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    Review of 'COVID-19 And Erythrocyte Aggregates: An Intensivists Experience When Being Affected'

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    COVID-19 And Erythrocyte Aggregates: An Intensivists Experience When Being AffectedCrossref
    Clinically important observation: Erythrocyte aggregates and increased ferritin in COVID19
    Average rating:
        Rated 3.5 of 5.
    Level of importance:
        Rated 4 of 5.
    Level of validity:
        Rated 3 of 5.
    Level of completeness:
        Rated 3 of 5.
    Level of comprehensibility:
        Rated 3 of 5.
    Competing interests:
    None

    Reviewed article

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    • Article: found
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    COVID-19 And Erythrocyte Aggregates: An Intensivists Experience When Being Affected

     Md Alam (corresponding) ,  Mahbuba Raheen (2020)
    COVID-19 pandemic has killed over 310,000 individuals as of 17 May 2020. Healthcare providers are profoundly vulnerable to be contaminated instead of taking every single careful step. Although the respiratory tract and the lungs are the target organs some complications may develop even at the introductory phase of this sickness course. Hemoconcentration with raised serum ferritin levels is one of the dangerous conditions that may occur from chronic hypoxia and severe dehydration because of increased insensible loss due to continuous excessive perspirations. Recent posthumous pulmonary tissue studies revealed that the viral infective mechanism, as well as the miniaturized erythrocyte aggregates, are additionally a significant contributing phenomenon to create acute respiratory distress syndrome (ARDS). Hematological issues require to deal proactively alongside other vital organ protection protocols for better outcomes. This article will depict the disease sequence of an intensivist working in a corona unit after being infected by COVID-19.
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      Review information

      10.14293/S2199-1006.1.SOR-MED.APVIOND.v1.RYXBGO

      This work has been published open access under Creative Commons Attribution License CC BY 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com.

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      Review text

      The article highlights an important aspect that might be contributing to the pathophysiology and complication process caused by nCOV-19. However, the presentation and writing style needs modification. The abstract appears to be more suitable as an introduction. Case description like age, physical activity, etc., is better noted under the case history. Medication dosage is essential to be mentioned and better presented in sentence format rather than in bullet. ESR data is missing: how the authors concluded about erythrocytes aggregates (increased) need more clarification. Many factors may cause hemoconcentration; even fever can cause it, infective etiologies can cause it [Sloop GD, De Mast Q, Pop G, Weidman JJ, St Cyr JA. The Role of Blood Viscosity in Infectious Diseases. Cureus. 2020;12(2):e7090. Published 2020 Feb 24. doi:10.7759/cureus.7090]. So, it is important to note the trend of ESR, PCV over time. 

      Intravenous fluid therapy has an inverse relation with PCV/Hematocrit [Lahsaee SM, Ghaffaripour S, Hejr H. The Effect of Routine Maintenance Intravenous Therapy on Hemoglobin Concentration and Hematocrit during Anesthesia in Adults. Bull Emerg Trauma. 2013;1(3):102‐107.]. Therefore, how negative fluid balance helped in maintaining normal or near-normal hematocrit in a person who already had hemoconcentration requires more explanation. 

      The case, however, teaches us important aspects to ponder in such patients and the possible role of iron chelation and supportive therapy.  

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