The Effect of SARS-COV-2 Infection on the Hematological Markers

Fatahi, Seyed Majid; Khanizadeh, Sayyad; Safarzadeh, Ali; Alamdary, Ashkan; Razavi Nikoo, Hadi; Mohammadi, Rasool; Ghalandarian, Annahita; Ajorloo, Mehdi

doi:10.30699/ijmm.17.2.202

year 17, Issue 2 (March - April 2023) Iran J Med Microbiol 2023, 17(2): 202-210 | Back to browse issues page

‎ 10.30699/ijmm.17.2.202

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Fatahi S M, Khanizadeh S, Safarzadeh A, Alamdary A, Razavi Nikoo H, Mohammadi R, et al . The Effect of SARS-COV-2 Infection on the Hematological Markers. Iran J Med Microbiol 2023; 17 (2) :202-210
URL: http://ijmm.ir/article-1-1803-en.html

The Effect of SARS-COV-2 Infection on the Hematological Markers

Seyed Majid Fatahi¹

, Sayyad Khanizadeh²

, Ali Safarzadeh³

, Ashkan Alamdary⁴

, Hadi Razavi Nikoo⁵

, Rasool Mohammadi⁶

, Annahita Ghalandarian¹

, Mehdi Ajorloo

⁷

1- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
2- Department of Virology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
3- Department of Biology, University of Padova, Padova, Italy
4- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
5- Infectious Disease Research Center, Golestan University of Medical Sciences, Gorgan, Iran
6- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
7- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran , kmehdiajorloo@gmail.com

Abstract: (1467 Views)

Background and Aim: The novel coronavirus 2019 can lead to a vast range of respiratory complications, from mild to severe, driving to acute respiratory distress syndrome (ARDS). Common symptoms of COVID-19 include fever, fatigue, and dry cough, which can lead to complications, such as gastrointestinal disorders, and liver, cardiac, and renal dysfunctions. Alteration in the hematological markers is one of the COVID-19 diseases evaluated by our study.
Materials and Methods: In this study, hematological markers, including the levels of ESR, BS, Hb, HCT, MCV, MCH, MCHC, platelet, WBC, RBC, neutrophil, and lymphocyte, have been assessed and compared in both case and control groups. Furthermore, we assessed the associations between hematological parameters, clinical manifestations, and underlying medical conditions.
Results: Our data showed that RBC, HCT, and ESR were significantly associated with the novel coronavirus 2019 infection according to the disease progression. ESR (P= 0.022), Hb (P= 0.032), and BS (P= 0.01) levels in male people infected by SARS-CoV-2 proved to have a significant relationship with the control group. Moreover, BS, Hb, HCT, ESR, and neutrophil showed significant variations in diabetic individuals suffering from SARS-CoV-2 infection.
Conclusion: The dropping of the hematological markers in COVID-19 is linked with a noticeably increased mortality rate, while high neutrophil and BS levels are related to aggravation of the disease. Monitoring the hematological markers can contribute significantly to selecting the proper treatment and hamper of disease worsening.

Keywords: COVID-19, SARS-CoV-2, Hematological, Marker

Full-Text [PDF 539 kb] (351 Downloads) | | Full-Text (HTML) (298 Views)

Type of Study: Original Research Article | Subject: Medical Virology
Received: 2022/08/28 | Accepted: 2022/12/26 | ePublished: 2023/03/30

References

1. Jia Z, Yan L, Ren Z, Wu L, Wang J, Guo J, et al. Delicate structural coordination of the Severe Acute Respiratory Syndrome coronavirus Nsp13 upon ATP hydrolysis. Nucleic Acids Res. 2019;47(12):6538-50. [DOI:10.1093/nar/gkz409] [PMID] [PMCID]

2. World Health Organization. Rolling updates on coronavirus disease (COVID-19) 2020 [Available from: [https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they]

3. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. [DOI:10.1001/jama.2020.2648] [PMID]

4. Wordometer. Covid-19 coronavirus pandemic 2020 [Available from: [https://www.worldometers.info/coronavirus/]

5. Li T, Lu H, Zhang W. Clinical observation and management of COVID-19 patients. Emerg Microbes Infect. 2020;9(1):687-90. [DOI:10.1080/22221751.2020.1741327] [PMID] [PMCID]

6. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020;12(1):8. [DOI:10.1038/s41368-020-0074-x] [PMID] [PMCID]

7. Wang X, Xu W, Hu G, Xia S, Sun Z, Liu Z, et al. Retraction Note to: SARS-CoV-2 infects T lymphocytes through its spike protein-mediated membrane fusion. Cell Mol Immunol. 2020;17(8):894. [DOI:10.1038/s41423-020-0498-4] [PMID] [PMCID]

8. Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L, et al. Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia. J Infect Dis. 2020;221(11):1762-9. [DOI:10.1093/infdis/jiaa150] [DOI:10.1093/infdis/jiw010] [PMCID]

9. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43. [DOI:10.1001/jamainternmed.2020.0994] [PMID] [PMCID]

