Coronavirus Disease 2019 (COVID–19): A Short Review on Hematological Manifestations

Słomka, Artur; Kowalewski, Mariusz; Żekanowska, Ewa

doi:10.3390/pathogens9060493

Cited by 92 publications

(114 citation statements)

References 145 publications

(265 reference statements)

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“…Females are more resistant to COVID-19 than men, as reported by [ 39 , 40 ], among others. Previous comorbidities are also associated with a higher risk of mortality; these data are consistent with the reported information of numerous studies [ 41 ], as well as low oxygen saturation levels; high levels of CRP, leukocytes, and D-dimer; and a low lymphocyte/leukocyte ratio [ 27 , 42 ].…”

Section: Discussionsupporting

confidence: 86%

A Predictive Model and Risk Factors for Case Fatality of COVID-19

Álvarez‐Mon

Ortega

Gasulla

et al. 2021

JPM

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This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February–June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Príncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (<5%), medium-risk level (5–20%), and high-risk level (>20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU–death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19.

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Section: Discussionsupporting

confidence: 86%

A Predictive Model and Risk Factors for Case Fatality of COVID-19

Álvarez‐Mon

Ortega

Gasulla

et al. 2021

JPM

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“…COVID-19 manifests as severe or critical systemic disease in only a minority of patients [5,6], particularly the elderly with serious comorbidities, including but not limited to cardiovascular diseases and diabetes mellitus [7][8][9]. Hyperinflammation, referred to as a cytokine storm, and hypercoagulability appear to be the pathophysiological basis of severe and critical COVID-19 [10]. Growing evidence indicates that patients with severe SARS-CoV-2 infection are at high risk of arterial and venous thrombotic events [11][12][13][14], which in most cases are accompanied by cytokine storm [15], endothelial dysfunction [16,17], and blood hyperviscosity [18], along with the presence of classic risk factors such as hypertension, obesity, and diabetes mellitus [11].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Hemostasis in Coronavirus Disease 2019—Lesson from Viscoelastic Methods: A Systematic Review

2021

Self Cite

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Haemostatic unbalance is often observed in patients with coronavirus disease 2019 (COVID-19), and patients with severe disease are at high risk of developing thromboembolic complications. Viscoelastic methods (VEMs), including thrombelastography (TEG) and thromboelastometry (TEM), provide data on the nature of haemostatic disturbance. In this systematic review, we assessed the performance of TEG and TEM in the assessment of blood coagulation and fibrinolysis in patients with COVID-19. PubMed, Scopus, Web of Science Core Collection, medRxiv and bioRxiv were systematically searched for clinical studies evaluating TEG and/or TEM variables in COVID-19 individuals. Ten studies, with a total of 389 COVID-19 patients, were included, and VEMs were performed in 292 of these patients. Most patients (90%) presented severe COVID-19 and required mechanical ventilation. TEG and TEM variables showed that these patients displayed hypercoagulability and fibrinolysis shutdown, despite the use of appropriate thromboprophylaxis. However, the mechanism underlying these phenomena and their clinical significance in COVID-19 patients who developed thrombosis, is still not clear. Further studies are warranted if VEMs might help to identify those at highest risk of thrombotic events and who therefore may derive the greatest benefit from antithrombotic therapy.

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“…The prothrombin time of patients with severe COVID-19 seems to be mildly but not consistently prolonged in non-survivors compared with survivors [ 1 , 15 , 17 ]. COVID-19 patients often also develop thrombocytopenia, particularly in case of more severe disease, but it is generally mild; very low platelet counts are rarely seen [ 1 , 10 , 18 , 19 ]. The combination of these laboratory findings initially raised the possibility of disseminated intravascular coagulation (DIC), but the pathomechanism seemed much more complex.…”

Section: Covid-19-associated Coagulopathymentioning

confidence: 99%

Stroke as a Potential Complication of COVID-19-Associated Coagulopathy: A Narrative and Systematic Review of the Literature

Szegedi

Orbán-Kálmándi

Csiba

et al. 2020

JCM

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Coronavirus disease 2019 (COVID-19) is the most overwhelming medical threat of the past few decades. The infection, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can cause serious illness leading to respiratory insufficiency, and, in severely ill patients, it can progress to multiple organ failure leading to death. It has been noted from the earliest reports that the disease influences the hemostasis system and a hallmark of severe infection is elevated D-dimer levels. The profound coagulation changes in COVID-19 seem to be linked to inflammation-related events and severe endothelial cell injury. Besides the high incidence of venous thromboembolic events in SARS-CoV-2 infections, arterial events, including cerebrovascular events, were found to be associated with the disease. In this review, we aimed to summarize the available literature on COVID-19-associated coagulopathy and thrombosis. Furthermore, we performed a systematic search of the literature to identify the characteristics of stroke in COVID-19. Our findings showed that acute ischemic stroke (AIS) is the most frequent type of stroke occurring in infected patients. In most cases, stroke was severe (median NIHSS:16) and most of the patients had one or more vascular risk factors. Laboratory findings in AIS patients were consistent with COVID-19-associated coagulopathy, and elevated D-dimer levels were the most common finding. The outcome was unfavorable in most cases, as a large proportion of the reported patients died or remained bedridden. Limited data are available as yet on outcomes after acute vascular interventions in COVID-19 patients. In the future, well-designed studies are needed to better understand the risk of stroke in COVID-19, to optimize treatment, and to improve stroke care.

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Coronavirus Disease 2019 (COVID–19): A Short Review on Hematological Manifestations

Cited by 92 publications

References 145 publications

A Predictive Model and Risk Factors for Case Fatality of COVID-19

A Predictive Model and Risk Factors for Case Fatality of COVID-19

Hemostasis in Coronavirus Disease 2019—Lesson from Viscoelastic Methods: A Systematic Review

Stroke as a Potential Complication of COVID-19-Associated Coagulopathy: A Narrative and Systematic Review of the Literature

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