Abstract
EVALUATION OF SOME ASPECTS OF HEMATOLOGICAL VALUES AND D-DIMER IN COVID-19 POSITIVE CHILDREN

Biva Rani Mondal*, Mashud Parvez, Kishor Chandra Paul, Lotifur Rahman and Waqar Ahmed Khan

ABSTRACT

Background: The current pandemicCOVID-19 was first identified in December 2019 in Wuhan City of China. In Bangladesh COVID-19 cases were first identified on March 8, 2020. With the emergence of SARS-CoV-2 mutants, the number of children infected with SARS-CoV-2 has gradually increased worldwide. It affected the health systems and the routine of the population globally. Several hematological parameters have been reported tobe disturbed in patients with COVID-19, starting from the disease’s early phases. So, hematological parameters are of significant importance for diagnosis and treatment decisions in severe COVID-19 patients. D-Dimer is also a specific diagnostic and prognostic bio-marker for COVID 19. It is also used as an inflammatory marker. Papers describing hemocytological and bio-markers like D-dimer in pediatric population of Bangladesh are scarce. Objective: The objective of this study is to evaluate blood cells, haemoglobin (Hb), haematocrit (Hct) and D-dimer in COVID-19 positive Children of Bangladesh. Materials and Methods: This was a cross-sectional descriptive study conducted in the department of Clinical Pathology, Bangladesh Shishu Hospital and Institute, Dhaka from August 2020 to April 2021. Forty-one COVID-19 positive children were recruited in the study. The measurements of hemoglobin blood cells, haemoglobin(Hb) and haematocrit (Hct) were done from an accredited laboratory. The study was approved by Institutional Ethics Review Board. A questionnaire was prepared and pretested to obtain the data. Statistical analysis was performed by on-line statistics calculator. The results were expressed as mean±SD, frequency and percentage of all variables into three categories: normal, lower than low normal and higher than high normal. Result: The mean age of the patients was 4.5 yrs with minimum age 5 days and maximum age 15 years. There were 27 (0.66%) male and 14 (o.44%) female children with a male/female ratio of 1.9:1. The mean±SD of D-dimer was 1.809±2.46 mg/L and 24.39% had higher than normal D-dimer value. The mean±SD of total WBC count was 9.44±5.25 x109/L and 14.63% children had leucopenia and 19.51% had leukocytosis. Neutropenia was present in 19.51% and neutrophilia in 34.15% children. Lymphopenia was present in 19.51% and lymphocytosis in 36.58% children. Similar number (12.20%) of patients had thrombocytopenia and thrombocytosis. RBC count was lower in 43.9% and higher in 7.31% children. The mean±SD of Hb was 10.82±2.41 gm/dl and anaemia was present in 56.1% children .60.97%) children had lower than normal Hct level and 4.88% had higher than normal value. Conclusion: The mean age of the patients was 4.5 yrs. Male children suffered almost 2 times more than female children from COVID-19. One-fourth of children had more than normal D-dimer level. Both leucopenia and leukocytosis were present in them but leukocytosis (19.51%) was more prevalent than leucopenia (14.63%). Neutrophilia (34.15%) was more prevalent than neutropenia (19.51%) in them. Similarly, lymphocytosis (36.58%) was more prevalent than lymphopenia (19.51%) in them. Equal number (12.20%) of patients suffered from thrombocytopenia and thrombocytosis. Significant number of COVID-19 positive children had less than normal RBC count (43.9%), hemoglobin level (56.1%) and hematocrit level (60.97%).

Keywords: COVID positive children, haematological values, D-dimer.


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