{"doi":"10.1371/journal.pgph.0001866","title":"Effects 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","abstract":"<h4>Background</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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 counterparts. 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.<h4>Conclusion</h4>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.","journal":"PLOS Global Public Health","year":2023,"id":10396,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0428,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-06-22","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":86763,"name":"Michael Owusu","orcid":"0000-0001-5066-150X","position":1,"is_corresponding":false},{"id":86764,"name":"Samuel Kwasi Appiah","orcid":null,"position":2,"is_corresponding":false},{"id":86765,"name":"Kofi Mensah","orcid":null,"position":3,"is_corresponding":false},{"id":86766,"name":"Simon Bannison Bani","orcid":"0000-0002-6713-6653","position":4,"is_corresponding":false},{"id":86767,"name":"Felix Osei-Boakye","orcid":null,"position":5,"is_corresponding":false},{"id":86768,"name":"Lawrence Duah Agyemang","orcid":null,"position":6,"is_corresponding":false},{"id":86769,"name":"Ezekiel Bonwin Ackah","orcid":"0000-0001-7491-5420","position":7,"is_corresponding":false},{"id":86770,"name":"Gabriel Abbam","orcid":"0000-0002-0408-6126","position":8,"is_corresponding":false},{"id":86771,"name":"Samira Daud","orcid":"0000-0003-0133-1760","position":9,"is_corresponding":false},{"id":86772,"name":"Yeduah Quansah","orcid":"0000-0001-6320-6952","position":10,"is_corresponding":false},{"id":86773,"name":"Charles Angnataa Derigubah","orcid":null,"position":11,"is_corresponding":false},{"id":86774,"name":"Francis Atoroba Apodola","orcid":null,"position":12,"is_corresponding":false},{"id":86775,"name":"Valentine Ayangba","orcid":null,"position":13,"is_corresponding":false},{"id":86776,"name":"David Amoah Afrifa","orcid":null,"position":14,"is_corresponding":false},{"id":86777,"name":"Caleb Paul Eshun","orcid":null,"position":15,"is_corresponding":false},{"id":86778,"name":"Abdul-Waliu Iddrisu","orcid":"0000-0002-8004-6441","position":16,"is_corresponding":false},{"id":86779,"name":"Selina Mintaah","orcid":"0009-0008-8277-3598","position":17,"is_corresponding":false},{"id":86780,"name":"Benjamin Twum","orcid":"0000-0003-0228-373X","position":18,"is_corresponding":false},{"id":86781,"name":"Abidatu Mohammed","orcid":null,"position":19,"is_corresponding":false},{"id":86782,"name":"Eugene Mensah Agyare","orcid":null,"position":20,"is_corresponding":false},{"id":86783,"name":"Wendy Akomeah Gyasi","orcid":null,"position":21,"is_corresponding":false},{"id":86784,"name":"Peace Esenam Agbadza","orcid":"0000-0001-9723-5065","position":22,"is_corresponding":false},{"id":86785,"name":"Candy Adwoa Ewusiwaa Wilson","orcid":null,"position":23,"is_corresponding":false},{"id":86786,"name":"Seth Anane","orcid":null,"position":24,"is_corresponding":false},{"id":86787,"name":"Prince Antwi","orcid":"0000-0002-6076-2600","position":25,"is_corresponding":false},{"id":86788,"name":"Reginald Akwasi Yeboah Antwi","orcid":"0000-0002-4312-4789","position":26,"is_corresponding":false},{"id":86789,"name":"Kofi Boamah Mensah","orcid":"0000-0002-7971-4270","position":27,"is_corresponding":false},{"id":86790,"name":"Felix Osei‐Boakye","orcid":"0000-0001-5126-7424","position":28,"is_corresponding":false},{"id":86791,"name":"Charles A. 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