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Document Type : Research Paper
Abstract
Background: In December 2019, a novel virus later named severe acute respiratory syndrome coronavirus-2 was isolated from the broncho-alveolar fluid of a patient in Wuhan, suffering from what became known as coronavirus disease 2019 (COVID-19). The first case was registered in Nineveh Province on March 22, 2020. Diagnosis was made by molecular identification of severe acute respiratory syndrome coronavirus-2 by polymerase chain reaction. So , clinical, haematological, and haemoststic parameters should take in account as they are important in determining the severity of the illness and outcome. This study focus on haematological and some haemostatic parameters in 100 cases with positive polymerase chain reaction.
Aim of study: To evaluate the haematological parameters “CBC” in patients with COVID 19 infection and to study some of the changes in first line of coagulation parameters.
Patients &methods: The current study is a case series study involving 100 patients admitted to Al-Shifaa hospital in Mousl city in the period between February 2021 and August 2021 involved collection of data, blood samples and laboratory investigations. The investigations include: complete blood count and coagulation parameters “prothrombin time (PT)” , “activated partial thromboplastin time (APTT)” , and “D.dimer”.
Results: Out of 100 patients encompasses , 51 were males, 49 were females with the age range between 10-87 years. The patients presented with a wide range of symptoms, fever and cough were the most common complains. “Lymphopenia” was the most common haematological abnormality (74%). “D.dimer” was the most common coagulation abnormality (31%). Smokers run mild to moderate course of illness.
Conclusion: Monitoring haematological and haemostatic parameters in patients with severe acute respiratory syndrome coronavirus-2 infection can predict the severity of the course of the disease and outcome of the patients.
- Paul Garner: For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion - The BMJ [Internet]. The BMJ. 2021. Available from: http://blogs.bmj.com/bmj/2020/05/05/paul-garner-people-who-have-a-more-protracted-illness-need-help-to-understand-and-cope-with-the-constantly-shifting-bizarre-symptoms/
- Kamps B, Hoffmann C. [Internet]. Amazon.com. 2021. Available from: https://www.amazon.com/COVID-Reference-ENG-2020-1-English/dp/3942687402.
- Li F. Structure, Function, and Evolution of Coronavirus Spike Proteins. Annual Review of Virology. 2016;3:237-61.
- Li W, Moore M, Vasilieva N, Sui J, Wong S, Berne M et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature. 2003;426:450-54.
- Hofmann H, Pyrc K, van der Hoek L, Geier M, Berkhout B, Pohlmann S. Human coronavirus NL63 employs the severe acute respiratory syndrome coronavirus receptor for cellular entry. Proceedings of the National Academy of Sciences. 2005;102:7988-93.
- Bertram S, Heurich A, Lavender H, Gierer S, Danisch S, Perin P et al. Influenza and SARS-Coronavirus Activating Proteases TMPRSS2 and HAT Are Expressed at Multiple Sites in Human Respiratory and Gastrointestinal Tracts. PLoS ONE. 2012;7:e35876.
- Zhao Y, Zhao Z, Wang Y, Zhou Y, Ma Y, Zuo W. Single-Cell RNA Expression Profiling of ACE2, the Receptor of SARS-CoV-2. American Journal of Respiratory and Critical Care Medicine. 2020;202:756-59.
- Qi F, Qian S, Zhang S, Zhang Z. Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses. Biochemical and Biophysical Research Communications. 2020;526:135-40.
- Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Frontiers of Medicine. 2020;14:185-92.
- Guan W, Ni Z, Hu Y, Liang W, Ou C, He J et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. 2020;382:1708-20.
- Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Annals of Hematology. 2020;99:1205-8.
- Bilaloglu S, Aphinyanaphongs Y, Jones S, Iturrate E, Hochman J, Berger J. Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System. JAMA. 2020;324:799.
