Neutrophil-lymphocyte and platelet-lymphocyte ratios in rheumatoid arthritis patients: Relation to disease activity

Aim of the work: To assess the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients and compare between active cases and those in remission. Patients and methods: The study included 50 RA patients and 20 matched control. Patients were enrolled into 2 equally divided groups; group A (active) with a disease activity score (DAS-28) ≥2.6 and group B (remission) <2.6. Laboratory investigations included the calculation of the NLR and PLR for all subjects. Results: The mean age of patients was 40.7 ± 10.1 years and the mean of disease duration was 5.9 ± 3.4 years. The DAS-28 was 3.9 ± 0.9 in active patients and 2.1 ± 0.3 in those in remission (p = .001). NLR was 2.8 ± 2.1 in the patients and 2.1 ± 0.59 in the control (p = .15). PLR was 1.7 ± 0.9 in the patients and 1.27 ± 0.46 in the control (p = .09). Active patients had an NLR of 3.27 ± 2.81 and PLR of 1.8 ± 1.2 while they were 2.3 ± 0.84 and PLR 1.5 ± 0.59 in patients in remission (p = .05 and p = .18 respectively). There was a significant difference regarding NLR and PLR between active patients and control (2.1 ± 0.59 and 1.27 ± 0.46; p = .03 and p = .04 respectively). In active patients, the NLR and PLR significantly correlated with the patients age (p = .02 and p = .006) and with the DAS-28 (p = .001 and p = .03 respectively). Conclusion: NLR and PLR are 2 emerging inflammatory biomarkers which could be used to evaluate disease activity in active RA patients. A larger scale longitudinal study is recommended to confirm the present results and further demonstrate the relation to medications received and disease outcome. Keywords: Rheumatoid arthritis, DAS-28, Neutrophil-lymphocyte ratio, Platelet-lymphocyte rati

Gender differences in patients with corona virus disease-2019 presenting with psychiatric disturbances: a multicentre study

Abstract Background The coronavirus disease known as COVID-19 (2019) pandemic may increase the likelihood of psychological symptoms that can reach the level of psychiatric disorders. Aim We aimed to study psychiatric morbidity in patients with COVID-19 concerning gender differences and disease severity in the acute phase of infection and after 6 months. Methods This is a multicenter follow-up study registered in ClinicalTrials.gov (NCT04459403). Patients were recruited consecutively from three quarantine hospitals in Egypt. Data were collected through a questionnaire built using Google Forms including the Arabic versions of General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), and Taylor Manifest Anxiety Scale (TMAS). Depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms were assessed after 6 months. Results The study questionnaire was offered to 400 patients and 199 patients agreed to fill it. BDI and TAMS were higher in mild than moderate and severe COVID-19 (14, 8, 8, P-value = 0.009, 17, 13.5, 14, P-value = 0.04, respectively). Females showed a higher prevalence of depression, anxiety, sleep problems, and insomnia due to anxiety than males. Education level, marital status, previous psychiatric illness, and severity of COVID-19 independently affected depression. Marital status, family history of psychiatric illness, and chronic medical illness independently affected anxiety. On 6-month follow-up, BDI significantly decreased in males but not females. TMAS showed no significant changes, but the severity of anxiety was still higher in females. PTSD was more frequent in females (26 (37.1%) versus 4 (9.5%), respectively, P-value = 0.02). Conclusion The prevalence and severity of depression and anxiety were higher in females than male participants, suggesting that females are more affected by the COVID-19 pandemic