Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1952
A. Sugianli, D. Turbawaty, I. Parwati
COVID-19 is a new respiratory disease caused by severe acute respiratory syndrome Coronavirus type 2 (SARS-CoV-2) and became a pandemic in early 2020. Since the clinical presentation of this viral infection can mimic other types of viral infection (e.g., dengue, influenza, and another respiratory disease), the laboratory approach becomes essential, particularly at the early stages of infection. This case-literature review approach described an outpatient case of a 39-year-old male patient with mild-to-moderate COVID-19 who recovered after 49 days of self-quarantine. Lymphopenia and mild thrombocytopenia can be used as early screening for COVID-19 at the early stages of infection and mainly occur in outpatient settings. Meanwhile, Neutrophil-to-Lymphocyte Count Ratio (NLCR), C-Reactive Protein (CRP), and Liver Function Test (LFT) can be used for severity prediction and/or follow-up the outcome of the infected patient. Therefore, the integrated clinical-laboratory finding at the early stages of infection is vital to provide better and effective patient management.
{"title":"Laboratory Diagnostic and Monitoring at Early Stages of SARS-CoV-2 Infection: Case Report and Literature Review","authors":"A. Sugianli, D. Turbawaty, I. Parwati","doi":"10.24293/ijcpml.v29i1.1952","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1952","url":null,"abstract":"COVID-19 is a new respiratory disease caused by severe acute respiratory syndrome Coronavirus type 2 (SARS-CoV-2) and became a pandemic in early 2020. Since the clinical presentation of this viral infection can mimic other types of viral infection (e.g., dengue, influenza, and another respiratory disease), the laboratory approach becomes essential, particularly at the early stages of infection. This case-literature review approach described an outpatient case of a 39-year-old male patient with mild-to-moderate COVID-19 who recovered after 49 days of self-quarantine. Lymphopenia and mild thrombocytopenia can be used as early screening for COVID-19 at the early stages of infection and mainly occur in outpatient settings. Meanwhile, Neutrophil-to-Lymphocyte Count Ratio (NLCR), C-Reactive Protein (CRP), and Liver Function Test (LFT) can be used for severity prediction and/or follow-up the outcome of the infected patient. Therefore, the integrated clinical-laboratory finding at the early stages of infection is vital to provide better and effective patient management.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122386355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1946
H. H. Hayuanta, A. Kosasih, Nasuroh Nasuroh
CD4 count is essential in evaluating the immunological status of HIV+ patients and the need for prophylaxis therapy + against opportunistic infections. CyFlow Counter is a novel Sysmex instrument to count CD4 cells and reports the results in + + absolute and percentage values (aCD4 , %CD4 ). However, it has not been evaluated in Indonesia. This study aimed to compare the Sysmex CyFlow Counter with BD FACSCanto II. Samples were collected from leftover EDTA blood samples of + + + patients with CD4 count tested in Dharmais Cancer Hospital. The aCD4 and %CD4 from CyFlow Counter were compared against FACSCanto II using correlation, Bland-Altman, and mean difference test. Sensitivity, specificity, and misclassification rates were also analyzed with aCD4+ count threshold of 200 cells/µL. A total of 70 EDTA blood samples from Dharmais + Cancer Hospital were analyzed with BD FACSCanto II and Sysmex CyFlow Counter, with 20 subjects having CD4 count of 150-299 cells/µL, 28 having 300-449 cells/µL, and 22 having 450-550 cells/µL. CyFlow Counter had a good correlation + + with FACSCanto II in aCD4 and %CD4 (r = 0.892 [p=0.000], r=0.955 [p=0.000], respectively). There was no significant mean + + difference between CyFlow Counter and FACSCanto II (p=0.097 for aCD4 and p=0.611 for %CD4 ). Bland-Altman test + results showed a high agreement (94.29%) with a mean difference of -32.29 cells/µL for aCD4 and a high agreement + (98.57%) with a mean difference of -0.76% for %CD4 . Sensitivity, specificity, and total misclassification rates were 83.33%, + 100.00%, and 3.33%, respectively. Sysmex CyFlow Counter CD4 count results were comparable to FACSCanto II.
