Search

The use of reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard laboratory test for diagnosing SARS-CoV-2 infection. However, it has the disadvantage of a long turnaround time and cost. The Nigeria Centre for Disease Control (NCDC) formulated a case definition for COVID-19. We sought to determine the utility of a 14-item, point-weighted clinical screening questionnaire adapted from the NCDC case definition in identifying patients more likely to have the disease. This was to aid prompt clinical decision-making.We retrospectively reviewed the data of 113 non-surgical patients presenting to the Accident and Emergency Department (A and E) of Lagos University Teaching Hospital, Lagos, Nigeria. Patients were stratified based on screening scores into low (0-2), moderate (3-5) and high (6) pre-test categories. Patients with low and high scores ≥6 were admitted to the A and E and the COVID-19 holding ward, respectively, while the moderate group had chest computed tomography scans to aid further decision-making, pending the outcome of their RT-PCR results. The validity of the triage score as compared to the RT-PCR test result was calculated and the kappa score of agreement was utilised to evaluate the concordance between two triage scores. The optimum cut-off score was also obtained based on the maximal Younden's index.The frequencies of low, moderate and high pre-test scores were 34 (30%), 43 (38.1%) and 36 (31.9%), respectively. Overall, 38.1% (43/113) were RT-PCR positive. RT-PCR was positive in 26.5% (9/34) with low screening scores, 55.8% (24/43) with moderate scores and 27.8% (10/36) with high scores. The sensitivity and specificity of a high score of 6 were 25% and 92.86%, while the lower score of 3 had sensitivity and specificity of 62.5% and 58.6%, respectively.The screening tool showed a high specificity in its initial design, which suggests that anyone with a low score using this tool has a high probability of testing negative. We recommend a cut-off score of 4 (score A) or 6 (score B) of the current screening tool be used to increase the chances of identifying persons with COVID-19 for RT-PCR testing.

Introduction: Human immunodeficiency virus (HIV) infection is characterized by excessive and dysregulated production of both proinflammatory and antiinflammatory interleukins, which produces various hematological changes. This study described hematological changes in HIV-positive patients in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods and Materials: This was a cross-sectional study involving 88 consecutive patients. They included 44 newly diagnosed antiretroviral treatment (ART)-naive patients (as the test group), and 44 ART- experienced patients (as the control group). All 88 patients were evaluated for full blood count and CD4+ T-cell count as well as interleukins 6 and 10 assays. Results: The mean packed cell volume in the ART-naive and the ART-experienced participants were 32.6 ± 5.7% and 38.6 ± 6.0% (P = 0.01). Mean hemoglobin were 10.8 ± 1.80 and 12.8 ± 1.66 g/dL in the ART-naive and the ART-experienced participants (P = 0.01), whereas the mean corpuscular volume among the ART-naive patients was 83.9 fL ± 7 and 99.3 fL ± 12 among the ART-experienced patients (P = 0.01). The median total white cell count among the ART-naive and the ART-experienced patients were 5.6 × 109 and 3.1 × 109 (P = 0.04), whereas their total platelet counts were 227 × 109 ± 116 and 252 × 109 ± 95 (P = 0.29). Conclusion: Use of ART reduces inflammatory response to HIV, thus lowering levels of interleukins 6 and 10 ultimately improving hematological outcomes, except in a few patients who use zidovudine.