Haematological Abnormalities and Risk of COVID-19 Infection in Adult Patients Attending Primary Fealthcare Settings

Abstract

Centres for Disease Control and prevention (CDC) reports that there are limited data and information about the impact of underlying medical conditions and the risk of infection. To date, there are no studies that report on the risk of infection among patients with haematological diseases or abnormalities. This cross-sectional study reports on the baseline complete blood count in patients attending publicly funded primary care settings with a diagnosis of suspected COVID-19 infections in the state of Qatar. The study will report on the descriptive characteristics of the population, including gender, age and prior abnormalities to their blood test results. We will compare the results of those with positive and negative PCR test results, where appropriate. Nine hundred sixty-two adult patients attended publicly funded primary health care settings in the state of Qatar between February the 10th and April the 30th 2020 with a diagnosis of suspected COVID-19 infections had prior recorded blood investigations in the last six months and were included in this study. The population was young, mean of age is 38.8±11.6. (Median: 36 [Min: 19 - Max: 85]). Complete blood count of the sample had minimal missing data points. Females were more presented in our samples, Female (n=560, 58.21%) and Male (n=402, 41.79%). Most of our sample had a documented PCR test result, negative (n=831, 86.38%); positive (n=123, 12.79%) and missing (n=8, 0.83%). Low haemoglobin values (n=265, 27.5%) and low red blood cell count (n =170, 17.7%) were the most prevalent complete blood count abnormality in the population. Leukopenia was less common (n=50, 8.2%). Most of the population had normal platelet count (n=895, 93%). Gender was the most influential factor in our sample to increase the odds of having a positive PCR t results; males were more likely to be affected (P<0.001, Chi-square test) (OR 2.56, 95% CI 1.73-3.77). Categories for haematological abnormalities were not associated with increased risk of having a positive PCT test result. In a population attending primary healthcare settings with early presentation of symptoms of COVID-19 infection, the risk of infection among our cohort was not affected by the prior haematological values of those patients. Gender was the most influential parameter in the risk of infection in our population. Analysis of the results using gender-specific categories for different haematological parameters suggested that patients with abnormal haematological values were not at increased risk of having a positive COVID-19 infection.

Hematological abnormalities in immunosuppressed patients with COVID-19: Evidence from a single center. A cross sectional study

“…Additionally, the prevalence of patients with neutrophils > 8 x 10 9 /L. and PLR <180 in the IC (+) were 9 times (PR:9,72; p: 0,004; CI95% [2] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ) and 4 times higher (PR: 4,15; p: 0,005; CI95% [1,54-11,22]) than IC (-) group respectively. Similar results were observed in IS (+) patients with high count neutrophils (PR: 14,8; p: 0,001; [2,90-75,47]) and PLR (PR: 4,96; p: 0,014; CI95%: [1,38-17,71]).…”

“… <80 0,098 0,11 -1,92 0,055 [0,00–1,04] MCHC (gr/L) <33 1,58 0,57 1,26 0,208 [0,77-3,23] >39 4,4 3,94 1,66 0,098 [0,76-25,51] Neutrophiles (10 9 /L.) <2 4,01 5,02 1,11 0,266 [0,34-46,71] >8 9,72 7,69 2,87 0,004 [2] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] Lymphocytes (10 9 /L.) <1 5,74 5,03 2 0,046 [1] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] >4 0,9 1,23 -0,07 0,943 [6] , …”

“…The degree to which immunosuppressive drugs cause clinically significant immunodeficiency generally is dose related and varies by drug. High-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive drugs [1] Immunosuppressive conditions may increase the risk of severe infection and result in an increased predisposition to transmit SARSCoV-2 virus [2] .…”

“…Among the platelets parameters, mean platelet volume (MPV), and platelet-lymphocyte ratio (PLR) have emerged as good indicators of subclinical systemic inflammation [5] . Among those hematological abnormalities, leukopenia, lymphopenia are reported to be the most commonly associated with COVID-19 infections in the general population [2] .…”

“…Immunosuppressed patients may have suboptimal compensatory mechanisms to deal with hematological changes during the progression of COVID-19 disease and this may explain the severe presentation associated with those conditions [2] .…”