{"title":"Comparison between Sysmex CyFlow Counter and BD FACSCanto II + for counting CD4 Cells in Indonesia","authors":"H. H. Hayuanta, A. Kosasih, Nasuroh Nasuroh","doi":"10.24293/ijcpml.v29i1.1946","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1946","url":null,"abstract":"CD4 count is essential in evaluating the immunological status of HIV+ patients and the need for prophylaxis therapy + against opportunistic infections. CyFlow Counter is a novel Sysmex instrument to count CD4 cells and reports the results in + + absolute and percentage values (aCD4 , %CD4 ). However, it has not been evaluated in Indonesia. This study aimed to compare the Sysmex CyFlow Counter with BD FACSCanto II. Samples were collected from leftover EDTA blood samples of + + + patients with CD4 count tested in Dharmais Cancer Hospital. The aCD4 and %CD4 from CyFlow Counter were compared against FACSCanto II using correlation, Bland-Altman, and mean difference test. Sensitivity, specificity, and misclassification rates were also analyzed with aCD4+ count threshold of 200 cells/µL. A total of 70 EDTA blood samples from Dharmais + Cancer Hospital were analyzed with BD FACSCanto II and Sysmex CyFlow Counter, with 20 subjects having CD4 count of 150-299 cells/µL, 28 having 300-449 cells/µL, and 22 having 450-550 cells/µL. CyFlow Counter had a good correlation + + with FACSCanto II in aCD4 and %CD4 (r = 0.892 [p=0.000], r=0.955 [p=0.000], respectively). There was no significant mean + + difference between CyFlow Counter and FACSCanto II (p=0.097 for aCD4 and p=0.611 for %CD4 ). Bland-Altman test + results showed a high agreement (94.29%) with a mean difference of -32.29 cells/µL for aCD4 and a high agreement + (98.57%) with a mean difference of -0.76% for %CD4 . Sensitivity, specificity, and total misclassification rates were 83.33%, + 100.00%, and 3.33%, respectively. Sysmex CyFlow Counter CD4 count results were comparable to FACSCanto II.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128212393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1981
Cynthia Ayu Permatasari, J. Nugraha, Munawaroh Fitriah
COVID-19 infection causes severe acute respiratory syndrome and requires immediate action. Therefore, developing safe vaccine efficacy and new therapies has become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein that can neutralize the virus, thus preventing it from binding to its specific receptor (ACE 2 receptor). This study aimed to analyze the kinetics of antibody response to the CoronaVac vaccine after administration of the second dose vaccine. An observational analytic study with a prospective cohort approach was conducted from January to November 2021 at Dr. Soetomo General Academic Hospital, Surabaya. Two hundred fifty specimens from 50 health workers who met the inclusion criteria were measured for S-RBD IgG levels using the indirect chemiluminescence immunoassay method on the Snibe Maglumi® device. The SARS-CoV-2 S-RBD IgG levels were measured five times, such as before vaccination (day 0) and day 14, day 28, month 3, and month 6 after vaccination of the second dose of CoronaVac. The median (min-max) of S-RBD IgG levels before and after vaccination of the second dose on day 14, day 28, month 3, and month 6 were 0.43 (0.43–4.07); 109,25 (30.71–1619,42); 136,46 (19.38–725,28); 26.56 (7.64–158,65); 13.11 (0.59–8666,00) BAU/mL, respectively. There was a significant difference in S-RBD IgG levels at six months post-vaccination between the group with COVID-19 infection and those without COVID-19 disease (p < 0.001). Vaccination of the second dose of CoronaVac resulted in antibody formation; however, there was a trend of decreasing humoral immunity in the 3rd month after the second dose of CoronaVac vaccination in healthy individuals.
