Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China - 22/07/20
![](/templates/common/images/mail.png)
![](/templates/common/images/mail.png)
![](/templates/common/images/mail.png)
on behalf of the
Medical Treatment Expert Group for COVID-19
Abstract |
Background |
Crucial roles of hematologic and immunologic responses in progression of coronavirus disease 2019 (COVID-19) remain largely unclear.
Objective |
We sought to address the dynamic changes in hematologic and immunologic biomarkers and their associations with severity and outcomes of COVID-19.
Methods |
A retrospective study including 548 patients with COVID-19 with clarified outcome (discharged or deceased) from a national cohort in China was performed. Cross-sectional and longitudinal variations were compared and the associations with different severity and outcomes were analyzed.
Results |
On admission, the counts of lymphocytes, T-cell subsets, eosinophils, and platelets decreased markedly, especially in severe/critical and fatal patients. Increased neutrophil count and neutrophils-to-lymphocytes ratio were predominant in severe/critical cases or nonsurvivors. During hospitalization, eosinophils, lymphocytes, and platelets showed an increasing trend in survivors, but maintained lower levels or dropped significantly afterwards in nonsurvivors. Nonsurvivors kept a high level or showed an upward trend for neutrophils, IL-6, procalcitonin, D-dimer, amyloid A protein, and C-reactive protein, which were kept stable or showed a downward trend in survivors. Positive correlation between CD8+ T-cell and lymphocytes count was found in survivors but not in nonsurvivors. A multivariate Cox regression model suggested that restored levels of lymphocytes, eosinophils, and platelets could serve as predictors for recovery, whereas progressive increases in neutrophils, basophils, and IL-6 were associated with fatal outcome.
Conclusions |
Hematologic and immunologic impairment showed a significantly different profile between survivors and nonsurvivors in patients with COVID-19 with different severity. The longitudinal variations in these biomarkers could serve to predict recovery or fatal outcome.
Il testo completo di questo articolo è disponibile in PDF.Graphical abstract |
Key words : Hematologic indices, immunologic responses, COVID-19, severity, outcome
Abbreviations used : COVID-19, CRP, HR, MERS, NLR, PCT, PLR, SAA, SARS, SARS-CoV-2
Mappa
Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 146 - N° 1
P. 89-100 - Luglio 2020 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.