Hematological findings and complications of COVID‐19

• Published in: American Journal of Hematology Vol. 95; no. 7; pp. 834 - 847
• Main Authors: Terpos, Evangelos, Ntanasis‐Stathopoulos, Ioannis, Elalamy, Ismail, Kastritis, Efstathios, Sergentanis, Theodoros N., Politou, Marianna, Psaltopoulou, Theodora, Gerotziafas, Grigoris, Dimopoulos, Meletios A.
• Format: Journal Article Web Resource
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.07.2020; Wiley Subscription Services, Inc; Wiley
• Subjects: Anticoagulants - therapeutic use; Betacoronavirus; Biomarkers; Blood & organ donations; Blood Coagulation Tests; Blood Donors - supply & distribution; C-Reactive Protein - analysis; Cell number; Clinical Laboratory Techniques; Coronavirus Infections - blood; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; COVID-19; COVID-19 Testing; Critical Review; Cytokine Release Syndrome - blood; Cytokine Release Syndrome - etiology; Cytokines - blood; Degradation products; Disseminated infection; Disseminated intravascular coagulation; Disseminated Intravascular Coagulation - blood; Disseminated Intravascular Coagulation - etiology; Early Diagnosis; Ferritin; Ferritins - blood; Fibrin; Fibrin Fibrinogen Degradation Products - analysis; Hematology; Hemostasis; Heparin; Human health and pathology; Humans; Inflammation; Life Sciences; Lymphocytes; Lymphopenia; Lymphopenia - etiology; Medical prognosis; Meta-Analysis as Topic; Molecular weight; Pandemics; Pneumonia, Viral - blood; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Procalcitonin; Risk; SARS-CoV-2; Thrombocytopenia; Thromboembolism; Thrombophilia - blood; Thrombophilia - drug therapy; Thrombophilia - etiology; Venous Thromboembolism - blood; Venous Thromboembolism - etiology; Venous Thromboembolism - prevention & control; Vigilance
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.25829

COVID‐19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential. Neutrophil/lymphocyte ratio and peak platelet/lymphocyte ratio may also have prognostic value in determining severe cases. During the disease course, longitudinal evaluation of lymphocyte count dynamics and inflammatory indices, including LDH, CRP and IL‐6 may help to identify cases with dismal prognosis and prompt intervention in order to improve outcomes. Biomarkers, such high serum procalcitonin and ferritin have also emerged as poor prognostic factors. Furthermore, blood hypercoagulability is common among hospitalized COVID‐19 patients. Elevated D‐Dimer levels are consistently reported, whereas their gradual increase during disease course is particularly associated with disease worsening. Other coagulation abnormalities such as PT and aPTT prolongation, fibrin degradation products increase, with severe thrombocytopenia lead to life‐threatening disseminated intravascular coagulation (DIC), which necessitates continuous vigilance and prompt intervention. So, COVID‐19 infected patients, whether hospitalized or ambulatory, are at high risk for venous thromboembolism, and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended. Last but not least, the need for assuring blood donations during the pandemic is also highlighted.