{"title":"S-RBD IgG Response After Second Dose of CoronaVac; Prospective Study on Health Workers","authors":"Cynthia Ayu Permatasari, J. Nugraha, Munawaroh Fitriah","doi":"10.24293/ijcpml.v29i1.1981","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1981","url":null,"abstract":"COVID-19 infection causes severe acute respiratory syndrome and requires immediate action. Therefore, developing safe vaccine efficacy and new therapies has become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein that can neutralize the virus, thus preventing it from binding to its specific receptor (ACE 2 receptor). This study aimed to analyze the kinetics of antibody response to the CoronaVac vaccine after administration of the second dose vaccine. An observational analytic study with a prospective cohort approach was conducted from January to November 2021 at Dr. Soetomo General Academic Hospital, Surabaya. Two hundred fifty specimens from 50 health workers who met the inclusion criteria were measured for S-RBD IgG levels using the indirect chemiluminescence immunoassay method on the Snibe Maglumi® device. The SARS-CoV-2 S-RBD IgG levels were measured five times, such as before vaccination (day 0) and day 14, day 28, month 3, and month 6 after vaccination of the second dose of CoronaVac. The median (min-max) of S-RBD IgG levels before and after vaccination of the second dose on day 14, day 28, month 3, and month 6 were 0.43 (0.43–4.07); 109,25 (30.71–1619,42); 136,46 (19.38–725,28); 26.56 (7.64–158,65); 13.11 (0.59–8666,00) BAU/mL, respectively. There was a significant difference in S-RBD IgG levels at six months post-vaccination between the group with COVID-19 infection and those without COVID-19 disease (p < 0.001). Vaccination of the second dose of CoronaVac resulted in antibody formation; however, there was a trend of decreasing humoral immunity in the 3rd month after the second dose of CoronaVac vaccination in healthy individuals.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125488667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1923
M. Monica, M. Hendrianingtyas
Obesity is a condition of excess body fat mass with cardiometabolic complications. The levels of serum 25-hydroxyvitamin D (25(OH)D) decrease in obesity because it is stored in adipose tissue compartments and is related to dyslipidemia conditions. A high triglyceride/HDL-cholesterol (TG/HDL-C) ratio in obesity is related to dyslipidemia. Visceral Adiposity Index (VAI) is one of the parameters indicating central obesity related to visceral fat distribution in dyslipidemia conditions. This study aimed to prove a correlation between TG/HDL-C ratio and VAI with 25(OH)D levels in obese females. Observational study with cross-sectional design in 66 female patients. HDL-C examinations and triglyceride using the enzymatic colorimetry method. The TG/HDL-C ratio was calculated by dividing TG by HDL. The equation obtained visceral adiposity index (WC/(36.58+(1.89xBMI)) x (TG/0.81) x (1.52/HDL). 25(OH)D examinations used the Enzyme Linked Fluorescent Immunoassay (ELFA) method. Relationship status used the spearman rank test (p<0.05). Median 25(OH) levels were 9.75 (8-18.6)ng/mL. There was a weak negative correlation between TG/HDL-C ratio with 25(OH)D levels in obese females (p=0.020; r= -0.287) and VAI with 25(OH)D in obese females (p=0.019; r= 0.287). There was a weak negative correlation between TG/HDL ratio and VAI with 25(OH)D in obese female patients.
肥胖是一种身体脂肪过多并伴有心脏代谢并发症的情况。肥胖患者血清25-羟基维生素D (25(OH)D)水平降低，因为它储存在脂肪组织间室中，与血脂异常有关。肥胖患者的高甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)比值与血脂异常有关。内脏脂肪指数(VAI)是血脂异常情况下与内脏脂肪分布相关的中心性肥胖指标之一。本研究旨在证明肥胖女性TG/HDL-C比值和VAI与25(OH)D水平之间的相关性。66例女性患者横断面设计观察性研究。用酶比色法检测HDL-C和甘油三酯。TG/HDL- c比值由TG除以HDL计算。公式得到内脏脂肪指数(WC/(36.58+(1.89xBMI)) x (TG/0.81) x (1.52/HDL)。25(OH)D检测采用酶联荧光免疫分析法(ELFA)。关系状态采用spearman秩检验(p<0.05)。中位25(OH)水平为9.75 (8-18.6)ng/mL。肥胖女性TG/HDL-C比值与25(OH)D水平呈弱负相关(p=0.020;r= -0.287)和肥胖女性VAI与25(OH)D (p=0.019;r = 0.287)。肥胖女性患者TG/HDL比值与VAI与25(OH)D呈弱负相关。
{"title":"Correlation of Triglyceride/HDL-Cholesterol Ratio and Visceral Adiposity Index with 25(OH)D in Obese Female","authors":"M. Monica, M. Hendrianingtyas","doi":"10.24293/ijcpml.v29i1.1923","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1923","url":null,"abstract":"Obesity is a condition of excess body fat mass with cardiometabolic complications. The levels of serum 25-hydroxyvitamin D (25(OH)D) decrease in obesity because it is stored in adipose tissue compartments and is related to dyslipidemia conditions. A high triglyceride/HDL-cholesterol (TG/HDL-C) ratio in obesity is related to dyslipidemia. Visceral Adiposity Index (VAI) is one of the parameters indicating central obesity related to visceral fat distribution in dyslipidemia conditions. This study aimed to prove a correlation between TG/HDL-C ratio and VAI with 25(OH)D levels in obese females. Observational study with cross-sectional design in 66 female patients. HDL-C examinations and triglyceride using the enzymatic colorimetry method. The TG/HDL-C ratio was calculated by dividing TG by HDL. The equation obtained visceral adiposity index (WC/(36.58+(1.89xBMI)) x (TG/0.81) x (1.52/HDL). 