Blood indices, in-hospital outcome and short-term prognosis in patients with COVID-19 pneumonia
The predictive role of blood indices in coronavirus disease 2019 (COVID-19) related in-hospital adverse outcomes and post-recovery status is not fully defined. The main aim was to assess the association of complete blood indices measured at baseline with COVID-19 related in-hospital clinical outcomes, including length of hospital and intensive care unit (ICU) stay, receiving mechanical ventilation, degree of lung injury and in-hospital death, and post-recovery status. This retrospective study included patients with newly diagnosed COVID-19 infection from August 20, to September 25, 2020. The initial study cohort included 127 patients with newly diagnosed COVID-19. Of whom 26 patients were excluded, leaving 101 patients for final analysis. low lymphocytes % [Odds ratio and confidence intervals = OR (CI)] [0.2(0.0-0.2, p=0.03] increased the odds of ICU stay length while high platelet mean volume (PMV) [0.9 (1.1-5, p<0.00], high platelet distribution width (PDW) [0.3(0.4-1.9), p<0.00], and low lymphocytes % [0.2 (0.0-0.2), p=0.02] increased the odds of length of hospital stay. Decreased lymphocytes % showed significant independent association with increased risk for mechanical ventilation use [0.9 (0.9-1), p=0.04], extensive degree of lung injury [0.2 (0.1-0.7), p<0.00], and in-hospital death [0.5 (0.3-0.8), p=0.01]. High lymphocytes %[0.9 (0.9-1), p<0.00] and high PMV [0.3 (0.3-0.8), p=0.02] were significantly associated with complete recovery while increased neutrophil % [1 (1-1.1), p=0.04] was associated with increased risk for post recovery fatigue. In conclusion, low lymphocytes % and high neutrophil % are useful markers for predicting adverse in-hospital outcome and post-recovery persistent fatigue, respectively. High PMV and lymphocyte % showed significant association with favorable short-term prognosis.
Zheng KI, Feng G, Liu WY, et al. Extrapulmonary complications of COVID-19: A multisystem disease? J Med Virol 2021;93:323-35. DOI: https://doi.org/10.1002/jmv.26294
de la Rica R, Borges M, Aranda M, et al. Low albumin levels are associated with poorer outcomes in a case series of COVID-19 patients in Spain: A retrospective cohort study. Microorganisms 2020;8:1106. DOI: https://doi.org/10.3390/microorganisms8081106
Liu Y, Sun W, Guo Y, et al. Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study. Platelets 2020;31:490-6. DOI: https://doi.org/10.1080/09537104.2020.1754383
Violetis OA, Chasouraki AM, Giannou AM, Baraboutis IG. COVID-19 infection and haematological involvement: a review of epidemiology, pathophysiology and prognosis of full blood count findings. SN Compr Clin Med 2020:1-5. DOI: https://doi.org/10.1007/s42399-020-00380-3
Chen R, Sang L, Jiang M, et al. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol 2020;146:89-100. DOI: https://doi.org/10.1016/j.jaci.2020.05.003
Zeng F, Li L, Zeng J, et al. Can we predict the severity of coronavirus disease 2019 with a routine blood test? Pol Arch Intern Med 2020;130:400-6.
Jutzeler CR, Bourguignon L, Weis CV, et al. Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020;37:101825. DOI: https://doi.org/10.1016/j.tmaid.2020.101825
Kennedy G, Spence V, Underwood C, Belch JJ. Increased neutrophil apoptosis in chronic fatigue syndrome. J Clin Pathol 2004;57:891-3. DOI: https://doi.org/10.1136/jcp.2003.015511
Güçlü E, Kocayiğit H, Okan HD, et al. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992) 2020;66:1122-7. DOI: https://doi.org/10.1590/1806-92188.8.131.522
Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care 2020;8:36. DOI: https://doi.org/10.1186/s40560-020-00453-4
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061. DOI: https://doi.org/10.1001/jama.2020.1585
Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020;95:E131-4. DOI: https://doi.org/10.1002/ajh.25847
Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1612-4. DOI: https://doi.org/10.1001/jama.2020.4326
Khartabil TA, Russcher H, van der Ven A, de Rijke YB. A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients. Crit Rev Clin Lab Sci 2020;57:415-31. DOI: https://doi.org/10.1080/10408363.2020.1774736
Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8:420-2. DOI: https://doi.org/10.1016/S2213-2600(20)30076-X
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020;95:834-47. DOI: https://doi.org/10.1002/ajh.25829
Zhang S, Liu Y, Wang X, et al. SARS-CoV-2 binds platelet ACE2 to enhance thrombosis in COVID-19. J Hematol Oncol 2020;13:120. DOI: https://doi.org/10.1186/s13045-020-00954-7
Kermali M, Khalsa RK, Pillai K, et al. The role of biomarkers in diagnosis of COVID-19 - A systematic review. Life Sci 202 ;254:117788. DOI: https://doi.org/10.1016/j.lfs.2020.117788
Manne BK, Denorme F, Middleton EA, et al. Platelet gene expression and function in patients with COVID-19. Blood 2020;136:1317-29. DOI: https://doi.org/10.1182/blood.2020007214
Kim JK, Jeon JS, Kim JW, Kim GY. Correlation between abnormal platelet count and respiratory viral infection in patients from Cheonan, Korea. J Clin Lab Anal 2016;30:185-9. DOI: https://doi.org/10.1002/jcla.21822
Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr Health Sci 2013;13:333-8. DOI: https://doi.org/10.4314/ahs.v13i2.19
He J, Wei Y, Chen J, et al. Dynamic trajectory of platelet-related indicators and survival of severe COVID-19 patients. Crit Care 2020;24:607. DOI: https://doi.org/10.1186/s13054-020-03339-x
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