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Published on: March 22, 2022
Hematology Laboratory Abnormalities in Patients with Coronavirus Disease 2019 (COVID-19)
Bianca Christensen1, Emmanuel J Favaloro2,3,4, Giuseppe Lippi5
1Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
Insights
Laboratory tests can help predict severe Coronavirus Disease 2019 (COVID-19) outcomes. Abnormalities in acute phase reactants, tissue injury markers, and coagulation factors indicate a higher risk of severe disease, guiding treatment decisions.
Area of Science:
- Infectious Diseases
- Clinical Pathology
Background:
- Coronavirus Disease 2019 (COVID-19) is a global pandemic with variable disease severity.
- Many patients experience mild symptoms, while a subset develops severe, potentially fatal illness.
Purpose of the Study:
- To identify laboratory tests that can predict unfavorable clinical outcomes in COVID-19 patients.
- To evaluate the efficiency of laboratory test panels for outcome prediction.
Main Methods:
- Review of laboratory abnormalities in hospitalized COVID-19 patients.
- Analysis of potential predictive markers including acute phase reactants, tissue injury markers, and coagulation parameters.
Main Results:
- Elevated C-reactive protein, lactic dehydrogenase, D-dimer, and decreased lymphocytes are associated with severe COVID-19.
- Abnormalities in coagulation and acute phase response correlate with poor prognosis.
Conclusions:
- Specific laboratory tests show promise in predicting severe COVID-19.
- Further research is needed to establish optimal test panels and anticoagulation strategies.
Abstract:
Over the past few months, Coronavirus Disease 2019 (COVID-19) has spread across much of the world leading to a pandemic. Many infected individuals do not experience signs or symptoms, or experience only mild symptoms, whilst a subset experience severe disease, which is often fatal. A number of laboratory tests have been found to be abnormal in hospitalized patients, and some studies suggest some of these tests can predict an unfavorable outcome. These include markers of acute phase reaction (elevated C-reactive protein, erythrocyte sedimentation rate, white blood cell count, fibrinogen, procalcitonin, factor VIII, von Willebrand factor), signs of tissue injury (elevated lactic dehydrogenase, alanine aminotransferase, cardiac troponins), changes in hemostasis and coagulation (elevated D-dimer, prolonged prothrombin time, decreased platelets, decreased antithrombin, elevated factor VIII and von Willebrand factor), and decreased lymphocytes. Additional studies are needed to confirm the most ideal panel of tests, and to confirm the efficiency of laboratory tests to predict clinical outcome, as well as the ideal anticoagulation management.
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