25(OH)D examinations used the Enzyme Linked Fluorescent Immunoassay (ELFA) method. Relationship status used the spearman rank test (p<0.05). Median 25(OH) levels were 9.75 (8-18.6)ng/mL. There was a weak negative correlation between TG/HDL-C ratio with 25(OH)D levels in obese females (p=0.020; r= -0.287) and VAI with 25(OH)D in obese females (p=0.019; r= 0.287). There was a weak negative correlation between TG/HDL ratio and VAI with 25(OH)D in obese female patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130915979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1951
Fenty Fenty, I. Putra
Any individual infected by COVID-19 can suffer various degrees of disease such as asymptomatic symptoms, mild, moderate or severe. Response to the antibody formation in the human body can be affected by the severity of COVID-19. Many researchers have stated that patients suffering a severe COVID-19 had a more significant antibody response, proven by higher antibody titers than those suffering mild or moderate severity. This research aimed to observe the different antibody responses in COVID-19 patients based on the severity of the disease. The research was a retrospective study with a cross-sectional design. The inclusion criteria were confirmed SARS-COV-2 patients determined by RT-PCR test results with age ≥18 years old and a complete medical record taken from electronic medical records and Laboratory Information System (LIS). This study involved 100 COVID-19 patients consisting of 51% non-severe and 49% severe COVID-19. Patients in the non-severe group had a relatively lower IgM and IgG antibody response than patients in the severe group. It could be th primarily observed at the time of antibody measurement > 15 day of symptoms onset (p<0.05).
{"title":"Antibody Responses to SARS-COV-2 of COVID-19 Patients Based on the Disease Severity","authors":"Fenty Fenty, I. Putra","doi":"10.24293/ijcpml.v29i1.1951","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1951","url":null,"abstract":"Any individual infected by COVID-19 can suffer various degrees of disease such as asymptomatic symptoms, mild, moderate or severe. Response to the antibody formation in the human body can be affected by the severity of COVID-19. Many researchers have stated that patients suffering a severe COVID-19 had a more significant antibody response, proven by higher antibody titers than those suffering mild or moderate severity. This research aimed to observe the different antibody responses in COVID-19 patients based on the severity of the disease. The research was a retrospective study with a cross-sectional design. The inclusion criteria were confirmed SARS-COV-2 patients determined by RT-PCR test results with age ≥18 years old and a complete medical record taken from electronic medical records and Laboratory Information System (LIS). This study involved 100 COVID-19 patients consisting of 51% non-severe and 49% severe COVID-19. Patients in the non-severe group had a relatively lower IgM and IgG antibody response than patients in the severe group. It could be th primarily observed at the time of antibody measurement > 15 day of symptoms onset (p<0.05).","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"2005 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125807819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1949
Y. K. A. A. Atmanto, Agus Alim Abdullah, D. Muhadi, M. Arif
The automatic platelet count sometimes requires confirmation on the peripheral blood smear. Platelet count estimation can also be used for reporting platelet count if an automatic cell counter is not available, with an estimation factor according to the Field Number (FN) of the microscope used. This study aimed to determine the platelet count estimation factor based on peripheral blood smear confirmation using an FN 22 microscope. An observational cross-sectional study was carried out in patients who had routine hematological and peripheral blood smear examinations during September 2021 by determination of platelet count using the automatic cell counter method and an average number of platelet counts per field of view with 100x objective magnification. The estimation factor is the total ratio divided by sample size. The total ratio of 254 samples was 4.086. The platelet count estimation factor was 16, indicating that 1 platelet per field of view was equivalent to 16x103/µL. There was a very strong significant correlation between mean platelet count