SARS-CoV-2 Infection: Differences in Hematological Parameters Between Adults and Children

Abstract

Since December 2019, corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic, posing a huge threat to human health, and the current epidemic prevention situation is still severe. Hematological parameters directly reflect the damage of SARS-CoV-2 to human blood cells, which can better assess the severity and prognosis of patients infected with COVID-19, but hematological parameters have some differences between adults and children. This article comprehensively reviews the differences in hematological parameters between adults and children after SARS-CoV-2 infection, and provides a reference for the diagnosis and treatment of COVID-19.

Progress in the Diagnosis and Treatment of COVID-19 in Children: A Review

“… 10 Therefore, pediatric patients are less affected by lymphopenia and decreased white blood cell count. 22 , 52 In addition, compared with adults, children are less likely to experience uncontrolled immune activation, less inflammatory cytokine (eg, Interleukin-6 (IL-6)) production, and more anti-inflammatory cytokine (eg, Interleukin-10 (IL-10)) production. 10 Therefore, children have mild symptoms and a good prognosis after viral infection.…”

“…MIS-C may be explained by an abnormal immune or inflammatory response triggered by SARS-CoV-2 infection. 55 The ratio of neutrophils to lymphocytes can be used as an inflammatory marker to assess the condition of COVID-19 patients with MIS-C. 52 When the immune system is activated to a certain degree or even out of control, there is an extreme immune attack on the host. When SARS-CoV-2 further invades children, it prompts the human body to secrete cytokines such as interleukin-8, IL-6, IL-10, and tumor necrosis factor-α and produce a cytokine storm, which leads to an excessive inflammatory response and destroys blood vessels, causing MIS-C. 56 Vascular endothelial injury and vasculitis are important lesions in MIS-C and may also be induced by immune complexes.…”

“… 3 The number of neutrophils in children with ordinary COVID-19 can be reduced, but the number of neutrophils in severely ill children is significantly increased. 52 For example, in children with progressive inflammation, they often present with lymphopenia, hypoalbuminemia, hypertriglyceridemia, and elevated IL-6, ESR, lactate dehydrogenase, CRP, fibrinogen, procalcitonin, D-dimer, and serum ferritin. 13 The levels of bilirubin and liver enzymes can be used to diagnose the severity of childhood diseases.…”

Studi Deskriptif dan Analitik COVID-19 pada Anak di Rumah Sakit Umum Daerah Ulin Banjarmasin

“…Selain itu, metabolisme besi yang abnormal pada COVID-19 akibat kelebihan produksi IL-6 juga dapat mengganggu eritropoiesis. [31][32][33][34] Penelitian lain menunjukkan hasil yang berbeda dengan penelitian kami yang melaporkan bahwa hemoglobin dan hematokrit pada COVID-19 anak umumnya memiliki nilai yang normal. 12,35 Rendahnya temuan anemia pada COVID-19 dapat berhubungan dengan masa hidup eritrosit yang panjang dan adanya proliferasi kompensasi eritrosit akibat hipoksia yang terjadi pada pasien COVID-19.…”

“…Demam merupakan gejala paling umum ditemukan pada anak dalam penelitian kami dan sejalan dengan hasil penelitian Yazidi dkk 28 yang juga melaporkan bahwa gejala paling umum COVID-19 anak adalah demam, baik riwayat demam Edi Hartoyo dkk: Studi deskriptif dan analitik COVID-19 pada anak di RSUD Ulin Banjarmasin anak dapat dikaitkan dengan rendahnya COVID-19 yang parah pada anak. 12,32,36,37 D-dimer sebagian besar ditemukan meningkat pada pasien. Peningkatan D-dimer menjadi penanda kecurigaan trombosis dan menjadi prediktor terjadinya ARDS, keperluan perawatan intensif, dan kematian pada COVID-19.…”