Open Access Review Article

Coronavirus: A Laboratory Perspective

Ransom Baribefii Jacob, Chukwu Christopher Ifunaya, Emeji Roseline

International Blood Research & Reviews, Page 1-7
DOI: 10.9734/ibrr/2021/v12i430155

COVID-19 is a virus of the species of the Family coronaviridae known as as SARS-COV-2. This virus is easily contracted and/transmitted from an infected person to another healthy individual and has continued to spread rapidly. The aim of this review is to identify laboratory methods used in the diagnosis of COVID-19 infection. COVID-19 test are aimed at detecting active infection, or past infection, or an immunization so as to treat and curb the further spread of the virus. The initial viral detection is typically carried out with the upper respiratory tract (URT) sample. Repeated testing is particularly helpful and essential if a patient has a clinical appearance of viral pneumonia, radiographic results consistent with pneumonia and/or a history of potential exposure. The Centre of Disease Control and Prevention, CDC recommends the collection of specimens from the lower respiratory tract, upper respiratory tract, and the blood. The lower respiratory tract sample includes; the sputum, broncheoalveolar lavage, bronchial wash, tracheal aspirate, and pleural fluid.  The upper respiratory tract specimens include; the nasopharyngeal swab, and oropharyngeal swab (NP/OP swabs). Some laboratory techniques developed and in use for the detection of Covid-19 are; nucleic acid amplification tests (NAATs), antibody detection, and viral antigen detection. The role of the laboratory assay in diagnosis of COVID-19 infection or disease cannot be                            under-estimated, timing and site of specimen collected must be followed by adequate                 professional training to ensure result accuracy. This review provides information on available laboratory techniques for the diagnosis of the viral infection and their potential merits and           limitations.

Open Access Review Article

Overview of Adverse Events Associated with Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy

Ekaterina Vorozheikina, Magdalena Ruiz, Leticia Solari, Dmitry Ostasevich, Luis Mendoza

International Blood Research & Reviews, Page 11-31
DOI: 10.9734/ibrr/2021/v12i430157

Anti-CD19 chimeric antigen receptor (CAR) T-cells represent a novel immunotherapy that has shown remarkable success in the treatment of adult relapsed or refractory (R/R) B-cell non-Hodgkin's lymphoma, adult R/R mantle cell lymphoma, and R/R acute paediatric lymphoblastic leukaemia. One barrier to the widespread use of CAR T-cell therapy is toxicity, primarily cytokine release syndrome (CRS) with a variable grade of severity. The main manifestations of CRS are fever, hypotension, cytopenia, organ dysfunction among others. Neurological toxicities vary widely and range from headaches to encephalopathy. In addition, anti-CD19 CAR T-cell therapy provokes an array of less frequent events, such as coagulopathies, delayed cytopenia, and cardiovascular toxicities. In general, toxicities are usually reversible and resolve on their own in most cases, though severe cases may require intensive care and immunosuppressive therapy. Deaths due to CRS, neurologic toxicity and infectious complications have been reported, which highlights the gravity of these syndromes and the critical nature of appropriate intervention. In this paper, we look at all available FDA- and EMA-approved information about the pathophysiology, clinical manifestations, risk factor reviews of existing toxicity grading systems, current management strategies, and guidelines for anti-CD19 CAR T-cell toxicities. We also present new approaches, which are under investigation, to mitigate these adverse events.

Open Access Original Research Article

Convalescent Plasma for COVID-19- is it Time to Say Goodbye? A Single-Center, Retrospective, Observational Study from Northern India

Rasika Setia, Mitu Dogra, Gokhula Prasath Thangavel, Ramesh Yadav, Amena Ebadur Rahman, Atul Bhasin, Rajesh Kumar Pande, Sandeep Nayar, R. K. Singal, Anil Vardani, Deepak Gargi Pande, R. N. Saini, Tribhuvan GulatI, Vivek Pal Singh, Sunny Kalra, Gagan Anand, Manish Garg, Santosh Ghai, N. M. Agarwal

International Blood Research & Reviews, Page 32-43
DOI: 10.9734/ibrr/2021/v12i430158

Background: COVID-19 pandemic continues threatening the world with no effective treatment to tackle the menace. Till date, there is conflicting evidence on efficacy of CP in reducing COVID-19 related mortality. The objective of this study was to see disease progression and 7, 14 and 28-day mortality after CP therapy and analyze CP efficacy with/without Remdesivir.