per field of view and platelet count using the automatic cell counter (p<0.001, R>0.750). The field number is the image diameter of the microscope eyepiece. The latest generations of microscope use FN 20 or more, which provides a wider field of view, enabling the observation of more platelets. Factor estimation was used to determine the estimated platelet count on a peripheral blood smear. A big difference between automatic cell counter and peripheral blood smear might indicate pre-analytic, analytic, and post-analytic errors. The platelet count estimation factor based on peripheral blood smear confirmation using the FN 22 microscope was 16. Each laboratory needs to determine the estimation factor according to the FN microscope used.
{"title":"Determination of Platelet Count Estimation Factor on Peripheral Blood Smear Confirmation Using Field Number 22 Microscope","authors":"Y. K. A. A. Atmanto, Agus Alim Abdullah, D. Muhadi, M. Arif","doi":"10.24293/ijcpml.v29i1.1949","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1949","url":null,"abstract":"The automatic platelet count sometimes requires confirmation on the peripheral blood smear. Platelet count estimation can also be used for reporting platelet count if an automatic cell counter is not available, with an estimation factor according to the Field Number (FN) of the microscope used. This study aimed to determine the platelet count estimation factor based on peripheral blood smear confirmation using an FN 22 microscope. An observational cross-sectional study was carried out in patients who had routine hematological and peripheral blood smear examinations during September 2021 by determination of platelet count using the automatic cell counter method and an average number of platelet counts per field of view with 100x objective magnification. The estimation factor is the total ratio divided by sample size. The total ratio of 254 samples was 4.086. The platelet count estimation factor was 16, indicating that 1 platelet per field of view was equivalent to 16x103/µL. There was a very strong significant correlation between mean platelet count per field of view and platelet count using the automatic cell counter (p<0.001, R>0.750). The field number is the image diameter of the microscope eyepiece. The latest generations of microscope use FN 20 or more, which provides a wider field of view, enabling the observation of more platelets. Factor estimation was used to determine the estimated platelet count on a peripheral blood smear. A big difference between automatic cell counter and peripheral blood smear might indicate pre-analytic, analytic, and post-analytic errors. The platelet count estimation factor based on peripheral blood smear confirmation using the FN 22 microscope was 16. Each laboratory needs to determine the estimation factor according to the FN microscope used.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129648219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1863
Nursin Abdul Kadir, I. Parwati
COVID-19 is a respiratory infection caused by a new strain of Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which is highly contagious, primarily through respiratory droplets and contact. Typical symptoms include fever, cough, and shortness of breath. Weakness, nausea, and vomiting are often accompanied by respiratory symptoms but are sometimes confusing when these symptoms occur without respiratory symptoms. COVID-19 can affect any age group, are more common in adults and males and increase in patients with comorbidities. One of the most common comorbidities is Diabetes Mellitus (DM). A 40-year-old male patient complained of fever and weakness for three days. Nausea and vomiting since nine days before hospital admission, accompanied by painful swallowing, heartburn, and decreased appetite. History of going out of town and eating with friends 14 days before access to the hospital. 3 3 Laboratory examination results: 6600 leukocytes/mm , 264,000/mm platelets, NLR 2.3, 209 mg/dL of blood glucose, HbA1C 8.6%, SGOT 67 IU/L, SGPT 102 IU/L, IgG SARS-CoV-2 reactive, positive TCM SARS-CoV-2 (N2 Ct 18 and E Ct 20.3), and the duration of negative conversion of RT-PCR SARS-CoV-2 results was 19 days. The SARS-CoV-2 virus not only infects pneumocytes but also gastrointestinal, pancreatic, and endothelial cells via ACE2 receptors in DM patients, causing increased cell wall permeability to foreign pathogens and viral replication in the gastrointestinal lining cells. Subsequent enterocyte invasion causes malabsorption resulting in enteric symptoms. Uncontrolled glycemia conditions can slow viral shedding, so the length of negative conversion of RT-PCR SARS-CoV-2 results is prolonged. Based on the data above, the diagnosis in this patient was COVID-19 (symptomatic non-respiratory) with type 2 DM.
