SARS-CoV-2 Altered Hemorheological and Hematological Parameters during One-Month Observation Period in Critically Ill COVID-19 Patients

Abstract

Hematological and hemorheological parameters are known to be altered in COVID-19; however, the value of combined monitoring in order to deduce disease severity is only scarcely examined. A total of 44 acute SARS-CoV-2-infected patients (aCOV) and 44 age-matched healthy controls (Con) were included. Blood of aCOV was sampled at admission (T0), and at day 2 (T2), day 5 (T5), day 10 (T10), and day 30 (T30) while blood of Con was only sampled once. Inter- and intra-group differences were calculated for hematological and hemorheological parameters. Except for mean cellular volume and mean cellular hemoglobin, all blood cell parameters were significantly different between aCOV and Con. During the acute disease state (T0–T5), hematological and hemorheological parameters were highly altered in aCOV; in particular, anemic conditions and increased immune cell response/inflammation, oxidative/nitrosative stress, decreased deformability, as well as increased aggregation, were observed. During treatment and convalescence until T30, almost all abnormal values of aCOV improved towards Con values. During the acute state of the COVID-19 disease, the hematological, as well as the hemorheological system, show fast and potentially pathological changes that might contribute to the progression of the disease, but changes appear to be largely reversible after four weeks. Measuring RBC deformability and aggregation, as well as oxidative stress induction, may be helpful in monitoring critically ill COVID-19 patients.

Strain Echocardiography in Acute COVID-19 and Post-COVID Syndrome: More than Just a Snapshot

“…This study also found a correlation of the level of inflammatory blood values and D-dimers with right ventricular dysfunction. Therefore, thromboembolic and vasculitic mechanisms are also discussed in this patient population, which seems reasonable, as haematological, inflammatory and rheological changes occur under COVID-19 and often persist for a long time [ 11 , 39 ].…”

“…Arrhythmias and stress cardiomyopathies have also been described and affect patient prognosis [8,9]. The pathogenesis is diverse including viral endothelitis, humoral and prothrombotic changes and systemic inflammatory response syndrome [10][11][12]. In particular, the co-expression of Arrhythmias and stress cardiomyopathies have also been described and affect patient prognosis [8,9].…”

“…In particular, the co-expression of Arrhythmias and stress cardiomyopathies have also been described and affect patient prognosis [8,9]. The pathogenesis is diverse including viral endothelitis, humoral and prothrombotic changes and systemic inflammatory response syndrome [10][11][12]. In particular, the co-expression of angiotensin convertase enzyme 2 (ACE-2) and transmembrane serine protease 2 (TMPRSS2) on the cell surfaces of some tissues as the site of invasion of SARS-CoV-2 appears to have an impact on disease progression and multi-organ involvement [13,14].…”

The Impact of COVID-19 on Cellular Factors Influencing Red Blood Cell Aggregation Examined in Dextran: Possible Causes and Consequences

“…Some studies have revealed increased aggregation of erythrocytes in patients with COVID-19 [1][2][3][4][5][6]. The precise mechanisms underlying this phenomenon have not yet been entirely elucidated.…”

“…The majority of the research indicates the role of plasma as a factor influencing aggregation in COVID-19 [1][2][3][4][5]. Despite its importance, focusing solely on fibrinogen and other plasma factors can overlook the potential influence of cellular factors on erythrocyte aggregation [7], while in the context of COVID-19, it is necessary to fully understand the contribution of both plasma and cellular factors to changes in erythrocyte aggregation.…”