Hematologic parameters in patients with COVID‐19 infection

Fan, Bingwen Eugene; Chong, Vanessa Cui Lian; Chan, Sui Yung; Lim, Gek Hsiang; Lim, Keith; Tan, Guat Bee; Mucheli, Sharavan Sadasiv; Kuperan, Ponnudurai; Ong, Kiat Hoe

doi:10.1002/ajh.25774

Cited by 647 publications

(768 citation statements)

References 6 publications

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“…Thus, the pooled analysis finally included 21 studies , with a total sample of 3377 confirmed COVID-19 patients, reporting data on 33 laboratory parameters. Most studies were from China, with the exception of two studies from Singapore [8,23]. All studies reported laboratory values measured at admission or earliest time point in hospitalization, except for six studies [7,14,[16][17][18]23], where the timepoint was unclear.…”

Section: Study Identification and Characteristics Of Included Studiesmentioning

confidence: 99%

Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis

Henry

Oliveira

Benoit

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

1,735

179

1,490

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AbstractBackgroundAs coronavirus disease 2019 (COVID-19) pandemic rages on, there is urgent need for identification of clinical and laboratory predictors for progression towards severe and fatal forms of this illness. In this study we aimed to evaluate the discriminative ability of hematologic, biochemical and immunologic biomarkers in patients with and without the severe or fatal forms of COVID-19.MethodsAn electronic search in Medline (PubMed interface), Scopus, Web of Science and China National Knowledge Infrastructure (CNKI) was performed, to identify studies reporting on laboratory abnormalities in patients with COVID-19. Studies were divided into two separate cohorts for analysis: severity (severe vs. non-severe and mortality, i.e. non-survivors vs. survivors). Data was pooled into a meta-analysis to estimate weighted mean difference (WMD) with 95% confidence interval (95% CI) for each laboratory parameter.ResultsA total number of 21 studies was included, totaling 3377 patients and 33 laboratory parameters. While 18 studies (n = 2984) compared laboratory findings between patients with severe and non-severe COVID-19, the other three (n = 393) compared survivors and non-survivors of the disease and were thus analyzed separately. Patients with severe and fatal disease had significantly increased white blood cell (WBC) count, and decreased lymphocyte and platelet counts compared to non-severe disease and survivors. Biomarkers of inflammation, cardiac and muscle injury, liver and kidney function and coagulation measures were also significantly elevated in patients with both severe and fatal COVID-19. Interleukins 6 (IL-6) and 10 (IL-10) and serum ferritin were strong discriminators for severe disease.ConclusionsSeveral biomarkers which may potentially aid in risk stratification models for predicting severe and fatal COVID-19 were identified. In hospitalized patients with respiratory distress, we recommend clinicians closely monitor WBC count, lymphocyte count, platelet count, IL-6 and serum ferritin as markers for potential progression to critical illness.

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Section: Study Identification and Characteristics Of Included Studiesmentioning

confidence: 99%

Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis

Henry

Oliveira

Benoit

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

1,735

179

1,490

View full text Add to dashboard Cite

show abstract

“…Zhou et al reviewed 191 COVID-19 patients and found that as compared to survivors, the non-survivors had lower baseline lymphocyte count, which continued to worsen until the day of death [43]. requiring patients (n=9 cases) were comparatively a decade older, and had significant lymphopenia (p<0.001), significant neutrophilia (p<0.001), significant elevated LDH (p<0.005) and significantly lower CD45+, CD3+, CD4+, CD19+, and CD16/56+ counts when compared with non-ICU patients (n=58 cases) [44].…”

Section: Laboratory Testingmentioning

confidence: 99%

COVID-2019: update on epidemiology, disease spread and management

Sahu

Mishra

Lal

2020

Monaldi Arch Chest Dis

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With each passing day, more cases of Coronavirus disease (COVID-2019) are being detected and unfortunately the fear of novel corona virus 2019 (2019-nCoV) becoming a pandemic disease has come true. Constant efforts at individual, national, and international level are being made in order to understand the genomics, hosts, modes of transmission and epidemiological link of nCoV-2019. As of now, whole genome sequence of the newly discovered coronavirus has already been decoded. Genomic characterization nCoV-2019 have shown close homology with batderived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. Structural analysis of the receptor binding site has confirmed that 2019-nCoV binds with the same ACE 2 receptor protein as human SARS virus. Compared to the previous coronavirus outbreaks, the overall mortality rate is relatively low for COVID-2019 (2-3%). Suspected cases must be quarantined till their test comes positive or they clear infection. At present, treatment of COVID-2019 is mostly based on the knowledge gained from the SARS and MERS outbreaks. Remdesivir, originally develop as a treatment for Ebola virus disease and Marburg virus infections, is being studied for its effectiveness against 2019-nCoV infection. Many other antiviral agents and vaccines are being tested but most of them are in phase I or II and hence unlikely to be of any benefit immediately with regards to current outbreak. Hence, the standard infection control techniques and preventive steps for healthy individuals and supportive care for the confirmed cases is the best available strategy to deal with current viral outbreak.

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“…Recent studies showed that a few hematologic parameters were clearly altered in COVID-19 patients [9,10]. For instance, Liu et al [11] showed a high level of transaminases and LDH in Chinese COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Routine blood tests as a potential diagnostic tool for COVID-19

Ferrari

Motta²,

Strollo³

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

241

208

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AbstractObjectivesThe outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to date, the epidemic has gradually spread to 209 countries worldwide with more than 1.5 million infected people and 100,000 deaths. Amplification of viral RNA by rRT-PCR serves as the gold standard for confirmation of infection, yet it needs a long turnaround time (3–4 h to generate results) and shows false-negative rates as large as 15%–20%. In addition, the need of certified laboratories, expensive equipment and trained personnel led many countries to limit the rRT-PCR tests only to individuals with pronounced respiratory syndrome symptoms. Thus, there is a need for alternative, less expensive and more accessible tests.MethodsWe analyzed the plasma levels of white blood cells (WBCs), platelets, C-reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase and lactate dehydrogenase (LDH) of 207 patients who, after being admitted to the emergency room of the San Raffaele Hospital (Milan, Italy) with COVID-19 symptoms, were rRT-PCR tested. Of them, 105 tested positive, whereas 102 tested negative.ResultsStatistically significant differences were observed for WBC, CRP, AST, ALT and LDH. Empirical thresholds for AST and LDH allowed the identification of 70% of either COVID-19-positive or -negative patients on the basis of routine blood test results.ConclusionsCombining appropriate cutoffs for certain hematological parameters could help in identifying false-positive/negative rRT-PCR tests. Blood test analysis might be used as an alternative to rRT-PCR for identifying COVID-19-positive patients in those countries which suffer from a large shortage of rRT-PCR reagents and/or specialized laboratory.

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Hematologic parameters in patients with COVID‐19 infection

Cited by 647 publications

References 6 publications

Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis

Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis

COVID-2019: update on epidemiology, disease spread and management

Routine blood tests as a potential diagnostic tool for COVID-19

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