Hematological findings and complications of COVID-19.
Evangelos Terpos,Ioannis Ntanasis-Stathopoulos,Ismail Elalamy,Efstathios Kastritis,Theodoros N. Sergentanis,Marianna Politou,Theodora Psaltopoulou,Grigoris T. Gerotziafas,Meletios A. Dimopoulos +8 more
TLDR
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.Abstract:
COVID-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.read more
Citations
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Journal ArticleDOI
Extrapulmonary manifestations of COVID-19.
Aakriti Gupta,Aakriti Gupta,Mahesh V. Madhavan,Kartik Sehgal,Kartik Sehgal,Nandini Nair,Shiwani Mahajan,Tejasav S. Sehrawat,Behnood Bikdeli,Behnood Bikdeli,Neha Ahluwalia,John C. Ausiello,Elaine Wan,Daniel E. Freedberg,Ajay J. Kirtane,Sahil A. Parikh,Mathew S. Maurer,Anna S. Nordvig,Domenico Accili,Joan M. Bathon,Sumit Mohan,Kenneth A. Bauer,Kenneth A. Bauer,Martin B. Leon,Harlan M. Krumholz,Nir Uriel,Mandeep R. Mehra,Mitchell S.V. Elkind,Mitchell S.V. Elkind,Gregg W. Stone,Allan Schwartz,David D. Ho,John P. Bilezikian,Donald W. Landry +33 more
TL;DR: The extrapulmonary organ-specific pathophysiology, presentations and management considerations for patients with COVID-19 are reviewed to aid clinicians and scientists in recognizing and monitoring the spectrum of manifestations, and in developing research priorities and therapeutic strategies for all organ systems involved.
Journal ArticleDOI
Immunology of COVID-19: Current State of the Science.
Nicolas Vabret,Graham J. Britton,Conor Gruber,Samarth Hegde,Joel Kim,Maria Kuksin,Rachel Levantovsky,Louise Malle,Alvaro Moreira,Matthew D. Park,Luisanna Pia,Emma Risson,Miriam Saffern,Bérengère Salomé,Myvizhi Esai Selvan,Matthew P. Spindler,Jessica Tan,Verena van der Heide,Jill Gregory,Konstantina Alexandropoulos,Nina Bhardwaj,Brian D. Brown,Benjamin Greenbaum,Zeynep H. Gümüş,Dirk Homann,Amir Horowitz,Alice O. Kamphorst,Maria A. Curotto de Lafaille,Saurabh Mehandru,Miriam Merad,Robert M. Samstein,Manasi Agrawal,Mark Aleynick,Meriem Belabed,Matthew Brown,Maria Casanova-Acebes,Jovani Catalan,Monica Centa,Andrew Charap,Andrew K Chan,Steven T. Chen,Jonathan Chung,Cansu Cimen Bozkus,Evan Cody,Francesca Cossarini,Erica Dalla,Nicolas F. Fernandez,John A. Grout,Dan Fu Ruan,Pauline Hamon,Etienne Humblin,Divya Jha,Julia Kodysh,Andrew Leader,Matthew Lin,Katherine E. Lindblad,Daniel Lozano-Ojalvo,Gabrielle Lubitz,Assaf Magen,Zafar Mahmood,Gustavo Martinez-Delgado,Jaime Mateus-Tique,Elliot Meritt,Chang Moon,Justine Noel,Timothy O'Donnell,Miyo Ota,Tamar Plitt,Venu Pothula,Jamie Redes,Ivan Reyes Torres,Mark P. Roberto,Alfonso R. Sanchez-Paulete,Joan Shang,Alessandra Soares Schanoski,Maria Suprun,Michelle Tran,Natalie Vaninov,C. Matthias Wilk,Julio A. Aguirre-Ghiso,Dusan Bogunovic,Judy H. Cho,Jeremiah J. Faith,Emilie K. Grasset,Peter S. Heeger,Ephraim Kenigsberg,Florian Krammer,Uri Laserson +87 more
TL;DR: The current state of knowledge of innate and adaptive immune responses elicited by SARS-CoV-2 infection and the immunological pathways that likely contribute to disease severity and death are summarized.
Journal ArticleDOI
Neutrophil extracellular traps contribute to immunothrombosis in COVID-19 acute respiratory distress syndrome.
Elizabeth A. Middleton,Xue-Yan He,Frederik Denorme,Robert A. Campbell,David Ng,Steven P. Salvatore,Steven P. Salvatore,Maria Mostyka,Amelia Baxter-Stoltzfus,Alain C. Borczuk,Alain C. Borczuk,Massimo Loda,Massimo Loda,Mark J. Cody,Bhanu Kanth Manne,Irina Portier,Estelle S. Harris,Aaron C. Petrey,Ellen J. Beswick,Aleah F. Caulin,Anthony J. Iovino,Lisa M. Abegglen,Andrew S. Weyrich,Matthew T. Rondina,Mikala Egeblad,Joshua D. Schiffman,Christian C. Yost +26 more
TL;DR: NETs triggering immunothrombosis may, in part, explain the prothrombotic clinical presentations in COVID-19, and NETs may represent targets for therapeutic intervention.
Journal ArticleDOI
Why does COVID-19 disproportionately affect older people?
TL;DR: The molecular differences between young, middle-aged and older people that may explain why COVID-19 is a mild illness in some but life-threatening in others are presented and treatments that could increase the survival of older people are discussed.
References
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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Chaolin Huang,Yeming Wang,Xingwang Li,Lili Ren,Jianping Zhao,Yi Hu,Li Zhang,Guohui Fan,Jiuyang Xu,Xiaoying Gu,Zhenshun Cheng,Ting Yu,Jia'an Xia,Yuan Wei,Wenjuan Wu,Xuelei Xie,Wen Yin,Li Hui,Min Liu,Yan Xiao,Hong Gao,Li Guo,Jungang Xie,Guang-Fa Wang,Rongmeng Jiang,Zhancheng Gao,Qi Jin,Jianwei Wang,Bin Cao +28 more
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Journal ArticleDOI
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Wang et al. as discussed by the authors used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death, including older age, high SOFA score and d-dimer greater than 1 μg/mL.
Journal ArticleDOI
Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.
Dawei Wang,Bo Hu,Chang Hu,Fangfang Zhu,Xing Liu,Jing Zhang,Binbin Wang,Hui Xiang,Zhenshun Cheng,Yong Xiong,Yan Zhao,Yirong Li,Xinghuan Wang,Zhiyong Peng +13 more
TL;DR: The epidemiological and clinical characteristics of novel coronavirus (2019-nCoV)-infected pneumonia in Wuhan, China, and hospital-associated transmission as the presumed mechanism of infection for affected health professionals and hospitalized patients are described.
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