Pattern of Potential Laboratory Markers for COVID-19 in Eastern Sudan

Background: Coronavirus disease 2019 (COVID-19) is a recent global health crisis. One of the major issues of COVID-19 is its unpredictable manifestations and serious outcomes. Many hematological parameters are thought to change dramatically during the course of the disease. These include white blood cells, red blood cells, and platelets. This study aimed at evaluating certain laboratory results;peripheral blood lymphopenia, relative neutrophilia, high neutrophil-lymphocyte ratio, and elevated C-reactive protein as potential laboratory markers of COVID-19 in Eastern Sudanese patients. Methods: We, retrospectively, aimed at the evaluation of peripheral blood leucocytes count, neutrophil-lymphocyte ratio NLR and C-reactive protein (CRP) levels in confirmed COVID-19 eastern Sudanese patients during the course of the disease. Results: The mean total leucocytes count, % neutrophils count, absolute neutrophils count and C-reactive protein (CRP) were significantly higher (P. value = 0.000) in COVID-19 patients than in the control group while the mean % lymphocytes count and % mixed cells count were found to be significantly lower in COVID-19 patients than in the control group (P. value 0.000). Conclusion: Peripheral blood leucocyte alterations (simultaneous presence of lymphopenia, relative neutrophilia and high neutrophil lymphocyte ratio (NLR) along with elevated CRP levels may be valuable biomarkers associated with COVID-19 in Port Sudan city, Red Sea state, Sudan. These markers might be important in prediction, inspection of disease progression and prognosis.

Hematological Alterations in an Eastern Sudanese Chronic Kidney Disease Patient Population

Background: Chronic Kidney Disease (CKD), associated with a slow and progressive loss of kidney function over a period of several years, is an important clinical disaster with an increasing rate of morbidity and mortality especially in the least developed countries. Many hematological parameters are thought to alter dramatically during the course of the disease. These include white blood cells, red blood cells, and platelets. Methods: We tried, retrospectively, to evaluate the peripheral blood hematological alterations in a group of patients undergoing hemodialysis in an eastern Sudan dialysis center to add local medical information. Results: Anemia (Low hemoglobin and hematocrit) was detected in 94% of the patients’ group. Mean Erythrocyte count (3.32vs.4.76 (×109/L)), Hemoglobin concentration (9.4vs.13 (g/dl)), Hematocrit (28.7vs.38.7 (L/L)) and platelet count (296 vs. 238 (×109/L)) were significantly lower in the patients’ group than in the control group (P-values Conclusion: Five out of eight studied parameters (Red cell count, hemoglobin, hematocrit, mean cell hemoglobin concentration, and platelets count) have shown a significant alteration in CKD patients. As the complete blood count (CBC) test is the most utilized test in clinical laboratory practice, these alterations may be considered as early indicators for CKD. Furthermore, all patients with CKD must be routinely checked for these alterations.

Prediction of Acute Renal Failure in Dengue Fever Patients

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes aegypti which is found in Sudan especially Red Sea and Kassala states in the east. The disease is known to cause renal disturbances and a thorough understanding of that will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infected patients along with 200 healthy appearing adults (control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including serum urea and creatinine values. Ethical approval was obtained from the ministry of health, Red Sea state and informed written consent was obtained from each participant. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Elevated blood urea levels were detected in 10 (5%) patients while elevated creatinine levels were seen in 17 (8.5%) patients. Although fallen within reference ranges found in the literature, mean blood urea and creatinine values differed significantly between patients and controls and between different categories of the disease. Mean blood urea concentration showed a statistically significant difference between the control (22.3 mg/dl) and the test (28.4 mg/dl) (P value Conclusion: We strongly conclude that renal involvement is not uncommon in Dengue fever and that blood urea and creatinine evaluation should be considered in the counseling of DENV infection patients. Patients need to be subjected to necessary laboratory investigations associated with acute kidney injury to decrease the rate of morbidity and mortality associated with the disease.

Significance of Serum Electrolyte Pattern in an Eastern Sudanese Dengue Fever Patients Population

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes Egyties which is found in Sudan especially Red Sea and Kassala states in the east. In the year 2020 there was a significant outbreak in the both states. The disease is known to cause renal and electrolyte disturbances and a thorough understanding of that which will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infection patients along with 200 healthy appearing adults (as a control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including electrolyte values. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Although fallen within reference ranges found in the literature, mean serum electrolyte values differed significantly between patients and controls and between different categories of the disease. For our patients, hyponatraemia was seen in 43.5%, hypokalaemia in 37%, hypocalcaemia in 30%, hypophosphataemia in 12% and low magnesium concentrations in 13%. Mean serum sodium concentration differed in the control (138.2 mmol/l) from in the test (132.5 mmol/l) (P. value 0.02). Similarly, mean serum potassium in the control (3.97 mmol/l) differed significantly (P. value 0.01) from test (3.30 mmol/l). Mean calcium and phosphorus (8.80 and 3.50 mg/dl) in the control were also differed from test (8.51 and 3.30), (P. values 0.02 and 0.004, respectively). In contrast, serum magnesium (mg/dl) in the control group (1.96) showed no significant difference from that of test group (1.90) (P. value 0.08). The biochemical parameters studied were neither affected by age nor by gender of the patient group. Clinically, fever was present in 97.5% of patient, headache in 95.5%, joints pain in 71%, lethargy 67%, vomiting in 49%, skin rash in 40%, abdominal pain 24% and bleeding in 17.5%. Conclusion: We strongly conclude that electrolyte evaluation should be considered in the counseling of DENV infected patients. Patients need to be subjected to necessary laboratory investigations including serum electrolyte levels to decrease the rate of morbidity and mortality associated with the disease.