Hematologic changes predict clinical outcome in recovered patients with COVID-19

Mao, Jian; Dai, Rong; Du, Rui-Chan; Zhu, Yan; Shui, Li-Ping; Luo, Xiao‐Hua

doi:10.1007/s00277-021-04426-x

Cited by 52 publications

(61 citation statements)

References 22 publications

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“…Interestingly, our search demonstrates that both basophils and mast cells are probably involved in the pathogenesis of COVID-19 disease: the former may exert a protective role and the latter may play a key role in the pathogenesis. Indeed, basophil count and/or percentage seems to be reduced in COVID-19 patients as compared to controls [43,45,46,63,64,79], and this is the case in severe COVID-19 disease as compared to mild/moderate disease [49][50][51]. As mentioned in the introduction, basophils can act synergically with dendritic cells as antigen-presenting cells to CD4+ T cells and promote B cell response through induction of Th2 cell differentiation [39,40,[82][83][84][85][86][87].…”

Section: Discussionmentioning

confidence: 95%

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Basophils and Mast Cells in COVID-19 Pathogenesis

Murdaca

Gioacchino

Greco³

et al. 2021

Cells

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Basophils and mast cells are among the principal inducers of Th2 responses and have a crucial role in allergic and anti-parasitic protective immunity. Basophils can function as antigen-presenting cells that bind antigens on their surface and boost humoral immune responses, inducing Th2 cell differentiation. Their depletion results in lower humoral memory activation and greater infection susceptibility. Basophils seem to have an active role upon immune response to SARS-CoV-2. In fact, a coordinate adaptive immune response to SARS-CoV-2 is magnified by basophils. It has been observed that basophil amount is lower during acute disease with respect to the recovery phase and that the grade of this depletion is an important determinant of the antibody response to the virus. Moreover, mast cells, present in a great quantity in the nasal epithelial and lung cells, participate in the first immune response to SARS-CoV-2. Their activation results in a hyperinflammatory syndrome through the release of inflammatory molecules, participating to the “cytokine storm” and, in a longer period, inducing pulmonary fibrosis. The literature data suggest that basophil counts may be a useful prognostic tool for COVID-19, since their reduction is associated with a worse prognosis. Mast cells, on the other hand, represent a possible therapeutic target for reducing the airway inflammation characteristic of the hyperacute phase of the disease.

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Section: Discussionmentioning

confidence: 95%

“…In the study from Wuhan No. 1 Hospital [43], involving 59 male and 68 female Chinese patients, a reduction in basophil count was present in 13.39% of enrolled patients. Moreover, authors noted that the reduction in basophils was present in the first three days of hospitalization and was restored to normal shortly.…”

Section: Basophils and Covid-19 Diseasementioning

confidence: 99%

Basophils and Mast Cells in COVID-19 Pathogenesis

Murdaca

Gioacchino

Greco³

et al. 2021

Cells

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“…On the other hand, eosinophils and basophils were found lower among the RT-PCR-positive patients. Lower levels of eosinophils and basophils are reported to be associated with delayed recovery in COVID-19 patients [ 17 ]. Contrastingly, we observed a similar time to discharge among the survivors in both groups.…”

Section: Discussionmentioning

confidence: 99%

Clinical and biochemical characteristics and outcomes of suspected COVID-19 hospitalized patients: RT-PCR swab positive and negative comparison

Alfadda¹,

Alkhowaiter²,

Alotaibi³

et al. 2021

Journal of Infection and Public Health

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Background COVID-19 is diagnosed using RT-PCR assays of samples from nasal and oropharyngeal swabs. People with negative RT-PCR often presented with clinical manifestations of COVID-19. The data on such patients are lacking. The present study aims to characterize the patients who were suspected COVID-19 cases and tested negative in RT-PCR compared to patients who had been tested RT-PCR positive. Methods This is a retrospective, observational study of adult suspected and confirmed patients of COVID-19 admitted to King Saud University Medical City, Riyadh, Saudi Arabia, from 1st March 2020 until 30th November 2020. Laboratory confirmation is done through nasal/pharyngeal swab specimens, tested positive in RT-PCR assay. Patients with initial negative RT-PCR test results were assessed again within 48-72 h to avoid false-negative results. Patient data were extracted from the electronic medical files of each included patient using a predesigned case report form. Results The study included 488 (80.93%) patients with RT-PCR swab results positive, and 115 (19.07%) patients who were negative. Respiratory rate and diastolic blood pressure were higher among the swab-positive cases. More number of swab-negative patients had comorbidities such as coronary heart disease, chronic kidney disease, and carcinoma. Fever, cough, and shortness of breath were reported higher among the swab-positive cases. ALT and AST, and LDH levels were found higher among RT-PCR-positive patients. Serum creatinine, blood urea nitrogen and troponin were more elevated in RT-PCR-negative patients. Antibiotics, anticoagulants, and corticosteroids were used more by swab-positive patients. Significantly higher number of RT-PCR-positive patients required proning, high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation. Acute cardiac ischemia and death were found to be similar among the patients. However, deaths occurred significantly earlier among the swab-positive cases when compared to the swab-negative group. Conclusion Distinctive symptoms and markers of COVID-19 are more frequent among patients who had RT-PCR-positive results.

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“…Mao et al, in their study, assessed the effect of the number of eosinophils on the severity of the disease. The researchers reported that the occurrence of eosinopenia negatively affects the prognosis of hospitalized patients [ 18 ]. Martens et al studied the usefulness of hemocytometric parameters for each of the leukocyte groups in patients suffering from COVID-19 who developed or did not develop a cytokine storm.…”

Section: Discussionmentioning

confidence: 99%

Cell Population Data and Serum Polyclonal Immunoglobulin Free Light Chains in the Assessment of COVID-19 Severity

Małecka‐Giełdowska

Fołta

Wiśniewska

et al. 2021

Viruses

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Distinguishing between severe and nonsevere COVID-19 to ensure adequate healthcare quality and efficiency is a challenge for the healthcare system. The aim of this study was to assess the usefulness of CBC parameters together with analysis of FLC serum concentration in risk stratification of COVID-19. Materials and methods: CBC was analyzed in 735 COVID ICU, COVID non-ICU, and non-COVID ICU cases. FLC concentration was analyzed in 133 of them. Results: COVID ICU had neutrophils and lymphocytes with the greatest size, granularity, and nucleic acid content. Significant differences in concentrations of κ and λ FLCs were shown between COVID ICU and COVID non-ICU. However, no difference was found in the κ/λ ratio between these groups, and the ratio stayed within the reference value, which indicates the presence of polyclonal FLCs. FLC κ measurement has significant power to distinguish between severe COVID-19 and nonsevere COVID-19 (AUC = 0.7669), with a sensitivity of 86.67% and specificity of 93.33%. The κ coefficients’ odds ratio of 3.0401 was estimated. Conclusion: It can be concluded that the results obtained from the measure of free light immunoglobulin concentration in serum are useful in distinguishing between severe and nonsevere COVID-19.

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Hematologic changes predict clinical outcome in recovered patients with COVID-19

Cited by 52 publications

References 22 publications

Basophils and Mast Cells in COVID-19 Pathogenesis

Basophils and Mast Cells in COVID-19 Pathogenesis

Clinical and biochemical characteristics and outcomes of suspected COVID-19 hospitalized patients: RT-PCR swab positive and negative comparison

Cell Population Data and Serum Polyclonal Immunoglobulin Free Light Chains in the Assessment of COVID-19 Severity

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