Changes of hematological and immunological parameters in COVID-19 patients

Abstract

The aim of this study was to identify the changes of hematologic and immunological parameters in COVID-19 patients. We collected and analyzed the data of 117 patients who were laboratory confirmed as SARS-CoV-2 infection. The cases were divided into regular group, severe group and critically ill group according to the sixth edition scheme for COVID-19 diagnosis and treatment of China. The laboratory tests included blood routine, cellular and humoral immunity indices, biochemical detections and inflammatory biomarker. Compared with regular patients, severe and critically ill patients had significantly lower lymphocyte count (p < 0.01), decreased red blood cell and hemoglobin (p < 0.01), low levels of immunoglobulin G (p < 0.05) and significantly higher in D-dimer (p < 0.0001), fibrinogen (p < 0.01), white blood cell count (p < 0.01), neutrophil count (p < 0.0001), interleukin-6 (p < 0.05), C-reactive protein (p < 0.01), procalcitonin (p < 0.01), erythrocyte sedimentation rate (p < 0.05), ferritin (p < 0.01) and lactate dehydrogenase (p < 0.0001). The specific immunoglobulin G antibodies to the SARS-CoV-2 in severe and critically ill patients were significantly lower than that in regular patients (p < 0.05). Our findings suggest that the lymphocyte counts, red blood cell counts and the immunoglobulin G antibodies of COVID-19 patients were impaired to varying degrees and the blood was in a state of hypercoagulation, which were more obvious in critically ill patients.

How do routine laboratory tests change in coronavirus disease 2019?

“…WBC, NEU, P-LCR, d-NLR, NLR, AST, urea, CK-MB and procalcitonin values were higher in the ICU group when compared to the non-ICU group, whereas LYM, eosinophil, RBC, hemoglobin, LMR and eGFR were lower. Previous studies also obtained similar results when compared with critically ill patients and regular patients [19,22]. While lymphocyte was low in 57.5% of patients in the ICU group, only 8.7% in the non-ICU group suggested that lymphopenia was an important indicator of poor prognosis.…”

Epidemiologic and Clinical Characteristics of COVID-19 Patients from a Quarantine Center in a Developing Community: A Retrospective Study

“… 25 Previous studies reported significantly higher ESR values in severe and critically ill patients than those in mild and moderately ill patients. 26 , 27 The higher ESR values in our symptomatic patients suggested that the inflammatory response was more prominent in them than in the asymptomatic patients. This also was supported by the longer infection period found in symptomatic than in asymptomatic patients.…”

COVID-19-associated coagulopathy and disseminated intravascular coagulation

“…Lymphocytes are known to decrease in particularly severe cases of COVID-19 [ 1 , 57 , 58 ]. Both CD4- and CD8-positive cells are decreased, and a strong correlation exists between lymphocyte count and CD4-positive cells [ 57 , 59 ].…”

“…These changes are associated with disease severity, and thus should be kept in mind during the development of future treatments. Some studies have suggested that the neutrophil-to-lymphocyte ratio is associated with the severity and prognosis of COVID-19 [ 58 , 60 , 61 ].…”