- Han H, Yang L, Liu R, Liu F, Wu K, Li J et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clinical Chemistry and Laboratory Medicine (CCLM). 2020;58:1116-20.
- Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo F, Chong M et al. Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. JAMA. 2020;323(16):1612.
- Bhatraju P, Ghassemieh B, Nichols M, Kim R, Jerome K, Nalla A et al. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series. New England Journal of Medicine.2020;382:2012-22.
- Anurag A, Jha P, Kumar A. Differential white blood cell count in the COVID-19: A cross-sectional study of 148 patients. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14:2099-102.
- Patel K, Patel B, Parmar R, Sharma B, Thacker M, Patel N. A study of hematological parameters in patients with COVID-19 infection at a tertiary care centre. Journal of Pathology of Nepal. 2021;11:1852-58.
- Agrawal A, Tyagi P, Mahavar S, Banerjee S, Sharma R, Bhandhari S et al. Study of hematological and biochemical parameters in a cohort of Indian COVID-19 patients admitted in a tertiary care centre. International Journal of Advances in Medicine. 2020;7:1840.
- Kantri A, Ziati J, Khalis M, Haoudar A, El Aidaoui K, Daoudi Y et al. Hematological and biochemical abnormalities associated with severe forms of COVID-19: A retrospective single-center study from Morocco. PLOS ONE. 2021;16:e0246295.
- da Rosa Mesquita R, Francelino Silva Junior L, Santos Santana F, Farias de Oliveira T, Campos Alcântara R, Monteiro Arnozo G et al. Clinical manifestations of COVID-19 in the general population: systematic review. Wiener Klinische Wochenschrift. 2020;133:377-82.
- Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiology. 2020;5:802.
- Yassin A, Nawaiseh M, Shaban A, Alsherbini K, El-Salem K, Soudah O et al. Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. BMC Neurology. 2021;21.
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395:497-506.
- Young B, Ong S, Kalimuddin S, Low J, Tan S, Loh J et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA. 2020;323:1488.
- Fan B. Hematologic parameters in patients with COVID ‐19 infection: a reply. American Journal of Hematology. 2020;95.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395:1054-62.
- Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Science China Life Sciences. 2020;63:364-74.
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395:507-13.
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA.2020;323:1061.
- Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine. 2020;180:934.
- Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020;8:475-81.
- YD P, K M, HQ G, L L, RR Z, BY W et al. [Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV] [Internet]. PubMed. Available from: https://pubmed.ncbi.nlm.nih.gov/32120458/
- Wan S, Xiang Y, Fang W, Zheng Y, Li B, Hu Y et al. Clinical features and treatment of COVID‐19 patients in northeast Chongqing. Journal of Medical Virology. 2020;92:797-806.
- M L, P H, HG L, XJ W, FJ L, S C et al. [Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia] [Internet]. PubMed. 2021. Available from: https://pubmed.ncbi.nlm.nih.gov/32062957/
- Zhang J, Dong X, Cao Y, Yuan Y, Yang Y, Yan Y et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy. 2020;75:1730-41.
- Linkins L, Takach Lapner S. Review of D-dimer testing: Good, Bad, and Ugly. International Journal of Laboratory Hematology. 2017;39:98-103.
- Mohsin F, Tonmon T, Nahrin R, Tithy S, Ame F, Ara I et al. Association Between Smoking and COVID-19 Severity: Evidence from Bangladesh. Journal of Multidisciplinary Healthcare. 2021;14:1923-33.
- Zhao Q, Meng M, Kumar R, Wu Y, Huang J, Lian N et al. The impact of COPD and smoking history on the severity of COVID‐19: A systemic review and meta‐ Journal of Medical Virology. 2020;92:1915-21.
- Cen Y, Chen X, Shen Y, Zhang X, Lei Y, Xu C et al. Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019—a multi-centre observational study. Clinical Microbiology and Infection. 2020;26:1242-47.
- Lippi G, Henry B. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). European Journal of Internal Medicine. 2020;75:107-8.