COVID‐19 and hematology findings based on the current evidences: A puzzle with many missing pieces

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Abstract

In December 2019, a new type of coronavirus was detected for the first time in Wuhan, Hubei Province, China. According to the reported data, the emerging coronavirus has spread worldwide, infecting more than fifty‐seven million individuals, leading to more than one million deaths. The current study aimed to review and discuss the hematological findings of COVID‐19. Laboratory changes and hematologic abnormalities have been reported repeatedly in COVID‐19 patients. WBC count and peripheral blood lymphocytes are normal or slightly reduced while these indicators may change with the progression of the disease. In addition, several studies demonstrated that decreased hemoglobin levels in COVID‐19 patients were associated with the severity of the disease. Moreover, thrombocytopenia, which is reported in 5%‐40% of patients, is known to be associated with poor prognosis of the disease. COVID‐19 can present with various hematologic manifestations. In this regard, accurate evaluation of laboratory indicators at the beginning and during COVID‐19 can help physicians to adjust appropriate treatment and provide special and prompt care for those in need.

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Dawei Wang, Bo Hu, Fangfang Zhu … (2020)

In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

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Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation

Daniel Wrapp, Nianshuang Wang, Kizzmekia S. Corbett … (2020)

Structure of the nCoV trimeric spike The World Health Organization has declared the outbreak of a novel coronavirus (2019-nCoV) to be a public health emergency of international concern. The virus binds to host cells through its trimeric spike glycoprotein, making this protein a key target for potential therapies and diagnostics. Wrapp et al. determined a 3.5-angstrom-resolution structure of the 2019-nCoV trimeric spike protein by cryo–electron microscopy. Using biophysical assays, the authors show that this protein binds at least 10 times more tightly than the corresponding spike protein of severe acute respiratory syndrome (SARS)–CoV to their common host cell receptor. They also tested three antibodies known to bind to the SARS-CoV spike protein but did not detect binding to the 2019-nCoV spike protein. These studies provide valuable information to guide the development of medical counter-measures for 2019-nCoV. Science, this issue p. 1260

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Author and article information

Contributors

Fariba Rad:

ORCID: https://orcid.org/0000-0003-0709-8832

fariba.rad89@gmail.com

Journal

Journal ID (nlm-ta): Int J Lab Hematol

Journal ID (iso-abbrev): Int J Lab Hematol

Journal ID (doi): 10.1111/(ISSN)1751-553X

Journal ID (publisher-id): IJLH

Title: International Journal of Laboratory Hematology

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 1751-5521

ISSN (Electronic): 1751-553X

Publication date (Electronic): 02 December 2020

Electronic Location Identifier: 10.1111/ijlh.13412

Affiliations

[ ¹ ] Department of Pathology Mashhad University of Medical Sciences Mashhad Iran

[ ² ] Student Research Committee Gonabad University of Medical Sciences Gonabad Iran

[ ³ ] Cellular and Molecular Research Center Yasuj University of Medical Sciences Yasuj Iran

[ ⁴ ] Blood Transfusion Research Center High Institute for Research and Education in Transfusion Medicine Tehran Iran

Author notes

[*] [* ] Correspondence

Fariba Rad, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran / Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.

Email: fariba.rad89@ 123456gmail.com

Author information

Mehdi Karimi Shahri https://orcid.org/0000-0003-4910-3134

Hamid R. Niazkar https://orcid.org/0000-0002-6143-9979

Fariba Rad https://orcid.org/0000-0003-0709-8832

Article

Publisher ID: IJLH13412

DOI: 10.1111/ijlh.13412

PMC ID: 7753300

PubMed ID: 33264492

SO-VID: bcd1a28c-7b1a-4e27-91eb-30e7d4a18cf4

License:

This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

History

Date received : 22 August 2020

Date revision received : 28 October 2020

Date accepted : 09 November 2020

Page count

Figures: 1, Tables: 1, Pages: 9, Words: 17956

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source-schema-version-number 2.0

edited-state corrected-proof

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.6 mode:remove_FC converted:22.12.2020

ScienceOpen disciplines: Hematology

Keywords: covid‐19,hematology,laboratory findings,sars‐cov‐2

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ScienceOpen disciplines: Hematology

Keywords: covid‐19, hematology, laboratory findings, sars‐cov‐2

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COVID‐19 and hematology findings based on the current evidences: A puzzle with many missing pieces

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Novel Coronavirus Disease COVID-19

Most cited references 58

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation

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