A1c were recorded. Control and patient groups were compared in terms of these parameters with student T test. In addition, the relationship between hemoglobin A1c value and complete blood count parameters were determined in patients with impaired glucose tolerance.
Results: There was no significantly difference between study and control groups in terms of hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, red blood cell count, red cell distrubition wide, leukocycte, neutrophil, lymphocycte, platelet levels. The mean platelet volume and platelet distribution wide values were significantly higher in the patient group than the control group (p value: 0.002, p value: 0.04 respectively).
Conclusion: Complete blood count is an easy, inexpensive test that can be performed in most hospitals. If our study results are supported by other studies, some hemogram parameters may be used to diagnose of impaired glucose tolerance.
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Objective To establish the reference values of venous blood cell parameters among the healthy adults in Chenzhou.Methods Eighteen parameters of venous blood cells of 5,566 healthy adults were detected by Abbott CD-1800 Hematology Analyzer,which included white blood cell (WBC),neutrophil (NEU),leukomonocyte (LC),intermediate cell (MID),neutrophils percentage (NEU%),lymphocyte percentage (LYMPH%),mid cell percentage (MID%),red blood cell (RBC),platelet (PLT),hemoglobin (HGB),hematocrit (HCT),mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC),red cell distribution width (RDW),thrombocytocrit (PCT),platelet distribution width (PDW),and mean platelet volume (MPV).Results The results of WBC,NEU,LC,MID,MID%,RBC,HGB,HCT,MCV,MCH,and MCHC in males were significantly higher than those of females (all P0.01).The results of PLT,MPV,and PCT in males were significantly lower than those of females (all P0.01).Except for WBC,MPV,and PDW,there were statistically significant differences in the other parameters between young males and middle-aged males (all P0.05).There were statistically significant differences in WBC,NEU,LC,MID%,MCV,RDW,MCHC,PLT,and MPV between young females and middle-aged females (all P0.05).Conclusions The adults' reference values of venous blood cell parameters have been established in Chenzhou,and the differences are statistically significant in many parameters of venous blood cells between young adults and middle-aged ones.
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Mean corpuscular hemoglobin
White blood cell
Venous blood
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