Differential alteration trend of white blood cells (WBCs) and monocytes count in severe and non-severe COVID-19 patients within a 7-day follow-up

Pirsalehi, Ali; Salari, Sina; Baghestani, Ahmadreza; Sanadgol, Ghazal; Shirini, Dorsa; Baerz, Maryam Moghbel; Abdi, Saeed; Akbari, Mohammad Esmaeil; Bashash, Davood

doi:10.18502/ijm.v13i1.5486

Cited by 12 publications

(11 citation statements)

References 30 publications

(27 reference statements)

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“…In a retrospective study, Pirsalehi et al reviewed the results of WBC and monocyte counts of 1320 COVID-19 patients (243 of whom had severe disease) both on admission and within a 7-day follow -up. They found that both the number of monocytes and the percentage of monocytosis were higher in the severe patients than non-severe patients [ 20 ]. Shulte-Schrepping et al ., recently reported depletion of all nonclassical monocytes in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients

et al. 2021

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Introduction Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 virus, is a major public health concern spanning from healthy carriers to patients with life-threatening conditions. Although most of COVID-19 patients have mild-to-moderate clinical symptoms, some patients have severe pneumonia leading to death. Therefore, the early prediction of disease prognosis and severity is crucial in COVID-19 patients. The main objective of this study is to evaluate the haemocytometric parameters and identify severity score associated with SARS-CoV-2 infection. Methods Clinical and laboratory records were retrospectively reviewed from 97 cases of COVID-19 admitted to hospitals in Istanbul, Turkey. The patient groups were subdivided into three major groups: Group 1 (Non-critical): 59 patients, Group 2 (Critical-Survivors): 23 patients and Group 3 (Critical-Non-survivors):15 patients. These data was tested for correlation, including with derived haemocytometric parameters. The blood analyses were performed the Sysmex XN-series automated hematology analyser using standard laboratory protocols. All statistical testing was undertaken using Analyse-it software. Results 97 patients with COVID-19 disease and 935 sequential complete blood count (CBC-Diff) measurements (days 0–30) were included in the final analyses. Multivariate analysis demonstrated that red cell distribution width (RDW) (>13.7), neutrophil to lymphocyte ratio (NLR) (4.4), Hemoglobin (Hgb) (<11.4 gr/dL) and monocyte to neutrophil ratio (MNR) (0.084) had the highest area under curve (AUC) values, respectively in discrimination critical patients than non-critical patients. In determining Group 3, MNR (<0.095), NLR (>5.2), Plateletcount (PLT) (>142 x103/L) and RDW (>14) were important haemocytometric parameters, and the mortality risk value created by their combination had the highest AUC value (AUC = 0.911, 95% CI, 0886–0.931). Trend analysis of CBC-Diff parameters over 30 days of hospitalization, NLR on day 2, MNR on day 4, RDW on day 6 and PLT on day 7 of admission were found to be the best time related parameters in discrimination non-critical (mild-moderate) patient group from critical (severe and non-survivor) patient group. Conclusion NLR is a strong predictor for the prognosis for severe COVID-19 patients when the cut-off chosen was 4.4, the combined mortality risk factor COVID-19 disease generated from RDW-CV, NLR, MNR and PLT is best as a mortality haematocytometric index.

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Section: Discussionmentioning

confidence: 99%

A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients

et al. 2021

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“…WBC count at one week of hospitalization has not been extensively evaluated. A prior study found that elevated WBC count at 1 week of hospitalization was more common in patients with severe COVID-19 compared to nonseverely ill patients [ 28 ]. Although this laboratory value may be influenced by several variables as the use of drugs as corticosteroids and the presence of other infections, we found that WBC at one week of hospitalization was an independent predictor of COVID-19-associated death.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Liver Tests during Hospitalization Predict Mortality in Patients with COVID-19: A Multicenter Study from South America

