Hematological findings in SARS patients and possible mechanisms (Review)

Yang, Mo; Li, Chi Kong; Li, Karen; Hon, Kam Lun; Ng, Margaret H.L.; Chan, Paul K.S.; Fok, Tai Fai

doi:10.3892/ijmm.14.2.311

Cited by 94 publications

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“…In Taiwan, thrombocytopenia was also found in 40% (n ¼ 40), 39% (n ¼ 46) and 34.5% (n ¼ 29) of the patients with SARS [4]. The lungs of patients who died of SARS infection show diffuse alveolar damage with pulmonary congestion, edema, formation of hyaline membrane, and fibrosis [4]. All these suggest the presence of an association between lung damage and deranged platelet homeostasis.…”

Section: Introductionmentioning

confidence: 94%

“…Reduction in platelet survival time has been observed in patients with chronic obstructive airway disease and pulmonary hypertension [2]. Thrombocytopenia is also common in patients with severe acute respiratory syndrome (SARS) [3,4]. In Hong Kong, a low platelet count (5150 Â 10 9 /L) was documented in 44.8% (n ¼ 138) and 55% (n ¼ 157) of the patients in the Prince of Wales Hospital [4].…”

Section: Introductionmentioning

confidence: 97%

“…In Hong Kong, a low platelet count (5150 Â 10 9 /L) was documented in 44.8% (n ¼ 138) and 55% (n ¼ 157) of the patients in the Prince of Wales Hospital [4]. Thrombocytopenia (50%) was present in SARS patients at the Princess Margaret Hospital (n ¼ 267) and in pediatric SARS patients (n ¼ 10) [4]. In Taiwan, thrombocytopenia was also found in 40% (n ¼ 40), 39% (n ¼ 46) and 34.5% (n ¼ 29) of the patients with SARS [4].…”

Section: Introductionmentioning

confidence: 98%

“…Thrombocytopenia (50%) was present in SARS patients at the Princess Margaret Hospital (n ¼ 267) and in pediatric SARS patients (n ¼ 10) [4]. In Taiwan, thrombocytopenia was also found in 40% (n ¼ 40), 39% (n ¼ 46) and 34.5% (n ¼ 29) of the patients with SARS [4]. The lungs of patients who died of SARS infection show diffuse alveolar damage with pulmonary congestion, edema, formation of hyaline membrane, and fibrosis [4].…”

Section: Introductionmentioning

confidence: 99%

“…Thrombocytopenia is also common in patients with severe acute respiratory syndrome (SARS) [3,4]. In Hong Kong, a low platelet count (5150 Â 10 9 /L) was documented in 44.8% (n ¼ 138) and 55% (n ¼ 157) of the patients in the Prince of Wales Hospital [4]. Thrombocytopenia (50%) was present in SARS patients at the Princess Margaret Hospital (n ¼ 267) and in pediatric SARS patients (n ¼ 10) [4].…”

Section: Introductionmentioning

confidence: 99%

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Lung damage may induce thrombocytopenia

Xiao

Yang

et al. 2006

Platelets

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Thrombocytopenia is common in patients with lung diseases. Lung injury is associated with deranged platelet homeostasis. The potential mechanisms underlying this association were investigated in this study. The number and morphology of circulating megakaryocytes (MK) were investigated in vivo during cardiopulmonary bypass (CPB) in patients undergoing elective cardiac surgery for heart disease. The association between lung injury and thrombocytopenia was further investigated in vitro in rats with lung injury. MK and platelet counts, and platelet activation between the prepulmonary (right atrial) and postpulmonary (left atrial) blood were also compared. In human, the total number of MK in central venous was higher than those of peripheral arteries during normal circulation. During CPB, the total MK and Type-4 MK of central venous and peripheral arteries were significant increased when compared with that in normal circulation. In healthy rats, the postpulmonary blood had lower MK count, higher platelet count, and similar P-selectin expression. However, the lung-damaged animals showed no such differences in either MK or platelet count, but P-selectin expression was greater in the postpulmonary blood. Peripheral platelets in the lung-injured rats were significantly lower than those in their respective controls. The lungs may play an active role in the regulation of MK levels and the lung damage may reduce circulating platelets.

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Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lung damage may induce thrombocytopenia

Xiao

Yang

et al. 2006

Platelets

Self Cite

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Clinical Prognostic Rules for Severe Acute Respiratory Syndrome in Low- and High-Resource Settings

Cowling¹,

Muller²,

Wong³

et al. 2006

Arch Intern Med

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Can COVID‐19 cause severe neutropenia?

Lopez‐Pereira

Iturrate

Cámara

et al. 2020

Clinical Case Reports

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produces a broad spectrum of respiratory symptoms, from mild to pneumonia and acute respiratory distress syndrome. Coronavirus disease (COVID-19) is associated with an inflammatory syndrome that may increase damage to the lungs. Several hematopoietic and hemostatic abnormalities have been described, as well as autoimmune disorders. 1,2 2 | CASE HISTORY We report a 33-year-old woman, a surgical nurse, with no relevant medical history (although her sister was diagnosed with Hodgkin lymphoma), who was admitted to the Hematology Department at our hospital with severe neutropenia, asthenia, and enlarged lymph nodes 11 days after being diagnosed with COVID-19. On April 1, the patient presented at her family doctor (FD) with a sore throat, asthenia, and myalgia. SARS-CoV-2 polymerase chain reaction revealed positivity on oropharyngeal swabs obtained by the FD on April 2. She did not receive antiviral treatment, only acetaminophen when needed, and was discharged to her home to remain in isolation. Initially, her symptoms improved, but on April 13, she presented to the emergency department because of asthenia, gum swelling, and chills without fever or respiratory symptoms, such as shortness of breath or cough. Her vital signs, including oxygen saturation, were normal, and physical examination showed mild enlargement of the cervical, axillary, and inguinal lymph nodes without other pathological findings. 2.1 | Investigations and treatment Blood counts showed mild leukopenia (3.07 × 10 9 /L) with severe neutropenia (0.33 × 10 9 /L) and eosinopenia (0.05 × 10 9 /L) with a normal lymphocyte count, hemoglobin level, and platelet count. No morphological abnormalities were observed in the peripheral blood smear. Blood biochemistry assessment showed an increased level of C-reactive protein (2.51 mg/dL; normal, <0.5 mg/dL). Her lactate dehydrogenase level, liver function, and renal function were normal. Her interleukin-6 level was 20 pg/mL (normal, <7 pg/ mL). She had a fibrinogen level of 603 mg/dL with a normal D-dimer level. Her chest radiography was normal, and the pregnancy test result was negative. A new oropharyngeal swab for the SARS-CoV-2 test was performed on April 14, which continued to show positivity.

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Hematological findings in SARS patients and possible mechanisms (Review)

Cited by 94 publications

References 0 publications

Lung damage may induce thrombocytopenia

Lung damage may induce thrombocytopenia

Clinical Prognostic Rules for Severe Acute Respiratory Syndrome in Low- and High-Resource Settings

Can COVID‐19 cause severe neutropenia?

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