10. Singh S, Sharma A, Arora SK. High producer haplotype (CAG) of -863C/A, -308G/A and -238G/A polymorphisms in the promoter region of TNF-α gene associate with enhanced apoptosis of lymphocytes in HIV-1 subtype C infected individuals from North India. PLoS One. 2014;9(5):e98020. [DOI:10.1371/journal.pone.0098020] [PMID] [PMCID]

11. Liao YC, Liang WG, Chen FW, Hsu JH, Yang JJ, Chang MS. IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha. J Immunol (Baltimore, Md : 1950). 2002;169(8):4288-97. [DOI:10.4049/jimmunol.169.8.4288] [PMID]

12. Aggarwal S, Gollapudi S, Gupta S. Increased TNF-alpha-induced apoptosis in lymphocytes from aged humans: changes in TNF-alpha receptor expression and activation of caspases. J Immunol (Baltimore, Md : 1950). 1999;162(4):2154-61. [DOI:10.4049/jimmunol.162.4.2154]

13. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(23):2950-73. [DOI:10.1016/j.jacc.2020.04.031] [PMID] [PMCID]

14. Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and Multiorgan Response. Curr Probl Cardiol. 2020;45(8):100618. [DOI:10.1016/j.cpcardiol.2020.100618] [PMID] [PMCID]

15. Das R, Sharma P. Chapter 18 - Disorders of abnormal hemoglobin. In: Kumar D, editor. Clinical Molecular Medicine. 2020. p. 327-39. [DOI:10.1016/B978-0-12-809356-6.00018-6] [PMCID]

16. Kazazian HH, Jr., Woodhead AP. Hemoglobin A synthesis in the developing fetus. N Engl J Med. 1973;289(2):58-62. [DOI:10.1056/NEJM197307122890202] [PMID]

17. Wenzhong l, Hualan L. COVID-19:Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism. 2020. [DOI:10.26434/chemrxiv.11938173] [PMID]

18. Yang M, Ng MH, Li CK. Thrombocytopenia in patients with severe acute respiratory syndrome (review). Hematology. 2005;10(2):101-5. [DOI:10.1080/10245330400026170] [PMID]

19. He WQ, Chen SB, Liu XQ, Li YM, Xiao ZL, Zhong NS. Death risk factors of severe acute respiratory syndrome with acute respiratory distress syndrome. Chin Crit Care Med (Zhongguo wei zhong bing ji jiu yi xue). 2003;15(6):336-7.

20. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. [DOI:10.1001/jama.2020.1585] [PMID] [PMCID]

21. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. [DOI:10.1056/NEJMoa2002032] [PMID] [PMCID]

22. Yuan X, Huang W, Ye B, Chen C, Huang R, Wu F, et al. Changes of hematological and immunological parameters in COVID-19 patients. Int J Hematol. 2020;112(4):553-9. [DOI:10.1007/s12185-020-02930-w] [PMID] [PMCID]

23. Zhu Y, Cao X, Tao G, Xie W, Hu Z, Xu D. The lymph index: a potential hematological parameter for viral infection. Int J Infect Dis. 2013;17(7):e490-3. [DOI:10.1016/j.ijid.2012.12.002] [PMID]

24. Rabaan AA, Al-Ahmed SH, Haque S, Sah R, Tiwari R, Malik YS, et al. SARS-CoV-2, SARS-CoV, and MERS-COV: A comparative overview. Le infezioni in medicina. 2020;28(2):174-84.

25. Al-Tawfiq JA, Hinedi K, Abbasi S, Babiker M, Sunji A, Eltigani M. Hematologic, hepatic, and renal function changes in hospitalized patients with Middle East respiratory syndrome coronavirus. Int J Lab Hematol. 2017;39(3):272-8. [DOI:10.1111/ijlh.12620] [PMID] [PMCID]

26. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-2. [DOI:10.1016/S2213-2600(20)30076-X] [PMID]

27. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-8. [DOI:10.1093/cid/ciaa248] [PMID] [PMCID]

28. Deng Y, Liu W, Liu K, Fang YY, Shang J, Zhou L, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: a retrospective study. Chin Med J. 2020;133(11):1261-7. [DOI:10.1097/CM9.0000000000000824] [PMID] [PMCID]

29. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. [DOI:10.1016/S0140-6736(20)30566-3]

30. Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):33. [DOI:10.1038/s41392-020-0148-4] [DOI:10.1038/s41392-020-0159-1]

31. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):E131-e4. [DOI:10.1002/ajh.25774]

32. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47. [DOI:10.1002/ajh.25829] [PMID] [PMCID]

33. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81. [DOI:10.1016/S2213-2600(20)30079-5] [PMID]

34. Chow N, Fleming, Dutra K, Gierke R, Hall A, Hughes M, et al. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 - United States, February 12-March 28, 2020. Morb Mortal Wkly Rep (MMWR). 2020;69(13):382-6. [DOI:10.15585/mmwr.mm6913e2] [PMID] [PMCID]

35. Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020;18(1):206. [DOI:10.1186/s12967-020-02374-0] [PMID] [PMCID]

36. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. [DOI:10.1016/S0140-6736(20)30183-5]

37. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-41. [DOI:10.1111/all.14238] [PMID]

38. Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47(3):193-9. [DOI:10.1007/s00592-009-0109-4] [PMID] [PMCID]