Binsaleh Naif K, Eltayeb Reem, Sherwani Subuhi, Almishaal Ali A, Hindi Emad A, Qanash Husam, Bazaid Abdulrahman S, Alharbi Abdulmajeed Owayed, Bazaid Mohammed B, Altamimi Shayaa Alsaadi
Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Ha'il, Hail, Saudi Arabia.
Medical and Diagnostic Research Centre, University of Ha'il, Hail, 55476, Saudi Arabia.
Int J Gen Med. 2023 Aug 31;16:3955-3962. doi: 10.2147/IJGM.S421418. eCollection 2023.
Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a communicable disease transmitted through the respiratory route and bodily contact. The severity of infection and mortality rate of COVID-19 cases was significantly high in the initial stages of the pandemic. This study aims to investigate the hematological profile of COVID-19 survivors and non-survivors.
This is a single-center retrospective study. A total of 108 hospitalized patients with laboratory-confirmed COVID-19 at East Jeddah Hospital between April and August 2020 were categorized into two groups based on outcome as survivors (n = 54) and non-survivors (n = 54). Hematological parameters and clinical profiles were analyzed and compared between the two groups.
The mean age and standard deviation of the survived (30-71 years) and non-survived (33-83) groups was 53 ± 10.8 and 57.9 ± 12.2 years, respectively, with no statistically significant difference in age between groups (p = 0.0513). Non-survivors had a significantly longer median length of stay in the intensive care unit (ICU) (7 days, IQR: 4.24 to 12) compared to survivors COVID-19 patients (5 days, IQR: 0 to 11.75) (p = 0.0151). For the survivors group, the participant's age positively correlated with the length of hospital stay (r(52) = 0.21, p = 0.0005) and ICU length of stay r(52) = 0.18, p = 0.001). The median red blood cells (RBC) counts were significantly higher in the survived group (4.56x10/L, IQR: 4.02 to 5.11) in comparison with the non-survived (4.23x10/L, IQR: 3.75 to 4.23) group (p = 0.0011). All COVID-19 patients exhibited lymphocytopenia and a significant negative correlation was observed between the lymphocyte values and length of hospital stay among the survived group (p < 0.001) as well as length of ICU stay among the survived group (p < 0.0480). Disease-related mortality was significantly associated with reduced white blood cells (WBCs) (8.5×10/L, IQR: 6.1 to 11.7) and reduced basophils (0.09%, IQR: 0.02 to 0.19). Additionally, statistically significant differences were found between the survived and non-survived groups with respect to prothrombin time (PT) (12.5 sec. vs 14 sec., p < 0.0001) and partial thromboplastin time (PTT) (31.8 sec. vs 40 sec., p = 0.0008).
Hematological parameters can serve as valuable indicators to identify patients with severe COVID-19 and expected poor-prognosis/outcomes upon hospital admission. Cell counts of lymphocytes, WBCs, basophils and parameters such as PT and PTT can serve as clinical indicators to assess disease severity and predict progression to critical illness.
2019冠状病毒病由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，是一种通过呼吸道和身体接触传播的传染病。在疫情初期，COVID-19病例的感染严重程度和死亡率显著较高。本研究旨在调查COVID-19幸存者和非幸存者的血液学特征。
这是一项单中心回顾性研究。2020年4月至8月期间，在吉达东部医院共108例实验室确诊的COVID-19住院患者根据结局分为两组，即幸存者（n = 54）和非幸存者（n = 54）。分析并比较两组的血液学参数和临床特征。
存活组（30 - 71岁）和非存活组（33 - 83岁）的平均年龄和标准差分别为53 ± 10.8岁和57.9 ± 12.2岁，两组之间年龄无统计学显著差异（p = 0.0513）。与COVID-19存活患者（5天，四分位间距：0至11.75）相比，非幸存者在重症监护病房（ICU）的中位住院时间显著更长（7天，四分位间距：4.24至12）（p = 0.0151）。对于存活组，参与者年龄与住院时间呈正相关（r(52) = 0.21，p = 0.0005）以及与ICU住院时间呈正相关（r(52) = 0.18，p = 0.001）。存活组的红细胞（RBC）计数中位数（4.56×10/L，四分位间距：4.02至5.11）显著高于非存活组（4.23×10/L，四分位间距：3.75至4.23）（p = 0.0011）。所有COVID-19患者均表现出淋巴细胞减少，并且在存活组中观察到淋巴细胞值与住院时间之间存在显著负相关（p < 0.001）以及与存活组的ICU住院时间之间存在显著负相关（p < 0.0480）。疾病相关死亡率与白细胞（WBC）减少（8.5×10/L，四分位间距：6.1至11.7）和嗜碱性粒细胞减少（0.09%，四分位间距：0.02至0.19）显著相关。此外，在存活组和非存活组之间，凝血酶原时间（PT）（12.5秒对14秒，p < 0.0001）和活化部分凝血活酶时间（PTT）（31.8秒对40秒，p = 0.0008）存在统计学显著差异。
血液学参数可作为识别严重COVID-19患者以及入院时预后不良/结局不佳患者的有价值指标。淋巴细胞、WBC、嗜碱性粒细胞的细胞计数以及PT和PTT等参数可作为评估疾病严重程度和预测进展为危重病的临床指标。
