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The hematology laboratory's response to the COVID-19 pandemic: A scoping review
Robert Bell1, Gina Zini2,3, Giuseppe d'Onofrio3
1Department of Pathology and Immunology, Washington University, St. Louis, MO, USA.
Insights
This review of COVID-19 hematology research found many studies focused on prognosis and risk factors, but gaps remain in areas like biosafety and laboratory screening guidelines for COVID-19.
Area of Science:
- Hematology
- Infectious Diseases
- Epidemiology
Background:
- The COVID-19 pandemic significantly impacted laboratory hematology.
- Research accelerated, establishing the value of hematology data for prognosis and outcomes.
Purpose of the Study:
- To conduct a scoping review of COVID-19 laboratory hematology research.
- To analyze the state of research published between December 2019 and July 2020.
Main Methods:
- Comprehensive literature search.
- Analysis of 402 retrieved studies based on origin, publication date, study type, and topic.
Main Results:
- Over half of studies (50.37%) originated in China.
- Retrospective cohort studies (43.89%) were most common, focusing on prognosis, risk factors, epidemiology, and coagulation.
- Research showed bias towards Chinese origin and retrospective studies with limited laboratory data reporting.
Conclusions:
- Significant progress was made in understanding coagulation, automated hematology, and cell morphology in COVID-19.
- Gaps exist in literature regarding biosafety, laboratory screening/prevention, and guidelines.
- Many areas related to laboratory data in COVID-19 remain unexplored or under-reported.
Abstract:
The ongoing COVID-19 pandemic has had a profound worldwide impact on the laboratory hematology community. Nevertheless, the pace of COVID-19 hematology-related research has continued to accelerate and has established the role of laboratory hematology data for many purposes including disease prognosis and outcome. The purpose of this scoping review was to assess the current state of COVID-19 laboratory hematology research. A comprehensive search of the literature published between December 1, 2019, and July 3, 2020, was performed, and we analyzed the sources, publication dates, study types, and topics of the retrieved studies. Overall, 402 studies were included in this scoping review. Approximately half of these studies (n = 202, 50.37%) originated in China. Retrospective cohort studies comprised the largest study type (n = 176, 43.89%). Prognosis/ risk factors, epidemiology, and coagulation were the most common topics. The number of studies published per day has increased through the end of May. The studies were heavily biased in favor of papers originating in China and on retrospective clinical studies with limited use of and reporting of laboratory data. Despite the major improvements in our understanding of the role of coagulation, automated hematology, and cell morphology in COVID-19, there are gaps in the literature, including biosafety and the laboratory role in screening and prevention of COVID-19. There is a gap in the publication of papers focused on guidelines for the laboratory. Our findings suggest that, despite the large number of publications related to laboratory data and their use in COVID-19 disease, many areas remain unexplored or under-reported.
