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British Journal of Healthcare and Medical Research - Vol. 9, No. 3
Publication Date: June, 25, 2022
DOI:10.14738/jbemi.93.12549. Mba, T. N., Kenguele, H. M., & Pambo-Pambo, B. A. (2022). Haemato-Biochemical Profile of COVID-19 Patients Hospitalized At the
The Amissa Bongo Regional Hospital Center (ABRHC) in Franceville, Gabon. British Journal of Healthcare and Medical Research, 9(3).
249-260.
Services for Science and Education – United Kingdom
Haemato-Biochemical Profile of COVID-19 Patients Hospitalized
At the The Amissa Bongo Regional Hospital Center (ABRHC) in
Franceville, Gabon
Thiéry Ndong Mba
Laboratory of Molecular and Cellular Biology (LABMC)
University of Science and Technology of Masuku
(USTM), Franceville, Gabon
Medical analysis laboratory of the Centre Hospitalier
Régional Amissa Bongo (CHRAB) Franceville, Gabon
Laboratory of Research in Biochemistry (LAREBIO)
University of Sciences and Techniques of Masuku
(USTM) Franceville, Gabon
Hilaire Moundounga Kenguele
Laboratory of Research in Biochemistry (LAREBIO)
University of Sciences and Techniques of Masuku
(USTM) Franceville, Gabon
Brice Arnaud Pambo-Pambo
Laboratory of Animal Physiology, University of Science and
Technology of Masuku (USTM), Franceville, Gabon
ABSTRACT
Taking place from 16 May to 31 August 2021, the aim of this study was to describe
the haemato-biochemical profile of COVID-19 patients in 250 diagnosed
individuals. With a sex ratio of 0.84, seventy-nine symptomatic COVID-19 patients,
36 of whom (45.57%) were less infected and 43 of whom (54.43%) were
predominantly infected, were hospitalised at the SICOV of the CHRAB. They ranged
in age from twenty-one to eighty-one years, with an average age of 45±5 years. After
taking blood samples and collecting certain biological specimens for the
determination of plasma electrolytes (sodium, potassium, chlorine and calcium),
the analysis of the results and the estimation of the values of the haematological
parameters of the interned patients revealed that one patient suffered from a
hypochromic microcytic anaemia associated with thrombocytopenia.
Hyperleukocytosis was found in 43% of cases, 43% of subjects had lymphopenia,
39.2% of cases had thrombocytopenia, and 63.3% had anemia. Observation of
biochemical parameters revealed a uraemia rate of less than 35.89% for all 79
patients. 31.7% of patients had elevated creatinemia. 58.34% had elevated AST and
ALT levels, 5% had elevated total bilirubin. Sodium (Na+=77%), potassium
(K+=33%) and calcium (Ca2+=20%) levels were significantly lower, forcing the
patients to develop a severe form of COVID- 19. Hypochloremia was present in 20%
of these patients. While 20% hypercalcaemia was recorded in the patients, there
were no cases of hypocalcaemia. Some patients suffered from co-morbidities such
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 3, June - 2022
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as renal failure and heart failure. Of the 79 patients hospitalised, 11 died (13.92%)
and 68 were cured (86.08%). The risk of death was higher in patients with one or
more co-morbidities. Our study shows that in patients under 58 years of age, 27.3%
of the deceased patients had at least one reported co-morbidity such as diabetes
(3.79%) and/or hypertension (6.28%).
Key words: COVID-19, SARS-CoV-2, Hematobiochemical
INTRODUCTION
Having been predicted by the United Nations Commission for Africa (UNCAF) and the World
Health Organization (WHO) to be subject to the greatest health catastrophe in its history when
the coronavirus pandemic arrives on its soil, the African continent has been spared due to
several parameters that are scientifically unknown until now and that could reduce the severity
of this pandemic. According to the African Centre for Disease Control and Prevention, Africa
had accumulated 4.437,846 cases and a total of 118,133 deaths by 20 April 2021 alone [1].
According to COVID pandemic data as of 1 November 2020 by country and territory, Gabon has
recorded: 8,968 confirmed cases, 215 active cases, 8,698 recoveries, and 55 deaths [2|. These
results are due to the fact that as soon as this coronavirus disease arrived on Gabonese soil in
March 2020, the government took public health and social measures such as: closing land, sea
and air borders, setting up quarantine centres for cases, respecting barrier measures and self- isolation of exposed persons. In concrete terms, the Integrated Disease Surveillance (IDS)
framework was used for surveillance and case detection [3]. As biochemical and haematological
reference values are essential to assess disease and monitor the effects of treatment in health
care practice and clinical trials [4], the extraordinary high cure rate recorded at national level
(90.9%) [5], prompted us to study the behaviour of blood cells, kidney and liver functions and
plasma electrolytes in symptomatic COVID-19 patients, especially as no studies had been done
on this subject in Haut Ogooué province. Out of 250 patients diagnosed by RT-PCR, this study
focused on 79 symptomatic COVID-19 patients admitted and hospitalised at the COVID-19
patient management site (SICOV) located within the Centre Hospitalier Régional Amissa Bongo
(CHRAB) in Franceville. A detailed history was taken of all patients and the clinical examination
involved haematological and biochemical investigations as well as repeated RT-PCR tests on
nasopharyngeal and oropharyngeal swab samples. Cure of the COVID-19 patient was confirmed
when the RT-PCR test was declared negative.
