Novel Insights into the Hematological Parameter Abnormalities in Pediatric COVID-19 Cases: Observation from A Preliminary Study of 11 Pediatric COVID-19 Cases in A Tertiary Care Center of North India

Tiwari, Neema; Nath, Devajit; Madan, Jyotsna; Bajpai, Prachi; Madan, Ujjwal; Singh, Savitri

doi:10.36348/sjpm.2020.v05i05.010

Cited by 8 publications

(12 citation statements)

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“…In a large study from China among 244 pediatric patients, 193 had symptomatic COVID-19 infection and significantly lower levels of hemoglobin were found [ 14 ]. A lower level of hemoglobin has been reported along with a decrease in MCV, while those findings were more consistent in severely ill adult patients [ 35 , 36 ]. Infection by SARS-CoV-2 may directly affect the red cell precursors of the bone marrow either directly through ACE-2 receptors, leading to early apoptosis, or by inhibiting hematopoiesis though cytokine action in severely ill patients due to inflammatory process.…”

Section: Discussionmentioning

confidence: 79%

A Case of COVID-19-Related Thrombocytopenia and Leukopenia in an Adolescent with Mild Symptoms

et al. 2021

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Since the beginning of the COVID-19 pandemic, there have been numerous reports and reviews on the complications caused by the disease, analyzing the acute and chronic consequences. The main symptoms of SARS-CoV-2 are dry cough, fever, and fatigue. COVID-19 appears to affect all systems, including renal, cardiovascular, circulatory, and respiratory systems, causing chronic obstructive pulmonary disease. We report on a 14-year-old male adolescent, who presented with thrombocytopenia (platelet count 92 × 109 /L) and leukopenia (white blood count 4.2 × 103 /μL) that was observed two months ago. Ten days before the first blood test, a viral infection with nasal congestion and runny nose was reported, without other accompanying symptoms. Viral antibodies screening revealed positivity for all the three specific COVID-19 antibodies. Further haematological evaluation with bone marrow aspiration revealed non-specific dysplastic features of the red cell and megakaryocyte progenitors. Although haematological alterations due to COVID-19 infection are available from adult patients’ reports, the effect of COVID-19 infection in the pediatric population is underestimated and this is the first case with such haematological involvement. Noteworthy, in the current case, the impact of the COVID-19 infection was not related to the severity of the disease, as the symptoms were mild. In similar cases, bone marrow aspiration would not be performed as a part of routine work-up. Thus, it is important when evaluating pediatric patients with COVID-19 infection to search and report those alterations in order to better understand the impact and the spectrum of clinical manifestations of the specific viral infection in children and adolescents.

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Section: Discussionmentioning

confidence: 79%

A Case of COVID-19-Related Thrombocytopenia and Leukopenia in an Adolescent with Mild Symptoms

et al. 2021

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“…28 To the best of our knowledge, limited studies on NLR levels in children with COVID-19 are available. Tiwari et al 12 reported no significant difference in NLR or PLR between asymptomatic adults and asymptomatic children. We found no statistically significant relationship in NLR, PLR, and MPV values between the pediatric patients with and without a positive PCR test result.…”

Section: Discussionmentioning

confidence: 94%

“…A study comparing children with adults reported no statistically significant difference in NLR and PLR, yet low hemoglobin and thrombocytosis were significant in children. 12 It seems that there is a gap in studies on CBC parameters in pediatric patients with COVID-19. To the best of our knowledge, the predictive properties of CBC parameters in children, such as the MPV, PLT/MPV, and PDW values for diagnosing COVID have yet to be studied.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of CBC Parameters in Relation to PCR Test Results in Diagnosing Pediatric COVID-19 Disease

