Diagnostic and Prognostic Value of Routine Blood Tests in Patients with COVID-19 in Iran, Tehran

Background: Routine blood testing consists of Complete Blood Count (CBC) indices together with Comprehensive Metabolic Panel (CMP) which have significant roles in both diagnosis and prognosis of the novel coronavirus disease 2019 (COVID-19). Methods: A total number of 942 COVID-19 patients and 400 healthy persons as the control group were enrolled in this study. All patients were admitted to a single center and were divided into two groups according to disease severity (severe or non-severe). Routine laboratory findings of peripheral blood sample were collected and then analyzed. Results: Neutrophil-Lymphocyte Ratio (NLR) had the highest sensitivity and specificity value for COVID-19 diagnosis. Among patients with different severities of COVID-19, the amount of neutrophil, NLR, platelet, hemoglobin, Red cell Distribution Width (RDW) and total bilirubin was significantly different (p<0.01). Conclusion: Some indices of complete blood count and comprehensive metabolic panel have diagnostic and prognostic roles in COVID-19 patients, which are helpful in early diagnosis, predicting severity and adverse outcomes of patients with COVID-19.

Biomarkers of Length of Stay on an Inpatient Eating Disorder Unit

Length of stay on an inpatient unit for treatment of anorexia nervosa (AN) is widely variable. Although previous research has used anthropometric and clinical variables and duration of illness to predict length of stay, there has been limited investigation of the predictive ability of biomarkers. Biomarkers, including those collected through a comprehensive metabolic panel (CMP) and appetite hormones, such as ghrelin and leptin, are impacted by disease presence and may play an etiological role in AN. Using a series of regression models, we evaluated the associations of these putative biomarkers with length of inpatient stay in 46 females receiving treatment on an inpatient eating disorder unit. Active ghrelin levels at inpatient admission positively predicted length of stay and alkaline phosphatase at discharge was significantly positively correlated with length of stay. This research provides further evidence supporting both biological and psychological components of AN, identifying potential biomarkers that could aid in prospective prediction of treatment needs. Further research is necessary to replicate and extend these findings across treatment settings.

Use of remdesivir in the presence of elevated LFTs for the treatment of severe COVID-19 infection

An 82-year-old man with an extensive medical history presented to the emergency room with complaints of generalised weakness and cough. He tested positive for COVID-19 10 days prior to presenting to the emergency room. Although his symptoms started a week prior to diagnosis, his weakness increased, warranting emergency response. A comprehensive metabolic panel was drawn from the patient on admission, indicating markedly high liver function tests (LFTs) ≥20 times above the upper limit of normal. On day 1 of admission, the decision was still made to start remdesivir (5-day course) due to decompensated acute respiratory failure as well as dexamethasone. The patient’s LFTs significantly improved throughout his hospital stay. The patient made a full recovery and was discharged on day 10 of hospitalisation.

The Utility of Comprehensive Metabolic Panel Tests for the Prediction of Bronchopulmonary Dysplasia in Extremely Premature Infants

Background. Comprehensive metabolic panel tests (CMP) are routinely performed in extremely premature infants within the first days of life. The association between the parameters of first postnatal CMP and the risk of bronchopulmonary dysplasia (BPD) remains elusive. Methods. A retrospective analysis was performed to evaluate the correlation between the parameters of first postnatal CMP and the risk of BPD in a cohort of extremely premature infants (born with a gestational age less than 28 weeks or a birth weight less than 1000 grams) at the neonatal intensive care unit, Shenzhen Maternity and Child Healthcare Hospital, from January 2016 to October 2018. A multivariant regression model was built to assess the association of the first postnatal CMP with the development of BPD. Results. A total of 256 extremely premature infants were included in this study. BPD developed in 76 (29.7%) infants. The first CMP in these infants was performed at 5 to 8 days after birth. The levels of blood urea nitrogen (BUN) and magnesium were significantly higher in infants with BPD compared to infants with no BPD (10.2 versus 7.5 mmol/L, P<0.001 and 0.9 versus 0.8 U/L, P=0.001, respectively) whereas the level of alkaline phosphatase (ALP) and total protein was significantly lower in infants with BPD (215.5 versus 310.0 U/L, P=0.002 and 41.2 versus 42.9 g/L, P=0.037, respectively). Multiple analysis showed that a higher level of BUN (>8.18 mmol/L) was independently associated with BPD (OR 3.261, 95% CI 1.779-5.978). Conclusion. Our findings indicate that a higher postnatal BUN level (>8.18 mmol/L) may be a predictor for the development of BPD in extremely premature infants.