Balderramo

Mattos

Mulqui

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Background. The role of liver function tests (LFT) as prognostic factors in patients admitted with COVID-19 has not been fully investigated, particularly outside resource-rich countries. We aimed at evaluating the prognostic value of abnormal LFT on admission and during hospitalization of patients with COVID-19. Methods. We performed a retrospective study that included 298 adult patients hospitalized for COVID-19, between 05/2020 and 02/2021, in 6 hospitals from 5 countries in South America. We analyzed demographic and comorbid variables and laboratory tests on admission and during hospitalization. LFT over twice the upper limit of normal (ALEx2) were also evaluated in relation to a variety of factors on admission and during hospitalization. De novo-ALEx2 was defined as the presence of ALEx2 at one week of hospitalization in patients without ALEx2 on admission. Patients were followed until hospital discharge or death. Multivariable analysis was used to evaluate the association between ALEx2 on admission and during hospitalization and mortality. Results. Of the total of 298 patients, 60% were male, with a mean age of 60 years, and 74% of patients had at least one comorbidity. Of those, 137 (46%) patients were transferred to the intensive care unit and 66 (22.1%) patients died during hospitalization. ALEx2 on admission was present in 87 (29.2%) patients and was found to be independently associated with 1-week mortality (odds ratio (OR) = 3.55; 95% confidence interval (95%CI) 1.05–12.05). Moreover, 84 (39.8%) out of 211 patients without ALEx2 at admission developed de novo-ALEx2, which was independently associated with mortality during second week of hospitalization (OR = 6.09; 95%CI 1.28–29) and overall mortality (OR = 2.93, 95%CI 1.05–8.19). Conclusions. A moderate elevation of LFT during admission was associated with a poor short-term prognosis in patients hospitalized with COVID-19. In addition, moderate elevation of LFT at one week of hospitalization was an independent risk factor for overall mortality in these patients.

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“…Other have reported neutrophilia, lymphopenia and monocytosis in COVID-19 patients were associated with poor outcomes 63 . While it is clear that high levels of neutrophils and monocytes arise from the body’s response to eliminate SARS-CoV-2 31 , 32 , 60 , 64 , specific mechanisms by which neutrophilia and monocytosis contribute to poor outcomes in COVID-19 patients remain poorly understood. We posit that neutrophilia and monocytosis could be contributing to poorer outcomes in COVID-19 patients in part by increasing production of the cytotoxic glycolysis metabolite MG.…”

Section: Discussionmentioning

confidence: 99%

Elevated plasma level of the glycolysis byproduct methylglyoxal on admission is an independent biomarker of mortality in ICU COVID-19 patients

Alomar

Alshakhs

Abohelaika

et al. 2022

Sci Rep

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Biomarkers to identify ICU COVID-19 patients at high risk for mortality are urgently needed for therapeutic care and management. Here we found plasma levels of the glycolysis byproduct methylglyoxal (MG) were 4.4-fold higher in ICU patients upon admission that later died (n = 33), and 1.7-fold higher in ICU patients that survived (n = 32),compared to uninfected controls (n = 30). The increased MG in patients that died correlated inversely with the levels of the MG-degrading enzyme glyoxalase-1 (r2 = − 0.50), and its co-factor glutathione (r2 = − 0.63), and positively with monocytes (r2 = 0.29). The inflammation markers, SSAO (r2 = 0.52), TNF-α (r2 = 0.41), IL-1β (r2 = 0.25), CRP (r2 = 0.26) also correlated positively with MG. Logistic regression analysis provides evidence of a significant relationship between the elevated MG upon admission into ICU and death (P < 0.0001), with 42% of the death variability explained. From these data we conclude that elevated plasma MG on admission is a novel independent biomarker that predicts mortality in ICU COVID-19 patients.

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Differential alteration trend of white blood cells (WBCs) and monocytes count in severe and non-severe COVID-19 patients within a 7-day follow-up

Cited by 12 publications

References 30 publications

A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients

A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients

Abnormal Liver Tests during Hospitalization Predict Mortality in Patients with COVID-19: A Multicenter Study from South America

Elevated plasma level of the glycolysis byproduct methylglyoxal on admission is an independent biomarker of mortality in ICU COVID-19 patients

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