{"title":"COVID-19 (Symptomatic Non-Respiratory) with Type 2 Diabetes Mellitus","authors":"Nursin Abdul Kadir, I. Parwati","doi":"10.24293/ijcpml.v29i1.1863","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1863","url":null,"abstract":"COVID-19 is a respiratory infection caused by a new strain of Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which is highly contagious, primarily through respiratory droplets and contact. Typical symptoms include fever, cough, and shortness of breath. Weakness, nausea, and vomiting are often accompanied by respiratory symptoms but are sometimes confusing when these symptoms occur without respiratory symptoms. COVID-19 can affect any age group, are more common in adults and males and increase in patients with comorbidities. One of the most common comorbidities is Diabetes Mellitus (DM). A 40-year-old male patient complained of fever and weakness for three days. Nausea and vomiting since nine days before hospital admission, accompanied by painful swallowing, heartburn, and decreased appetite. History of going out of town and eating with friends 14 days before access to the hospital. 3 3 Laboratory examination results: 6600 leukocytes/mm , 264,000/mm platelets, NLR 2.3, 209 mg/dL of blood glucose, HbA1C 8.6%, SGOT 67 IU/L, SGPT 102 IU/L, IgG SARS-CoV-2 reactive, positive TCM SARS-CoV-2 (N2 Ct 18 and E Ct 20.3), and the duration of negative conversion of RT-PCR SARS-CoV-2 results was 19 days. The SARS-CoV-2 virus not only infects pneumocytes but also gastrointestinal, pancreatic, and endothelial cells via ACE2 receptors in DM patients, causing increased cell wall permeability to foreign pathogens and viral replication in the gastrointestinal lining cells. Subsequent enterocyte invasion causes malabsorption resulting in enteric symptoms. Uncontrolled glycemia conditions can slow viral shedding, so the length of negative conversion of RT-PCR SARS-CoV-2 results is prolonged. Based on the data above, the diagnosis in this patient was COVID-19 (symptomatic non-respiratory) with type 2 DM.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125135919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1910
Uswatun Hasanah, Ani Kartini, N. A. Kadir, Agus Alim Abdullah
Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Knowing the severity of COVID-19 is important during a pandemic. Measurement of Lactate Dehydrogenase (LDH) levels is a simple, quick, and widely available laboratory test in most health facilities. Lactate dehydrogenase levels change significantly in patients with tissue damage including COVID-19 disease. The purpose of this study was to analyze the LDH levels as a marker of the severity of COVID-19. The research method used was a cross-sectional approach using primary data from 70 suspected COVID-19 patients from June to July 2021 at Labuang Baji Hospital, Hasanuddin University Hospital, and Makassar City Hospital. Samples were grouped into mild, moderate, and severe COVID-19. The LDH levels at the time of hospital admission were measured using an Architect device. Chi-Square, Kruskal-Wallis, and ROC curve statistical tests were used to obtain the LDH value with a significant value of p<0.05. The sample consisted of 24 mild COVID-19, 23 moderate COVID-19, and 23 severe COVID-19. The LDH levels in mild COVID-19 were 101.00 U/L (74.00-156.00 U/L) significantly different from moderate COVID-19 was 143.00 U/L (126.00-253.00 U/L) and COVID-19 were 291.00 U/L (177.00-655.00 U/L) (p<0.001) and had a very strong positive correlation (r=0.914). The ROC curve showed that LDH had a sensitivity of 91.3%, specificity of 94.7% with the cut-off >250.5 U/L, NPV of 96.4%, PPV of 87.5%, and accuracy of 91.3%. LDH levels increase along with the increasing severity of COVID-19 caused by tissue damage due to increased inflammatory response. LDH can be used as a marker of COVID-19 severity.
