Background The Coronavirus 2019 is a pandemic that has spread worldwide, threatening human health. The main cause of death in patients with COVID-19 is a systemic pro-inflammatory mechanism that quickly progresses to acute respiratory distress syndrome. Hematological ratios as affordable indicators of inflammatory response were studied in COVID-19 patients. The study aimed to study the importance of the blood cell indexes of the systemic inflammatory response, as the Aggregate Index of Systemic Inflammation (AISI), neutrophils lymphocyte to platelet ratio (NLPR), systemic immune-inflammation index (SII) and, systemic inflammation response index (SIRI) in predicting intensive care unit (ICU) admission of COVID-19 patients. Methods 495 COVID-19 patients managed in four tertiary centers; divided into non-ICU and ICU groups. Results Total leucocyte count (TLC), AISI, NLPR, SII, and SIRI were more elevated in the ICU group (P < 0.001 for all except AMC P = 0.006), while this group had less absolute lymphocyte count (ALC) (P = 0.047). We estimated the optimal cut-off values of the hematological ratio; AISI (729), NLPR (0.0195), SII (1346), and SIRI (2.5). SII had the highest specificity (95.6%), while NLPR had the highest sensitivity (61.3%). Age, AISI, CRP, D-dimer, and oxygen aid were the independent predictors for ICU admission in COVID-19 in multivariate logistic regression. Conclusion AISI is a predictor for severity and ICU admission in COVID-19 patients, SII is a predictor of survival, while NLPR and SIRI have an additive role that needs further evaluation.

Introduction Coronaviruses belong to a large family that leads to respiratory infection of various severity. Hematological ratios are indicators of inflammatory response widely used in viral pneumonia with affordability in developing countries. Purpose Study the role of the neutrophil lymphocyte ratio (NLR), derived NLR ratio (d-NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR) in predicting the outcome of COVID-19 Egyptian patients. Methods A retrospective study on 496 COVID-19 Egyptian patients, managed in four tertiary centers, grouped into non-severe, severe, and critical. Patients’ laboratory assessment including total leucocyte count (TLC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count (AMC), NLR, d-NLR, LMR and, PLR were reported as well as C reactive protein (CRP), D-dimer and serum ferritin. Results TLC, ANC, AMC, NLR, d-NLR and, PLR were highest in the critical group ( p <0.001 for all except AMC p =0.033), while this group had the least ALC and LMR ( p =0.049 and <0.001, respectively). Higher CRP and d-dimer levels were reported in the critical group ( p <0.001). At the same time, higher ferritin was found in the severe group more than the critical and non-severe groups ( p <0.001, p =0.005, respectively). We calculated the optimal cut-off values of the hematological ratio; NLR (3.5), d-NLR (2.86), PLR (192), and LMR (3). D-NLR had the highest specificity (89.19%), while NLR had the highest sensitivity (71.38%). By univariate logistic regression, age, DM, HTN, cardiovascular diseases, COPD, NLR, d-NLR, LMR and PLR, CRP, steroid, oxygen aids, and mechanical ventilation were associated with the severity of COVID-19. Still, only age, NLR, CRP, and oxygen aid were independent predictors in multivariate logistic regression. Conclusion NLR is a predictor for severity in COVID-19. LMR, d-NLR, and PLR may assist in risk stratification.

Background As vaccination is a cornerstone strategy to prevent the spread of COVID-19, this study assessed and compared beliefs about and barriers to COVID-19 vaccination among the population of three countries with different Human Development Index (HDI) scores: Saudi Arabia (very high), India (medium), and Sudan (low). Methods A web-based, self-administered structured questionnaire was employed to collect data from the three countries. The questionnaire contained three sections that measured sociodemographic characteristics, participants’ beliefs about and attitudes toward COVID-19 vaccines, barriers to receiving COVID-19 vaccines, and scenarios in which there is a possibility to take a COVID-19 vaccine. Multinomial logistic regression was used to determine whether there was an association between the country of the participant and their beliefs about COVID-19 vaccines. Results 972 responses were collected. The study participants from India were more likely to believe in the safety and efficacy of vaccines than those from Saudi Arabia or Sudan. Consequently, they reported more willingness to get vaccinated to avoid complications from COVID-19. Regarding barriers to COVID-19 vaccination, concerns about adverse effects and ineffectiveness of vaccines were more common among Saudi participants, while concerns about conspiracy were more common among Sudanese participants. Conclusion COVID-19 vaccine acceptance was higher in countries with a very high to medium Human Development Index, indicating greater belief in the safety and efficacy of COVID-19 vaccines.

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Background:The novel corona virus is attacking several millions of people worldwide, resulting in death of almost a million and a half-humans. The rational of the current study was to detect clinical characteristics of severe COVID- 19 patients, and assessment of risk factors for death.Methodology:This retrospective cohort study included all laboratory confirmed COVID-19 patients with severe disease admitted to critical care unit in June and July 2020. All recorded data were collected,which included clinincal, radiological, and laboratory data, in addition to the outcome and duration of ICU stay.Statistical analysis was performed for obtaining descriptive information, comparison between living and dead patients,in addition to regression analysis to identify risk factors for mortality.Results:One hundred and three patients were included in the current study;cough and fever were the most common clinical presentations, and bilateral ground glass opacity was the most common radiological presentation. Patients had elevated values of neutrophils, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), serum ferritin, CRP, and D-dimer, also had longer ICU stay ,with reduced values of lymphocytes, and PaO2/FIO2 ratio. Most of these variables were more exaggerated in dead patients compared to living ones. Older age, lower values of PaO2/FIO2 ratio, and higher values of neutrophils, NLR, and D-dimer were predictors for death.Conclusion: Cough, fever and bilateral ground glass opacity were the most common clinical and radiological presentation of severe COVID 19. Older age, lower value of PaO2/FIO2 ratio, and higher values of D- dimer, neutrophil and NLR were risk factors associated with increased risk of mortality.