MATERIALS AND METHODS
Location of the study
This study was conducted between the medical analysis laboratory and the medicine
department of the Centre Hospitalier Régional Amissa Bongo in Franceville, the second largest
province in Gabon, where a site for the management of COVID-19 patients was set up and
named "SICOV" for the isolation of Covid-19 patients.
Type and period of study
This is a retrospective observational and descriptive study of data obtained from the results of
medical analyses of blood samples of 79 symptomatic COVID-19 patients hospitalised at the
Amissa Bongo Regional Hospital of Franceville (CHRAB), named SICOV between 16 May and 31
August 2021. The diagnosis of the virus was carried out by gene amplification on the Applied
Biosystems AB 7500 Real Time PCR System according to a diagnostic protocol for SARS-CoV-2
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Mba, T. N., Kenguele, H. M., & Pambo-Pambo, B. A. (2022). Haemato-Biochemical Profile of COVID-19 Patients Hospitalized At the The Amissa
Bongo Regional Hospital Center (ABRHC) in Franceville, Gabon. British Journal of Healthcare and Medical Research, 9(3). 249-260.
URL: http://dx.doi.org/10.14738/jbemi.93.12549
validated by Africa CDC and the African Union. Patient demographics as recorded by the nursing
staff on the patient's chart, medical history: diabetes, hypertension, tuberculosis, malaria, renal
failure, smoking, alcoholism, anaemia, hypercholesterolaemia, asthenia, coronary artery
disease and obesity were recorded. Obstetrical history such as pregnancy, caesarean delivery
and the circumstances of discovery of the disease were recorded. Functional symptomatology,
vital signs, and laboratory and radiological findings on admission were also recorded.
Inclusion and exclusion criteria
COVID-19 patients admitted to SICOV during the study period from 16 May to 31 August 2020
were included in the study. Any COVID-19 patient not admitted to the SICOV during the study
period was excluded, as well as all non-operational records.
Sampling
Blood samples taken in dry tubes, fluoride oxalate tubes and EDTA tubes from SICOV and
provided with their examination vouchers were collected at any time of the day or night in the
medical analysis laboratory of CHRAB. For the determination of plasma electrolytes (sodium,
potassium, chlorine and calcium). Biological specimens were collected in lithium heparin tubes.
Analytical procedure
The pre-analytical phase consisted of ensuring the conformity of the sample (correct
identification, sufficient quantity of blood, appropriate container, absence of blood clots), then
recording the patient's data in the central activity register (name, first names, age, sex,
examinations requested). A fractionation of the blood collected in the fluoride oxalate tubes and
dry tubes, was then centrifuged "Hettich Zentrifugen Rotina 35 Type 1705" set at 4500 rpm for
5 minutes. The analytical phase consisted of carrying out the various examinations recorded on
the examination form. Thus, with the whole blood collected on EDTA tubes, a haemogram was
carried out on the "Mindray BC 3000Plus" haematology machine. The determination of
biochemical parameters (blood glucose, urea, creatinine, transaminases, total bilirubin) was
carried out using the "ABX Pentra 400" biochemistry analyser with the plasma collected in the
fluoride oxalate tube and the serum in the dry tube. Finally, the post-analytical phase consisted
of checking and recording all the analytical results obtained in the registers of the disciplines
concerned, and then transcribing them on "Microsoft Word Office 2007" software.
Approval of the study
The study was approved by the General Management of CHRAB. The law on the protection of
privacy was respected according to the code of ethics in the Gabonese Republic and the
publication of this manuscript was authorised by the General Management of CHRAB.
Statistical studies
The descriptive statistical studies are presented as mean and standard deviation for continuous
variables and as frequencies for categorical variables.
RESULTS
Socio-demographic characteristics
Distribution of SARS-CoV-2 carriage according to gender and age groups
For this study, only 79 patients or 36.1% were selected out of 250 patients diagnosed by RT- PCR. With (54.43%, n=43), women were in the majority compared to men (45.57, n=36). The
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18 - Chen N., Zhou M., Dong X., Qu J., Gong F. and Han Y., 2020. Epidemiological and clinical characteristics of
99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet; 395 (10233):
507-513.
19 - Zhao K., Huang J., Dai D., Feng Y., Liu L. and Nie Shuke ., 2020. Acute myelitis after SARS-Cov2 infection:
https://doi.org/10.1101/20035105.
20 - Lippi G., South A. and Henry B., 2020. Electrolyte Imbalances in Patients with Severe Coronavirus Disease
2019 (COVID-19). Annals of Clinical Biochemistry.
21 - La rédaction de LCI - Publié le 10 avril 2020 à 13h30, mis à jour le 10 avril 2020 à 13h40 . Pourquoi les
hommes sont-ils plus touchés par le Covid-19 que les femmes?