{"title":"Lactate Dehydrogenase Levels as A Marker of COVID-19 Severity","authors":"Uswatun Hasanah, Ani Kartini, N. A. Kadir, Agus Alim Abdullah","doi":"10.24293/ijcpml.v29i1.1910","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1910","url":null,"abstract":"Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Knowing the severity of COVID-19 is important during a pandemic. Measurement of Lactate Dehydrogenase (LDH) levels is a simple, quick, and widely available laboratory test in most health facilities. Lactate dehydrogenase levels change significantly in patients with tissue damage including COVID-19 disease. The purpose of this study was to analyze the LDH levels as a marker of the severity of COVID-19. The research method used was a cross-sectional approach using primary data from 70 suspected COVID-19 patients from June to July 2021 at Labuang Baji Hospital, Hasanuddin University Hospital, and Makassar City Hospital. Samples were grouped into mild, moderate, and severe COVID-19. The LDH levels at the time of hospital admission were measured using an Architect device. Chi-Square, Kruskal-Wallis, and ROC curve statistical tests were used to obtain the LDH value with a significant value of p<0.05. The sample consisted of 24 mild COVID-19, 23 moderate COVID-19, and 23 severe COVID-19. The LDH levels in mild COVID-19 were 101.00 U/L (74.00-156.00 U/L) significantly different from moderate COVID-19 was 143.00 U/L (126.00-253.00 U/L) and COVID-19 were 291.00 U/L (177.00-655.00 U/L) (p<0.001) and had a very strong positive correlation (r=0.914). The ROC curve showed that LDH had a sensitivity of 91.3%, specificity of 94.7% with the cut-off >250.5 U/L, NPV of 96.4%, PPV of 87.5%, and accuracy of 91.3%. LDH levels increase along with the increasing severity of COVID-19 caused by tissue damage due to increased inflammatory response. LDH can be used as a marker of COVID-19 severity.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134082827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1924
Fitriana Andiani, Rita Herawati, Y. Triyani
When the COVID-19 outbreak is ongoing, the classification of COVID-19 patients based on the severity assessment is necessary to optimize the allocation of existing resources and early management interventions to improve prognosis. Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are two of the most common, simple, inexpensive, rapid, and widely available tests in all health facilities, which indirectly indicate the inflammatory status of COVID-19 patients. This study aimed to analyze the correlation between NLR and PLR with the severity of COVID-19 inpatients. This cross-sectional study was conducted retrospectively using medical record data of COVID-19 patients hospitalized at Al Islam Hospital, Bandung, from January to March 2021. COVID-19 patients involved in this study were classified into moderate, severe, and critical degrees. Statistical analysis was carried out using ANOVA or Kruskal-Wallis and Spearman with a significant value of p < 0.05. The median NLR and PLR results based on the severity were 3.49; 6.27; 8.4 (p<0.001) and 159.2; 202.6; 250.9 (p<0001), respectively. There was a correlation between NLR and PLR and the severity with r= 0.415 (p<0.001) and r=0.216 (p<0.001), respectively. The correlation between NLR and the severity was stronger than PLR. Therefore, it was concluded that there was a correlation between NLR and PLR with the severity of COVID-19 patients.
