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Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study.
Hematology. 2020 Dec; 25(1):383-388.H

Abstract

Background:

The first cases of proved COVID-19 in Iran were reported in February 2020 and has since rapidly spread worldwide. We aimed to clarify the clinical significance of hematologic parameters alteration in COVID-19.

Methods:

Different hematologic parameters were measured in 225 hospitalized COVID-19 patients in a tertiary care university hospital, during the peak of COVID-19 outbreak and their association with duration of hospitalization, ICU admission and especially mortality was analyzed.

Results:

Among a total of 225 patients, 24.4% did not survive after admission. Lymphopenia and neutrophilia were observed in 52.7% and 21.4% of the patients, respectively. The mean count of neutrophils was significantly higher in non-survived patients (P = .032). Elevated neutrophil-to-lymphocyte ratio (NLR) was significantly associated with mortality (P < .001). Low hemoglobin (Hb) concentration significantly correlated with mortality (P = .004) and ICU admission (P = .04). Platelet (Plt) count was significantly lower in the non-survived patients (P = .023). Non-survivors had significantly lower nadir Hb and Plt counts than survivors (P < .001 in both parameters). Platelet-to-lymphocyte ratio (PLR) also correlated with mortality and was significantly higher in non-survivors (P = .034).

Conclusions:

Hematologic laboratory parameters have always been a crucial component of diagnostic and therapeutic strategies in infectious disease. Hematologic predictors of a fatal outcome in COVID19 hospitalized patients in our series include elevated NLR and PLR, lower than normal Hb and Plt, elevated d-dimer and prolonged prothrombin time (PT), together with elevated inflammatory indicators in the blood.

Authors+Show Affiliations

Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

33124971

Citation

Mousavi, Seied Asadollah, et al. "Hematologic Predictors of Mortality in Hospitalized Patients With COVID-19: a Comparative Study." Hematology (Amsterdam, Netherlands), vol. 25, no. 1, 2020, pp. 383-388.
Mousavi SA, Rad S, Rostami T, et al. Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study. Hematology. 2020;25(1):383-388.
Mousavi, S. A., Rad, S., Rostami, T., Rostami, M., Mousavi, S. A., Mirhoseini, S. A., & Kiumarsi, A. (2020). Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study. Hematology (Amsterdam, Netherlands), 25(1), 383-388. https://doi.org/10.1080/16078454.2020.1833435
Mousavi SA, et al. Hematologic Predictors of Mortality in Hospitalized Patients With COVID-19: a Comparative Study. Hematology. 2020;25(1):383-388. PubMed PMID: 33124971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study. AU - Mousavi,Seied Asadollah, AU - Rad,Soroush, AU - Rostami,Tahereh, AU - Rostami,Mohammadreza, AU - Mousavi,Seyed Ali, AU - Mirhoseini,Seied Amirhosein, AU - Kiumarsi,Azadeh, PY - 2020/10/30/entrez PY - 2020/10/31/pubmed PY - 2020/11/11/medline KW - CBC KW - COVID-19 KW - CRP KW - ESR KW - hemoglobin KW - lymphocyte KW - neutrophil KW - platelet SP - 383 EP - 388 JF - Hematology (Amsterdam, Netherlands) JO - Hematology VL - 25 IS - 1 N2 - Background: The first cases of proved COVID-19 in Iran were reported in February 2020 and has since rapidly spread worldwide. We aimed to clarify the clinical significance of hematologic parameters alteration in COVID-19. Methods: Different hematologic parameters were measured in 225 hospitalized COVID-19 patients in a tertiary care university hospital, during the peak of COVID-19 outbreak and their association with duration of hospitalization, ICU admission and especially mortality was analyzed. Results: Among a total of 225 patients, 24.4% did not survive after admission. Lymphopenia and neutrophilia were observed in 52.7% and 21.4% of the patients, respectively. The mean count of neutrophils was significantly higher in non-survived patients (P = .032). Elevated neutrophil-to-lymphocyte ratio (NLR) was significantly associated with mortality (P < .001). Low hemoglobin (Hb) concentration significantly correlated with mortality (P = .004) and ICU admission (P = .04). Platelet (Plt) count was significantly lower in the non-survived patients (P = .023). Non-survivors had significantly lower nadir Hb and Plt counts than survivors (P < .001 in both parameters). Platelet-to-lymphocyte ratio (PLR) also correlated with mortality and was significantly higher in non-survivors (P = .034). Conclusions: Hematologic laboratory parameters have always been a crucial component of diagnostic and therapeutic strategies in infectious disease. Hematologic predictors of a fatal outcome in COVID19 hospitalized patients in our series include elevated NLR and PLR, lower than normal Hb and Plt, elevated d-dimer and prolonged prothrombin time (PT), together with elevated inflammatory indicators in the blood. SN - 1607-8454 UR - https://www.unboundmedicine.com/medline/citation/33124971/Hematologic_predictors_of_mortality_in_hospitalized_patients_with_COVID_19:_a_comparative_study_ L2 - https://www.tandfonline.com/doi/full/10.1080/16078454.2020.1833435 DB - PRIME DP - Unbound Medicine ER -