Hematological features of persons with COVID-19

Abstract

We studied admission and dynamic demographic, hematological and biochemical co-variates in 1449 hospitalized subjects with coronavirus infectious disease-2019 (COVID-19) in five hospitals in Wuhan, Hubei province, China. We identified two admission co-variates: age (Odds Ratio [OR] = 1.18, 95% Confidence Interval [CI] [1.02, 1.36]; P = 0.026) and baseline D-dimer (OR = 3.18 [1.48, 6.82]; P = 0.003) correlated with an increased risk of death in persons with COVID-19. We also found dynamic changes in four co-variates, Δ fibrinogen (OR = 6. 45 [1.31, 31.69]; P = 0.022), Δ platelets (OR = 0.95 [0.90-0.99]; P = 0.029), Δ C-reactive protein (CRP) (OR = 1.09 [1.01, 1.18]; P = 0.037), and Δ lactate dehydrogenase (LDH) (OR = 1.03 [1.01, 1.06]; P = 0.007) correlated with an increased risk of death. The potential risk factors of old age, high baseline D-dimer, and dynamic co-variates of fibrinogen, platelets, CRP, and LDH could help clinicians to identify and treat subjects with poor prognosis. data of hematological abnormalities in persons with . We studied hematological co-variates in 1449 hospitalized persons with COVID-19 in five hospitals in Wuhan, China, interrogating correlations of admission parameters with COVID-19 outcomes. Methods Study design and subjectsWe studied subjects in seven centers of five hospitals of

The Impact of COVID-19 Disease on Platelets and Coagulation

“…A meta-analysis of 7,613 COVID-19 patients revealed that patients with severe disease had a lower platelet count than those with non-severe disease. Additionally, the non-survivors had a much lower platelet count than the survivors [ 25 , 36 ]. However, not all studies have found platelet counts to be a predictor of COVID-19 mortality [ 37 ].…”

“…Temporally increasing D-dimer levels indicate the progressive severity of COVID-19 infection and can be used as a predictor that more aggressive critical care will be needed. Of nearly 1,500 COVID-19 hospital admissions, Li et al [ 25 ]found two admission covariates that correlated with an increased risk of death: age (OR 1.18; 95% CI 1.02–1.36) and baseline D-dimer level (OR 3.18; 95% CI 1.48–6.82).…”

“…However, D-dimer levels are elevated far out of proportion to any abnormalities detected in the PT/INR, aPTT, fibrinogen level, or platelet count; these findings are unusual for DIC, as defined by the criteria of the International Society of Thrombosis and Hemostasis (ISTH) [ 23 ]. Unlike the pattern seen in classic DIC from bacterial sepsis or trauma, in COVID-19 prolongation of the aPTT and/or PT is minimal [ 24 ], thrombocytopenia is mild (a platelet count of 100–150 ×10 9 /L), hypofibrinogenemia is rare, and laboratory results supporting hyperfibrinolysis are uncommon [ 25 ]. COVID-19-associated coagulopathy is the term used to describe this spectrum of coagulation changes.…”

Early detection of COVID-19 mortality risk using non-invasive clinical characteristics

“…A crucial clinical aspect of the COVID-19 outbreak is the possible outcomes of the disease. The severity spectrum of COVID-19 varies from mild asymptomatic to severe and critical conditions [3]. Critical patients will need timely intensive care unit (ICU) admission and ventilators.…”

A Haematologist’s Guide to Coronavirus Disease 2019: Encyclopaedia or Doorstop?

“…The issue of lymphocytopenia is especially important because it may correlate with survival. In a study of 1,571 subjects with COVID-19 we found a significant difference between 1,440 survivors (median 1.2 × 10E+9/L [IQR 0.9, 1.7 × 10E+9/L]) and 131 subjects who died (0.5 × 10E+9/L [0.4, 0.8 × 10E+9/L]; p < 0.001) [ 2 ]. Another example are data on admission prothrombin time.…”