{"title":"Correlation between NLR and PLR with the Severity of COVID-19 Inpatients","authors":"Fitriana Andiani, Rita Herawati, Y. Triyani","doi":"10.24293/ijcpml.v29i1.1924","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1924","url":null,"abstract":"When the COVID-19 outbreak is ongoing, the classification of COVID-19 patients based on the severity assessment is necessary to optimize the allocation of existing resources and early management interventions to improve prognosis. Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are two of the most common, simple, inexpensive, rapid, and widely available tests in all health facilities, which indirectly indicate the inflammatory status of COVID-19 patients. This study aimed to analyze the correlation between NLR and PLR with the severity of COVID-19 inpatients. This cross-sectional study was conducted retrospectively using medical record data of COVID-19 patients hospitalized at Al Islam Hospital, Bandung, from January to March 2021. COVID-19 patients involved in this study were classified into moderate, severe, and critical degrees. Statistical analysis was carried out using ANOVA or Kruskal-Wallis and Spearman with a significant value of p < 0.05. The median NLR and PLR results based on the severity were 3.49; 6.27; 8.4 (p<0.001) and 159.2; 202.6; 250.9 (p<0001), respectively. There was a correlation between NLR and PLR and the severity with r= 0.415 (p<0.001) and r=0.216 (p<0.001), respectively. The correlation between NLR and the severity was stronger than PLR. Therefore, it was concluded that there was a correlation between NLR and PLR with the severity of COVID-19 patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"49 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134263627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1932
Lawly Arrel Dionnie Greatalya, D. Ariningrum, Lukman Aryoseto
The COVID-19 pandemic has drawn global attention as its main health issue. The rapid transmission and the diverse degree of severity have caused complicacy in controlling the disease. A hematological lab test has been a standard procedure done during therapy. This study aimed to determine the relation of the hematological parameter as a COVID-19 mortality predictor. The cohort retrospective method was used for this study by observing the medical records of critically ill COVID-19 patients admitted at Dr. Moewardi Hospital, Surakarta, from May 2020 to June 2021. The observed variables in this study were age, gender, comorbidities, and hematological lab test towards the outcome. The results were then analyzed bivariate and multivariate with SPSS. Out of 161 data, 101 were found alive and 60 deceased. Bivariate analysis showed that age of 50-80 years (RR= 2.246; p=0.029), comorbidities (RR=2.891; p=0.008), leucocyte>9850/µl (RR=2.634; p=0.004), neutrophil percentage >84.25% (RR=4.808; p=0.000), lymphocyte percentage<22% (RR=0.065; p=0.008), and NLR>9.326 (RR=5.031; p=0.000) had a relationship with the outcome. Gender, hemoglobin level, and platelet did not significantly correlate with the patient's outcome. Multivariate analysis showed that a history of comorbidities (RR=2.9326; p=0.012) and NLR >9.326 (RR=5.073; p=0.000) were proven to be a good predictor for mortality of COVID-19 patients. This result can be advantageous for clinicians in predicting the mortality of COVID-19 patients.
{"title":"Neutrophil-to-Lymphocyte Ratio and Comorbidities as Mortality Predictors for COVID-19 Patient at Dr. Moewardi Hospital Surakarta","authors":"Lawly Arrel Dionnie Greatalya, D. Ariningrum, Lukman Aryoseto","doi":"10.24293/ijcpml.v29i1.1932","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1932","url":null,"abstract":"The COVID-19 pandemic has drawn global attention as its main health issue. The rapid transmission and the diverse degree of severity have caused complicacy in controlling the disease. A hematological lab test has been a standard procedure done during therapy. This study aimed to determine the relation of the hematological parameter as a COVID-19 mortality predictor. The cohort retrospective method was used for this study by observing the medical records of critically ill COVID-19 patients admitted at Dr. Moewardi Hospital, Surakarta, from May 2020 to June 2021. The observed variables in this study were age, gender, comorbidities, and hematological lab test towards the outcome. The results were then analyzed bivariate and multivariate with SPSS. Out of 161 data, 101 were found alive and 60 deceased. Bivariate analysis showed that age of 50-80 years (RR= 2.246; p=0.029), comorbidities (RR=2.891; p=0.008), leucocyte>9850/µl (RR=2.634; p=0.004), neutrophil percentage >84.25% (RR=4.808; p=0.000), lymphocyte percentage<22% (RR=0.065; p=0.008), and NLR>9.326 (RR=5.031; p=0.000) had a relationship with the outcome. Gender, hemoglobin level, and platelet did not significantly correlate with the patient's outcome. Multivariate analysis showed that a history of comorbidities (RR=2.9326; p=0.012) and NLR >9.326 (RR=5.073; p=0.000) were proven to be a good predictor for mortality of COVID-19 patients. This result can be advantageous for clinicians in predicting the mortality of COVID-19 patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133808181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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