Materials and Methods: A retrospective single-centre observational study done from August 20, 2020, to 20 November 2020. Records of 294 COVID-19 patients with moderate to severe disease given CP therapy were analysed based on disease progression and length of hospital stay, further subcategorized on age, clinical profile, risk factors, ward/ICU, ventilatory support and co-administration of Remdesivir.

Results: Lowest 7-day mortality rate was seen within age group 20-40 years (0%) and was highest in ≥61 years (24.3%). 87 patients on ventilatory support showed higher 28day mortality (48.28%) compared to non-ventilated (10.14%), (P<0.00001). Lesser 7-day mortality was seen in early CP therapy ≤3 days of admission (P=0.01). Patients requiring ICU admission showed higher 14 and 28-day mortality compared to ward P=0.001%). Median (IQR) length of hospital stay from CP transfusion was shorter, 4 (3 to 9) days in group 2 (CP only) compared to 7 (4 to 12) days in group1 (CP+Remdesivir ).

Conclusion: CP therapy in ≤3 days of hospital admission in COVID-19 patients with moderate to severe infection not on ventilatory support showed reduction in mortality and length of hospital stay. Length of hospital stay was shorter in the CP-only group as compared to the CP+ Remdesivir group.

Open Access Original Research Article

Inflammatory Markers in Workers Occupationally Exposed to Petrol and Petroleum Products

Anya Ojiugo Hannah, Nwachuku Edna Ogechi, A. Waribo Hellen, Bartimaeus Ebirien-Agana Samuel

International Blood Research & Reviews, Page 44-52
DOI: 10.9734/ibrr/2021/v12i430159

Place and Duration of Study: Sample: Abia State University Teaching Hospital, Aba, Abia State and Laboratory Department, JAROS Inspection Services Limited, Port Harcourt, Rivers State, between April 2018 and June 2018.

Methodology: A total of 204 samples comprising of 123 auto-mechanics and 81 non -auto-mechanics were assayed. Detailed information of the bio-data of the subjects including age, gender, medical history, health information and lifestyle were obtained from each participant. Blood samples were collected from for the analysis of inflammation markers, IL-6, TNF-α and CRP were determined using standard methods and techniques. The effect of age and duration of exposure on the inflammation parameters were considered.  Statistical Analysis System (SAS), STAT 15.1, developed by SAS Institute, North Carolina State University, USA was used for statistical analysis. Data were presented as Mean ± SEM, comparison of means of groups that are more than two was done using Analysis of Variance (ANOVA), and the Tukey test of multiple comparison was used to test for variance within and across groups.

Results: There was significant increase in the means of IL-6, TNF-α and CRP in the exposed subjects (p <0.05) compared with the control subjects There was no significant difference (p >0.05) in the means of IL-6, TNF-α and C-reactive protein (CRP) between the age groups of the exposed and the control subjects. Similarly, there was no significant difference between the groups, based on duration of exposure. This suggests that the toxic effect does not depend on the age or duration of exposure but on other factors for the automechanics in Aba. 

Conclusion: This study shows that the exposure of automechanics may significantly increase the serum IL-6 TNF-α and Hs-CRP levels. Increase in the serum levels of the inflammation markers is predictive of the danger of future pathology in automechanics compared with non automechanics in Aba metropolis. Age and duration did not influence significant variation in the automechanics.

Open Access Short Communication

Hypocholesterolemia and Statins in Multiple Myeloma

Irfan Yavaşoğlu, Atakan Turgutkaya

International Blood Research & Reviews, Page 8-10
DOI: 10.9734/ibrr/2021/v12i430156

Statins are lipid-lowering agents. They also have immunomodulatory, anti-inflammatory, anti-angiogenic, and anti-proliferative functions. In this context, they are demonstrated to have beneficial effects on mortality in several malignancies including esophageal, breast, lung, liver, pancreatic, endometrial, and colorectal cancers. Multiple myeloma is considered as an incurable plasma cell disorder with current therapy; however due to the current knowledge about the correlation between cholesterol-lowering agents and myeloma; it’s suggested to have lower mortality rates for patients using statins.  Patients with multiple myeloma usually have a low cholesterol level which is often underestimated by clinicians. Hereby we aimed to summarize the myeloma-hypocholesterolemia relationship and emphasize the importance of statins as an inexpensive and beneficial approach for these patients.