Study Finds Hematological Changes Common in Patients with COVID-19

The early stage of COVID-19 is typically characterized by lymphocytopenia and thrombocytopenia, whereas the late stage may be characterized by more severe lymphocytopenia and other changes.

Although the mechanism is still unclear, a retrospective analysis presented at the American Society of Hematology 62nd Annual Meeting and Exposition found that hematological changes, such as lymphocytopenia, thrombocytopenia, and coagulation dysfunction, are common in patients with coronavirus disease 2019 (COVID-19).

Investigators analyzed 633 patients with COVID-19 from a hospital in Wuhan, China and collected clinical data of all patients, including gender, age, chronic underlying diseases, outcome, and blood laboratory test results. They then analyzed the hematological features of the patients and the factors affecting their outcome.

Of the 633 patients, the median age was 62 years and 52% were men. According to the study results, lymphocytopenia occurred in 317 of 607 patients analyzed for the condition; prolonged prothrombin time occurred in 289 of 486 analyzed patients; increased D-Dimer levels were noted in 230 of 411 patients; and increased C-reactive protein levels were seen in 217 of 426 patients. Notably, thrombocytopenia occurred in 14 of 62 patients who died.

Compared with patients who survived, patients who died had a higher white blood cell count, neutrophil count, lymphocyte count, activated partial thromboplastin time, prothrombin time, D-Dimer level, C-reactive protein level, and low lymphocyte count, according to the study authors. Based on a logistic multivariate regression analysis, the authors concluded that age, neutrophil count, prothrombin time, and C-reactive protein were risk factors for patients with COVID-19.

Based on these findings, the study authors said hematological changes are common in patients with COVID-19. The early stage of the disease is typically characterized by lymphocytopenia and thrombocytopenia, whereas the late stage may be characterized by more severe lymphocytopenia, even neutrophils elevation, elevated C-reactive protein, and severe coagulation disorder. The authors concluded that the pathogenesis may be mediated by a direct viral infection or indirect immunopathology.

REFERENCE

Coagulation Dysfunction and Hematological Changes in 633 Patients with COVID-19. Presented at ASH Virtual Conference; December 5, 2020. https://ash.confex.com/ash/2020/webprogram/Paper140274.html. Accessed December 8, 2020.