Mara Gabriela, Nini Gheorghe, Cotoraci Coralia
Multidisciplinary Doctoral School, Vasile Goldis Western University of Arad, 310414 Arad, Romania.
Pneumology Department, Vasile Goldis Western University of Arad, 310414 Arad, Romania.
J Clin Med. 2025 Apr 17;14(8):2765. doi: 10.3390/jcm14082765.
Chronic obstructive pulmonary disease (COPD) patients are at heightened risk of severe COVID-19 due to underlying respiratory impairment, systemic inflammation, and immune dysregulation. This review explores the hematological changes that occur in COPD patients with COVID-19 and their implications for disease progression, prognosis, and clinical management. We conducted a comprehensive analysis of recent peer-reviewed studies from medical databases including Clarivate Analytics, PubMed, and Google Scholar. Hematological alterations, such as lymphopenia, elevated neutrophil-to-lymphocyte ratio (NLR), increased D-dimer and fibrinogen levels, inflammatory anemia, and erythrocyte dysfunction, are commonly observed in COPD patients with COVID-19. These changes are linked to immune suppression, hyperinflammation, oxidative stress, and thromboembolic complications. Hematological biomarkers are valuable tools for early risk assessments and guiding treatment strategies in this high-risk population. The regular monitoring of D-dimer, fibrinogen, and NLR is advisable. Prophylactic anticoagulation and immunomodulatory therapies, such as corticosteroids and IL-6 and IL-1 inhibitors, may improve clinical outcomes. Further clinical studies are needed to validate personalized approaches and explore antioxidant-based interventions.
慢性阻塞性肺疾病（COPD）患者由于潜在的呼吸功能损害、全身炎症和免疫失调，患重症 COVID-19 的风险更高。本综述探讨了 COVID-19 合并 COPD 患者发生的血液学变化及其对疾病进展、预后和临床管理的影响。我们对来自包括科睿唯安分析、PubMed 和谷歌学术在内的医学数据库中最近经过同行评审的研究进行了全面分析。在 COVID-19 合并 COPD 患者中，常见血液学改变，如淋巴细胞减少、中性粒细胞与淋巴细胞比值（NLR）升高、D-二聚体和纤维蛋白原水平增加、炎症性贫血和红细胞功能障碍。这些变化与免疫抑制、过度炎症、氧化应激和血栓栓塞并发症有关。血液学生物标志物是对这一高危人群进行早期风险评估和指导治疗策略的有价值工具。建议定期监测 D-二聚体、纤维蛋白原和 NLR。预防性抗凝和免疫调节治疗，如使用皮质类固醇以及 IL-6 和 IL-1 抑制剂，可能会改善临床结局。需要进一步的临床研究来验证个性化方法并探索基于抗氧化剂的干预措施。