Bağcı

Uğur

2021

J Pediatr Infect Dis

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Objective This study aimed to investigate whether complete blood count parameters have predictive properties in diagnosing coronavirus disease 2019 (COVID-19) in regard to positive polymerase chain reaction (PCR) test in children with a prediagnosis of COVID-19, and whether these parameters are related to the severity of clinical findings in children with COVID-19. Methods This retrospective cross-sectional study included children who were hospitalized with a possible diagnosis of COVID-19 and had undergone PCR testing in the COVID-19 children's clinic. Probable case definition was made according to the COVID-19 diagnostic and therapeutic guidelines of the Ministry of Health of the Republic of Turkey. Results A total of 133 patients were included in the study, of which 46 (34.6%) were negative for the PCR test and 87 (65.4%) were positive for the PCR test. white blood cell (WBC), neutrophil, lymphocyte, and platelet levels were significantly lower in the PCR positive group than in the PCR negative group. The platelet to mean platelet volume ratio (PLT/MPV) was significantly lower in the PCR positive group than the PCR negative group, whereas the platelet distribution width (PDW) of the PCR positive patient group was significantly higher than the PCR negative group. For the multivariable model with PDW and neutrophil to lymphocyte ratio/age factors included, F1 score was 0.864, area under the receiver operating characteristics was 0.804, and area under the precision-recall curve was 0.873. The decision tree had a 72.9% cross-validation accuracy value. Conclusion WBC, neutrophils, lymphocytes, platelets, PLT/MPV, and PDW parameters could be used in conjunction with clinical symptoms and findings to predict the PCR test result.

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“…The lymphocyte count is found to be significant for the prognosis of patients with COVID-19. Another common laboratory finding is thrombocytosis [9]. Some also suggest that eosinopenia is an important predictor of the outcome [8].…”

Section: Introductionmentioning

confidence: 99%

“…All data were primarily documented from adult cases. The information about hematological abnormalities in children with SARS-CoV-2 infection are very limited worldwide, since the incidence of the disease in the pediatric population is significantly lower than in the adults [9]. Additionally, the interpretation of these results varies to a significant extent [10].…”

Section: Introductionmentioning

confidence: 99%

Hematological parameters in children with severe acute respiratory syndrome coronavirus 2 infection

et al. 2020

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Introduction. Recently, there has been a need to use more readily available parameters to assess the severe acute respiratory syndrome coronavirus 2 infection in children. Material and Methods. A single-center retrospective study included 30 children with severe acute respiratory syndrome coronavirus 2 infection who were admitted to the Isolation Department of the Institute for Child and Youth Health Care of Vojvodina from April to September 2020. A complete blood count with differential was performed. Additionally, systemic inflammatory index, neutrophil-lymphocyte ratio and plateletlymphocyte ratio were calculated. For comparison, age- and sex-matched 30 children negative for severe acute respiratory syndrome coronavirus 2 were included in the study. Results. In the period from April to September 2020, 30 laboratory-confirmed cases of coronavirus-19, aged 0 - 17 years, were admitted to the Institute for Child and Youth Health Care of Vojvodina. The age was not a risk factor for the development of coronavirus-19 (p = 0.707; OR: 1.018; 95% CI: 0.927 - 1.119). The comparison of hematological parameters of severe acute respiratory syndrome coronavirus 2 status showed that hemoglobin concentration (p < 0.01) and hematocrit (p < 0.01) were lower, and the percentage of neutrophil granulocytes (p < 0.05) was higher among severe acute respiratory syndrome coronavirus 2 positive children. Furthermore, it was found that some severe acute respiratory syndrome coronavirus 2 positive children had a higher (p < 0.01), while others had a lower (p < 0.01) percentage of lymphocytes. The systemic inflammatory index, the ratio of neutrophils to lymphocytes, and the ratio of platelets to lymphocytes, were not found to be statistically significantly different (p > 0.05). Conclusion. Low hemoglobin and hematocrit levels, a high percentage of neutrophil granulocytes, and a non-physiological percentage of lymphocytes (both, low and high) may have a diagnostic significance in children with severe acute respiratory syndrome coronavirus 2 infection.

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Novel Insights into the Hematological Parameter Abnormalities in Pediatric COVID-19 Cases: Observation from A Preliminary Study of 11 Pediatric COVID-19 Cases in A Tertiary Care Center of North India

Cited by 8 publications

References 0 publications

A Case of COVID-19-Related Thrombocytopenia and Leukopenia in an Adolescent with Mild Symptoms

A Case of COVID-19-Related Thrombocytopenia and Leukopenia in an Adolescent with Mild Symptoms

Evaluation of CBC Parameters in Relation to PCR Test Results in Diagnosing Pediatric COVID-19 Disease

Hematological parameters in children with severe acute respiratory syndrome coronavirus 2 infection

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