Hematological findings and complications of COVID‐19

American Journal of Hematology - Tập 95 Số 7 - Trang 834-847 - 2020
Evangelos Terpos1, Ioannis Ntanasis‐Stathopoulos1, Ismaı̈l Elalamy2,3,4, Efstathios Kastritis1, Theodoros Ν. Sergentanis1, Marianna Politou5, Θεοδώρα Ψαλτοπούλου1, Grigoris T. Gerotziafas4,6, Meletios Α. Dimopoulos1
1Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
2Centre de Recherche Saint-Antoine
3Department of Obstetrics and Gynaecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
4Hematology and Thrombosis Center, Tenon University Hospital, Sorbonne University, INSERM U938, Sorbonne University, Paris, France
5Hematology Laboratory‐Blood Bank, Aretaieio Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece
6Research Group “Cancer, Haemostasis and Angiogenesis,” INSERM U938, Centre de Recherche Saint‐Antoine Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University Paris France

Tóm tắt

AbstractCOVID‐19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential. Neutrophil/lymphocyte ratio and peak platelet/lymphocyte ratio may also have prognostic value in determining severe cases. During the disease course, longitudinal evaluation of lymphocyte count dynamics and inflammatory indices, including LDH, CRP and IL‐6 may help to identify cases with dismal prognosis and prompt intervention in order to improve outcomes. Biomarkers, such high serum procalcitonin and ferritin have also emerged as poor prognostic factors. Furthermore, blood hypercoagulability is common among hospitalized COVID‐19 patients. Elevated D‐Dimer levels are consistently reported, whereas their gradual increase during disease course is particularly associated with disease worsening. Other coagulation abnormalities such as PT and aPTT prolongation, fibrin degradation products increase, with severe thrombocytopenia lead to life‐threatening disseminated intravascular coagulation (DIC), which necessitates continuous vigilance and prompt intervention. So, COVID‐19 infected patients, whether hospitalized or ambulatory, are at high risk for venous thromboembolism, and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended. Last but not least, the need for assuring blood donations during the pandemic is also highlighted.

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