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Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China
Suyu Sun1, Xuejiao Cai2, Huaguo Wang3
1Gynaecology and Obstetrics, Wenzhou Central Hospital, Dingli Clinical School of Wenzhou Medical University, Wenzhou 325000, China.
Insights
Peripheral blood tests reveal abnormal results in COVID-19 patients. Monitoring eosinophils can help predict severe cases of coronavirus disease 2019 (COVID-19).
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) emerged in December 2019.
- The pandemic rapidly spread globally from its origin in Wuhan, China.
Purpose of the Study:
- To analyze peripheral blood routine examination results in COVID-19 patients.
- To compare these results between common, severe non-ICU, and severe ICU groups.
- To evaluate the predictive value of blood parameters for severe COVID-19.
Main Methods:
- Collected data from 116 COVID-19 patients in Wenzhou (Jan 19 - Feb 20, 2020).
- Categorized patients into common, severe non-ICU, and severe ICU groups.
- Dynamically observed and compared blood routine examination results, including leucocytes, lymphocytes, eosinophils, platelets, hemoglobin, neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR).
Main Results:
- COVID-19 patients showed lower leucocyte, lymphocyte, eosinophil, platelet, and hemoglobin counts, with higher NLR and MLR compared to controls (P < 0.001).
- Severe ICU patients had the lowest lymphocyte counts and highest neutrophil counts and NLR (P < 0.05).
- Combined NLR and MLR achieved an area under the curve of 0.925 for diagnosing severe COVID-19. Delayed increase in eosinophil count predicted severe outcomes (OR 2.291).
Conclusions:
- COVID-19 is associated with abnormal peripheral blood findings.
- Dynamic monitoring of peripheral blood parameters, particularly eosinophils, aids in predicting severe COVID-19 cases.
Background:
In December 2019, coronavirus disease 2019 (COVID-19) was first found in Wuhan, China and soon was reported all around the world.
Methods:
All confirmed cases with COVID-19 in Wenzhou from January 19 to February 20, 2020, were collected and analyzed. Of the 116 patients with COVID-19, 27 were diagnosed as severe cases. Among severe cases, 9 were treated in ICU. The data of blood routine examination were analyzed and compared among common patients (as common group), severe patients admitted to intensive care unit (as severe ICU group) and severe patients not admitted to ICU (as severe non-ICU group). The blood routine examination results were dynamically observed in the above groups after admission.
Results:
Patients with COVID-19 have lower counts of leucocytes, lymphocytes, eosinophils, platelets, and hemoglobin, but have higher neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), which were compared with controls (P < 0.001). In severe ICU group, patients have the lowest count of lymphocytes, but the highest neutrophil count and NLR among the above three groups (all P values < 0.05); NLR and MLR indicators were combined for diagnostic efficacy analysis of severe COVID-19, and its area under the curve reached 0.925. The odds ratio of the delay in days to the start of the increase of eosinophil count for predicting the outcome of patients with severe COVID-19 was 2.291 after age adjusted.
Conclusions:
Patients with COVID-19 have abnormal peripheral blood routine examination results. Dynamic surveillance of peripheral blood system especially eosinophils is helpful in the prediction of severe COVID-19 cases.
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