1Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
2Department of Zoology and Environment Sciences, Faculty of Science, University of Colombo, Colombo, Sri Lanka.
Am J Trop Med Hyg. 2021 Feb 19;104(4):1188-1201. doi: 10.4269/ajtmh.20-1536.
COVID-19 is caused by SARS-CoV-2. Although pulmonary manifestations have been identified as the major symptoms, several hematological abnormalities have also been identified. This review summarizes the reported hematological abnormalities (changes in platelet, white blood cell, and hemoglobin, and coagulation/fibrinolytic alterations), explores their patho-mechanisms, and discusses its management. Common hematological abnormalities in COVID-19 are lymphopenia, thrombocytopenia, and elevated D-dimer levels. These alterations are significantly more common/prominent in patients with severe COVID-19 disease, and thus may serve as a possible biomarker for those needing hospitalization and intensive care unit care. Close attention needs to be paid to coagulation abnormalities, and steps should be taken to prevent these occurring or to mitigate their harmful effects. The effect of COVID-19 in patients with hematological abnormalities and recognized hematological drug toxicities of therapies for COVID-19 are also outlined.
新型冠状病毒肺炎(COVID-19)由严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)引起。虽然肺部表现已被确定为主要症状,但也已发现几种血液学异常。本综述总结了已报道的血液学异常(血小板、白细胞和血红蛋白的变化,以及凝血/纤维蛋白溶解的改变),探讨了其发病机制,并讨论了其管理。COVID-19 常见的血液学异常包括淋巴细胞减少、血小板减少和 D-二聚体水平升高。这些改变在重症 COVID-19 患者中更为常见/突出,因此可能成为需要住院和重症监护治疗的患者的一个潜在生物标志物。应密切关注凝血异常,并采取措施预防其发生或减轻其有害影响。本文还概述了 COVID-19 对血液学异常患者的影响,以及 COVID-19 治疗中已认识到的血液学药物毒性。