Mousavi Seied Asadollah, Rad Soroush, Rostami Tahereh, Rostami Mohammadreza, Mousavi Seyed Ali, Mirhoseini Seied Amirhosein, Kiumarsi Azadeh
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Hematology. 2020 Dec;25(1):383-388. doi: 10.1080/16078454.2020.1833435.
: The first cases of proved COVID-19 in Iran were reported in February 2020 and has since rapidly spread worldwide. We aimed to clarify the clinical significance of hematologic parameters alteration in COVID-19. : Different hematologic parameters were measured in 225 hospitalized COVID-19 patients in a tertiary care university hospital, during the peak of COVID-19 outbreak and their association with duration of hospitalization, ICU admission and especially mortality was analyzed. : Among a total of 225 patients, 24.4% did not survive after admission. Lymphopenia and neutrophilia were observed in 52.7% and 21.4% of the patients, respectively. The mean count of neutrophils was significantly higher in non-survived patients ( = .032). Elevated neutrophil-to-lymphocyte ratio (NLR) was significantly associated with mortality ( < .001). Low hemoglobin (Hb) concentration significantly correlated with mortality ( = .004) and ICU admission ( = .04). Platelet (Plt) count was significantly lower in the non-survived patients ( = .023). Non-survivors had significantly lower nadir Hb and Plt counts than survivors ( < .001 in both parameters). Platelet-to-lymphocyte ratio (PLR) also correlated with mortality and was significantly higher in non-survivors ( = .034). : Hematologic laboratory parameters have always been a crucial component of diagnostic and therapeutic strategies in infectious disease. Hematologic predictors of a fatal outcome in COVID19 hospitalized patients in our series include elevated NLR and PLR, lower than normal Hb and Plt, elevated d-dimer and prolonged prothrombin time (PT), together with elevated inflammatory indicators in the blood.
2020年2月，伊朗报告了首例确诊的新冠病毒病病例，此后迅速在全球传播。我们旨在阐明新冠病毒病血液学参数改变的临床意义。在一家三级护理大学医院，对225例住院的新冠病毒病患者在疫情高峰期测量了不同的血液学参数，并分析了这些参数与住院时间、入住重症监护病房（ICU）情况，尤其是死亡率的关联。在总共225例患者中，24.4%的患者入院后未存活。分别有52.7%和21.4%的患者出现淋巴细胞减少和中性粒细胞增多。未存活患者的中性粒细胞平均计数显著更高（P = 0.032）。中性粒细胞与淋巴细胞比值（NLR）升高与死亡率显著相关（P < 0. < 0.001）。低血红蛋白（Hb）浓度与死亡率（P = 0.004）和入住ICU情况（P = 0.04）显著相关。未存活患者的血小板（Plt）计数显著更低（P = 0.023）。非存活者的最低Hb和Plt计数显著低于存活者（两个参数的P均< 0.001）。血小板与淋巴细胞比值（PLR）也与死亡率相关，且在非存活者中显著更高（P = 0.034）。血液学实验室参数一直是传染病诊断和治疗策略的关键组成部分。在我们的系列研究中，新冠病毒病住院患者死亡结局的血液学预测指标包括升高的NLR和PLR、低于正常的Hb和Plt、升高的D-二聚体和延长的凝血酶原时间（PT），以及血液中升高的炎症指标。
