Correlation of hematological findings with severity of COVID-19

Main Article Content

Wajid Ali Rafai Ahmad Ussaid Babar Riaz Faisal Amin Baig Sohail Anwar Atif Masood Rahma Fiaz Khurram Saleem Farrukh Iqbal

Abstract

SARS-COV-2 emerged as pneumonia of unknown etiology and transforming into global pandemic leading mass casualties globally. It leads to serious complications with a wide range of symptoms and laboratory and radiological abnormalities.


Methodology: This retrospective study included 191 admitted patients was conducted between 15 April 2020 and 31 August 2020 at university of Lahore teaching hospital, Lahore, Pakistan. Baseline demographics, clinical, laboratory and radiological characteristics were compared amongst disease severity categories with One way ANOVA and comparison amongst recovered and non-recovered was carried out  by independent t test, Fisher’s exact and chi-square test respectively.  All data were analysed in SPSS 25 and p-value <0.05 was considered significant.


Results: Out of 191 patients enrolled in this study, majority were male and above 50 year age. Fever (68%) was the most common symptom though dyspnea was statistically significant (p-value<0.05) and diabetes (41.4%) being the most common comorbidity. A statistical significant downtrend in eosinophil counts were observed in critical and severe disease from non-severe disease and similar trend was observed in non-recovered (died) patients than recovered. A significant rise in neutrophil to lymphocyte ratio, crp, ferritin and d-dimer were observed amongst critical and severe disease and non-recovered patients (p-value<0.05). Patients with eosinopenia had low survival proportion at day 5 and 10 than those with relatively normal eosinophil counts.


Conclusion: Patients with advanced age, multiple comorbidities, elevated hematological, deranged coagulation markers presented with more severe disease and had poor outcome. In particular, eosinopenia can play key role in early diagnosis, disease severity recognition and disease surveillance as it is an independent risk factor for prognosis.

Article Details

How to Cite
RAFAI, Wajid Ali et al. Correlation of hematological findings with severity of COVID-19. Medical Research Archives, [S.l.], v. 10, n. 5, june 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2740>. Date accessed: 30 june 2022. doi: https://doi.org/10.18103/mra.v10i5.2740.
Section
Research Articles

References

1. Lu H, Stratton CW, Tang YW. The Wuhan SARS‐CoV‐2—What's next for China. Journal of medical virology. 2020 Jun;92(6):546-7.
2. World Health Organization (30 January 2020). Novel Coronavirus (2019-nCoV): situation report, 10 (Report). World Health Organization. hdl:10665/330775.
3. Eskild P, Marion K, Unyeong G. Hamer Davidson H, Petrosillo Nicola, Castelli Francesco, Storgaard Merete, Al Khalili Sulien, Simonsen Lone. Comparing sars-cov-2 with sars-cov and influenza pandemics. The Lancet Infectious Diseases. 2020.
4. Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. The 2019‐new coronavirus epidemic: evidence for virus evolution. Journal of medical virology. 2020 Apr;92(4):455-9.
5. World Health Organization. Coronavirus disease (COVID-19): situation report, 67. https://apps.who.int/iris/handle/10665/331613
6. Wang F, Hou H, Luo Y, Tang G, Wu S, Huang M, Liu W, Zhu Y, Lin Q, Mao L, Fang M. The laboratory tests and host immunity of COVID-19 patients with different severity of illness. JCI insight. 2020 May 21;5(10).
7. Franchini M, Marano G, Cruciani M, Mengoli C, Pati I, Masiello F, Veropalumbo E, Pupella S, Vaglio S, Liumbruno GM. COVID-19-associated coagulopathy. Diagnosis. 2020 Dec 1;7(4):357-63.
8. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, Xie C, Ma K, Shang K, Wang W, Tian DS. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical infectious diseases. 2020 Jul 28;71(15):762-8.
9. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E. & Du, B.(2020). Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive care medicine.:1-34.
10. Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020 May 1;8(5):475-81.
11. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, Wang M. Presumed asymptomatic carrier transmission of COVID-19. Jama. 2020 Apr 14;323(14):1406-7.
12. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, Nigoghossian CD, Ageno W, Madjid M, Guo Y, Tang LV. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. Journal of the American college of cardiology. 2020 Jun 16;75(23):2950-73.
13. Li MD, Arun NT, Gidwani M, Chang K, Deng F, Little BP, Mendoza DP, Lang M, Lee SI, O’Shea A, Parakh A. Automated assessment and tracking of COVID-19 pulmonary disease severity on chest radiographs using convolutional siamese neural networks. Radiology: Artificial Intelligence. 2020 Jul 22;2(4):e200079.
14. https://covid.gov.pk/new_guidelines/11December2020_20201211_Clinical_Management_Guidelines_for_COVID-19_infection_1204.pdf
15. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, Li C, Ai Q, Lu W, Liang H, Li S. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. The lancet oncology. 2020 Mar 1;21(3):335-7.

16. Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, Lu H, Liu J, Yang J, Dong Y, Pan D. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. The Lancet Oncology. 2020 Jul 1;21(7):904-13.

17. Asghar K, Abu Bakar M, Akram MJ, Farooq A, Siddique K, Rana IA, Ali J, Rashid MU, Khan AA, Loya A. Clinical Characteristics of COVID-19-Infected Cancer Patients in Pakistan: Differences Between Survivors and Non-Survivors. Frontiers in oncology. 2021 May 20;11:1563.

18. Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020 May 1;8(5):475-81.

19. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, Xie C, Ma K, Shang K, Wang W, Tian DS. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical infectious diseases. 2020 Jul 28;71(15):762-8.

20. Ponti G, Ruini MM. C, Tomasi, A, Ozben, T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci. 2020;57:389-99.

21. Yan B, Yang J, Xie Y, Tang X. Relationship between blood eosinophil levels and COVID-19 mortality. World Allergy Organization Journal. 2021 Mar 1;14(3):100521.

22. Tan Y, Zhou J, Zhou Q, Hu L, Long Y. Role of eosinophils in the diagnosis and prognostic evaluation of COVID‐19. Journal of Medical Virology. 2021 Feb;93(2):1105-10.

23. Mateos González M, Sierra Gonzalo E, Casado Lopez I, Arnalich Fernández F, Beato Pérez JL, Monge Monge D, Vargas Nunez JA, Garcia Fenoll R, Suarez Fernandez C, Freire Castro SJ, Mendez Bailon M. The prognostic value of eosinophil recovery in COVID-19: A multicentre, retrospective cohort study on patients hospitalised in Spanish hospitals. Journal of clinical medicine. 2021 Jan;10(2):305.

24. Zhang JJ, Cao YY, Tan G, Dong X, Wang BC, Lin J, Yan YQ, Liu GH, Akdis M, Akdis CA, Gao YD. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID‐19 patients. Allergy. 2021 Feb;76(2):533-50.

25. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, Zhang Z. D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19. Journal of thrombosis and haemostasis. 2020 Jun;18(6):1324-9.

26. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, Zhang Z. D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19. Journal of thrombosis and haemostasis. 2020 Jun;18(6):1324-9.