Hematological findings and complications of COVID-19.
Identifieur interne : 001744 ( Main/Corpus ); précédent : 001743; suivant : 001745Hematological findings and complications of COVID-19.
Auteurs : Evangelos Terpos ; Ioannis Ntanasis-Stathopoulos ; Ismail Elalamy ; Efstathios Kastritis ; Theodoros N. Sergentanis ; Marianna Politou ; Theodora Psaltopoulou ; Grigoris Gerotziafas ; Meletios A. DimopoulosSource :
- American journal of hematology [ 1096-8652 ] ; 2020.
English descriptors
- KwdEn :
- Anticoagulants (therapeutic use), Betacoronavirus (MeSH), Biomarkers (MeSH), Blood Coagulation Tests (MeSH), Blood Donors (supply & distribution), C-Reactive Protein (analysis), Clinical Laboratory Techniques (MeSH), Coronavirus Infections (blood), Coronavirus Infections (complications), Coronavirus Infections (diagnosis), Cytokine Release Syndrome (blood), Cytokine Release Syndrome (etiology), Cytokines (blood), Disseminated Intravascular Coagulation (blood), Disseminated Intravascular Coagulation (etiology), Early Diagnosis (MeSH), Ferritins (blood), Fibrin Fibrinogen Degradation Products (analysis), Humans (MeSH), Lymphopenia (etiology), Meta-Analysis as Topic (MeSH), Pandemics (MeSH), Pneumonia, Viral (blood), Pneumonia, Viral (complications), Pneumonia, Viral (diagnosis), Risk (MeSH), Thrombophilia (blood), Thrombophilia (drug therapy), Thrombophilia (etiology), Venous Thromboembolism (blood), Venous Thromboembolism (etiology), Venous Thromboembolism (prevention & control).
- MESH :
- chemical , analysis : C-Reactive Protein, Fibrin Fibrinogen Degradation Products.
- chemical , blood : Cytokines, Ferritins.
- chemical , therapeutic use : Anticoagulants.
- blood : Coronavirus Infections, Cytokine Release Syndrome, Disseminated Intravascular Coagulation, Pneumonia, Viral, Thrombophilia, Venous Thromboembolism.
- complications : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Thrombophilia.
- etiology : Cytokine Release Syndrome, Disseminated Intravascular Coagulation, Lymphopenia, Thrombophilia, Venous Thromboembolism.
- prevention & control : Venous Thromboembolism.
- supply & distribution : Blood Donors.
- Betacoronavirus, Biomarkers, Blood Coagulation Tests, Clinical Laboratory Techniques, Early Diagnosis, Humans, Meta-Analysis as Topic, Pandemics, Risk.
Abstract
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.
DOI: 10.1002/ajh.25829
PubMed: 32282949
PubMed Central: PMC7262337
Links to Exploration step
pubmed:32282949Le document en format XML
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Sechenov Moscow State Medical University, Moscow, Russia.</nlm:affiliation></affiliation></author><author><name sortKey="Kastritis, Efstathios" sort="Kastritis, Efstathios" uniqKey="Kastritis E" first="Efstathios" last="Kastritis">Efstathios Kastritis</name><affiliation><nlm:affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Sergentanis, Theodoros N" sort="Sergentanis, Theodoros N" uniqKey="Sergentanis T" first="Theodoros N" last="Sergentanis">Theodoros N. Sergentanis</name><affiliation><nlm:affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Politou, Marianna" sort="Politou, Marianna" uniqKey="Politou M" first="Marianna" last="Politou">Marianna Politou</name><affiliation><nlm:affiliation>Hematology Laboratory-Blood Bank, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Psaltopoulou, Theodora" sort="Psaltopoulou, Theodora" uniqKey="Psaltopoulou T" first="Theodora" last="Psaltopoulou">Theodora Psaltopoulou</name><affiliation><nlm:affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Gerotziafas, Grigoris" sort="Gerotziafas, Grigoris" uniqKey="Gerotziafas G" first="Grigoris" last="Gerotziafas">Grigoris Gerotziafas</name><affiliation><nlm:affiliation>Hematology and Thrombosis Center, Tenon University Hospital, Sorbonne University, INSERM U938, Sorbonne University, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Research Group "Cancer, Haemostasis and Angiogenesis," INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Dimopoulos, Meletios A" sort="Dimopoulos, Meletios A" uniqKey="Dimopoulos M" first="Meletios A" last="Dimopoulos">Meletios A. Dimopoulos</name><affiliation><nlm:affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation></affiliation></author></analytic><series><title level="j">American journal of hematology</title><idno type="eISSN">1096-8652</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anticoagulants (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>Biomarkers (MeSH)</term><term>Blood Coagulation Tests (MeSH)</term><term>Blood Donors (supply & distribution)</term><term>C-Reactive Protein (analysis)</term><term>Clinical Laboratory Techniques (MeSH)</term><term>Coronavirus Infections (blood)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (diagnosis)</term><term>Cytokine Release Syndrome (blood)</term><term>Cytokine Release Syndrome (etiology)</term><term>Cytokines (blood)</term><term>Disseminated Intravascular Coagulation (blood)</term><term>Disseminated Intravascular Coagulation (etiology)</term><term>Early Diagnosis (MeSH)</term><term>Ferritins (blood)</term><term>Fibrin Fibrinogen Degradation Products (analysis)</term><term>Humans (MeSH)</term><term>Lymphopenia (etiology)</term><term>Meta-Analysis as Topic (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (blood)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (diagnosis)</term><term>Risk (MeSH)</term><term>Thrombophilia (blood)</term><term>Thrombophilia (drug therapy)</term><term>Thrombophilia (etiology)</term><term>Venous Thromboembolism (blood)</term><term>Venous Thromboembolism (etiology)</term><term>Venous Thromboembolism (prevention & control)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analysis" xml:lang="en"><term>C-Reactive Protein</term><term>Fibrin Fibrinogen Degradation Products</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Cytokines</term><term>Ferritins</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anticoagulants</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Coronavirus Infections</term><term>Cytokine Release Syndrome</term><term>Disseminated Intravascular Coagulation</term><term>Pneumonia, Viral</term><term>Thrombophilia</term><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Thrombophilia</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cytokine Release Syndrome</term><term>Disseminated Intravascular Coagulation</term><term>Lymphopenia</term><term>Thrombophilia</term><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="supply & distribution" xml:lang="en"><term>Blood Donors</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>Biomarkers</term><term>Blood Coagulation Tests</term><term>Clinical Laboratory Techniques</term><term>Early Diagnosis</term><term>Humans</term><term>Meta-Analysis as Topic</term><term>Pandemics</term><term>Risk</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32282949</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>29</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1096-8652</ISSN><JournalIssue CitedMedium="Internet"><Volume>95</Volume><Issue>7</Issue><PubDate><Year>2020</Year><Month>07</Month></PubDate></JournalIssue><Title>American journal of hematology</Title><ISOAbbreviation>Am. J. Hematol.</ISOAbbreviation></Journal><ArticleTitle>Hematological findings and complications of COVID-19.</ArticleTitle><Pagination><MedlinePgn>834-847</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/ajh.25829</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>© 2020 Wiley Periodicals, Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Terpos</LastName><ForeName>Evangelos</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0001-5133-1422</Identifier><AffiliationInfo><Affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ntanasis-Stathopoulos</LastName><ForeName>Ioannis</ForeName><Initials>I</Initials><Identifier Source="ORCID">0000-0002-6328-9783</Identifier><AffiliationInfo><Affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Elalamy</LastName><ForeName>Ismail</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Hematology and Thrombosis Center, Tenon University Hospital, Sorbonne University, INSERM U938, Sorbonne University, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Obstetrics and Gynaecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kastritis</LastName><ForeName>Efstathios</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0001-8191-5832</Identifier><AffiliationInfo><Affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sergentanis</LastName><ForeName>Theodoros N</ForeName><Initials>TN</Initials><AffiliationInfo><Affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Politou</LastName><ForeName>Marianna</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Hematology Laboratory-Blood Bank, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Psaltopoulou</LastName><ForeName>Theodora</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gerotziafas</LastName><ForeName>Grigoris</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Hematology and Thrombosis Center, Tenon University Hospital, Sorbonne University, INSERM U938, Sorbonne University, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Research Group "Cancer, Haemostasis and Angiogenesis," INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dimopoulos</LastName><ForeName>Meletios A</ForeName><Initials>MA</Initials><Identifier Source="ORCID">0000-0001-8990-3254</Identifier><AffiliationInfo><Affiliation>Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Hematol</MedlineTA><NlmUniqueID>7610369</NlmUniqueID><ISSNLinking>0361-8609</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000925">Anticoagulants</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015415">Biomarkers</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D016207">Cytokines</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005338">Fibrin Fibrinogen Degradation Products</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C036309">fibrin fragment D</NameOfSubstance></Chemical><Chemical><RegistryNumber>9007-41-4</RegistryNumber><NameOfSubstance UI="D002097">C-Reactive Protein</NameOfSubstance></Chemical><Chemical><RegistryNumber>9007-73-2</RegistryNumber><NameOfSubstance UI="D005293">Ferritins</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000657964">COVID-19 diagnostic testing</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 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MajorTopicYN="N">Clinical Laboratory Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000080424" MajorTopicYN="N">Cytokine Release Syndrome</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016207" MajorTopicYN="N">Cytokines</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004211" MajorTopicYN="N">Disseminated Intravascular Coagulation</DescriptorName><QualifierName UI="Q000097" 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