Browsing by Author "0000-0001-5126-7424"
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- ItemEffect of Pulmonary Tuberculosis on Protein C, S, and Antithrombin-III among Therapy-naïve Ghanaian Adults; A Comparative Cross-Sectional Study(Journal of Immunoassay and Immunochemistry, 2020-12-30) Osei-Boakye, Felix; Addai-Mensah, Otchere; Owusu, Michael; Saasi, Abdul-Razak; Appiah, Samuel Kwasi; Nkansah, Charles; Wiafe, Yaw Amo; Debrah, Alexander Yaw; 0000-0001-5126-7424; 0000-0001-9225-5876; 0000-0001-5066-150X; 0000-0003-1855-5840; 0000-0001-6986-9976; 0000-0002-0944-0577; 0000-0001-5721-0891Background: Tuberculosis (TB) constitutes a global emergency as it affects one-third of the world’s inhabitants. Although pulmonary Tuberculosis (PTB) is curable, immunological responses to the infection induce several haematological derangements. This study evaluated the effect of PTB on Protein C, Protein S, Antithrombin-III, and blood count parameters. Methods. Ninety adults with ages ≥18 years were purposively recruited: 60 PTB patients and 30 non-TB controls. All patients were diagnosed with sputum GeneXpert MTB/Rif assay. Blood specimens were collected from each participant for Protein C, S, Antithrombin-III and complete blood count. Results: Pulmonary TB was associated with signifi cantly reduced Protein C activity (101.46 [87.61-128.3] vs 121.44 [99.50-149.8] IU/L, p=0.038), RBC (3.88±0.91 vs 4.80±0.55, p<0.0001), HgB (10.24±2.42 vs 11.78±1.42, p=0.0019), HCT (32.21±7.79 vs 42.05±4.97, p<0.0001), MCV (83.80 [79.33-90.08] vs 89.00 [83.75-92.00], p=0.0133) and PDW (12.95 [10.73-15.00] vs 15.30 [14.18-15.93], p<0.0001) compared to controls. Conversely, PTB patients were associated with signifi cantly increased MCH (26.83±4.33 vs 24.59±1.99, p=0.0086), TWBC (7.76 [6.06-9.78] vs 6.50 [4.85-7.50], p=0.0047), Abs. GRAN (5.27 [3.30-6.71] vs 3.75 [2.48-4.75], p=0.0226), RDW-CV (13.70 [13.20-15.43] vs 12.95 [12.50-13.65], p<0.0001), MCHC (32.10 [28.70-35.63] vs 27.85 [27.40-28.53], p<0.0001) and MPV (8.3 [6.7-9.7] vs 7.0 [6.4-7.5], p=0.0027) compared to controls. The PTB patients were disproportionately affected with anaemia (91.7%, p=0.001), erythrocytopenia (75.0%; p≤0.001) and reduced HCT (80.0%, p≤0.001). The frequency of thrombocytosis, leucocytosis, and granulocytosis (50.0%, p=0.013; 23.3%, p=0.013; 18.3%, p=0.025; respectively) in PTB patients were signifi cantly higher than in controls. Conclusion. Our findings suggest that PTB predisposes patients to hypercoagulability, with a significant reduction in Protein C activity but not Protein S and antithrombin-III. The condition causes derangements in erythrocytes, leucocytes, and thrombocytes, and disproportionately causes anaemia. Protein C activity and complete blood count are useful in the management of PTB and should be included in the routine workup for patients.
- ItemEffects of COVID-19 disease on PAI-1 antigen and haematological parameters during disease management: A prospective cross sectional study in a regional Hospital in Ghana(PLOS Glob Public Health, 2023) Nkansah, Charles; Owusu, Michael; Appiah, Samuel Kwasi; Mensah, Kofi; Bani, Simon Bannison; Osei-Boakye, Felix; Agyemang, Lawrence Duah; Ackah, Ezekiel Bonwin; Abbam, Gabriel; Dauda, Samira; Quansah, Yeduah...et.al; 0000-0001-6986-9976; 0000-0001-5066-150X; 0000-0002-2238-2797; 0000-0002-6713-6653; 0000-0001-5126-7424Background: Individuals with COVID-19 experience thrombotic events probably due to the associated hypofibrinolysis resulting from the upregulation of plasminogen activator inhibitor-1 (PAI-1) antigen. This study evaluated plasma PAI-1 antigen levels and haematological parameters before treatment and after recovery from severe COVID-19 in Ghana. Materials and methods: This cross-sectional study was conducted at Sunyani Regional Hospital, and recruited 51 patients who had RT-PCR-confirmed SARS-CoV-2. Participants’ sociodemographic data and clinical characteristics were taken from the hospital records. Venous blood was taken before COVID-19 treatment commenced for FBC, PAI-1 and ferritin assays. FBC was assessed using an automated haematology analyzer, whilst plasma PAI-1 Ag and serum ferritin levels were assessed with sandwich ELISA. All the tests were repeated immediately after participants recovered from COVID-19. Results: Of the 51 participants recruited into the study, 78.4% (40) had non-severe COVID-19 whiles 21.6% (11) experienced a severe form of the disease. Severe COVID-19 participants had significantly lower haemoglobin (g/dL): 8.1 (7.3–8.4) vs 11.8 (11.0–12.5), p<0.001; RBC x 1012/L: 2.9 (2.6–3.1) vs 3.4 (3.1–4.3), p = 0.001; HCT%: 24.8 ± 2.6 vs 35.3 ± 6.7, p<0.001 and platelet x 109 /L: 86.4 (62.2–91.8) vs 165.5 (115.1–210.3), p<0.001, compared with the non-severe COVID-19 group. But WBC x 109 /L: 11.6 (9.9–14.2) vs 5.4 (3.7–6.6), p<0.001 and ferritin (ng/mL): 473.1 (428.3–496.0) vs 336.2 (249.9–386.5), p<0.001, were relatively higher in the participants with severe COVID-19 than the non-severe COVID-19 counter parts. Also, the severely ill SARS-CoV-2-infected participants had relatively higher plasma PAI-1 Ag levels (ng/mL): 131.1 (128.7–131.9) vs 101.3 (92.0–116.8), p<0.001, than those with the non-severe form of the disease. Participants had lower haemoglobin (g/dL): 11.4 (8.8–12.3 vs 12.4 (11.5–13.6), p<0.001; RBC x 1012/L: 3.3 (2.9–4.0) vs 4.3 (3.4–4.6), p = 0.001; absolute granulocyte count x 109 /L: 2.3 ± 1.0 vs 4.6 ± 1.8, p<0.001, and platelet x 109 /L: 135.0 (107.0–193.0) vs 229.0 (166.0–270.0), p<0.001 values at admission before treatment commenced, compared to when they recovered from the disease. Additionally, the median PAI-1 Ag (ng/mL): 89.6 (74.9–100.8) vs 103.1 (93.2–128.7), p<0.001 and ferritin (ng/mL): 242.2 (197.1–302.1) vs 362.3 (273.1–399.9), p<0.001 levels were reduced after a successful recovery from COVID-19 compared to the values at admission. Conclusion: Plasma PAI-1 Ag level was higher among severe COVID-19 participants. The COVID-19- associated inflammation could affect red blood cell parameters and platelets. Successful recovery from COVID-19, with reduced inflammatory response as observed in the decline of serum ferritin levels restores the haematological parameters. Plasma levels of PAI-1 should be assessed during the management of severe COVID-19 in Ghana. This will enhance the early detection of probable thrombotic events and prompts Physicians to provide interventions to prevent thrombotic complications associated with COVID-19.