HAEMATOLOGICAL PARAMETERS AND OUTCOME IN HOSPITALIZED PATIENTS WITH COVID-19: A DEVELOPING COUNTRY EXPERIENCE

Authors

  • Raheel Iftikhar AFBMTC/NIBMT
  • Sultan Mehmood Kamran Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Zill-e-Humayun Mirza Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Arshad Naseem Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Syed Asif Ali Shah Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi
  • Sidra Riaz Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Imran Fazal Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Wasim Alamgir Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Farrukh Saeed Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Salman Saleem Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Rao Saad Ali Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Qamar Chaudhry Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a multisystem disorder and haematological abnormalities are frequently documented in affected patients. Methods: This retrospective study included 549 patients hospitalized with COVID-19 from 1st June to 15th July 2020 at Pak Emirates hospital, Rawalpindi Pakistan. p<0.05 was considered statistically significant. Results: Median age was 60 years (range 12–94 years), males 442 (80.5%) and females 107 (19.5%). There was no patient with mild illness, 181 (32.9%) had moderate, 158 (28.7%) severe and 210 (38.2%) patients had critical disease. Patients with severe and critical disease had lower absolute lymphocyte count (ALC) and platelets (p<0.001 for both) while higher white blood cell count (WBC), neutrophil lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6) and lactate dehydrogenase levels (LDH) levels (all p<0.001). Overall survival of study cohort was 83.2%(n=457). Median haemoglobin and platelet count were significantly lower (p<0.001) while WBC, ANC, NLR, prothrombin time (PT), activated partial thromboplastin time (APTT), ferritin, IL-6, LDH were significantly higher (p<0.001) for patients who died.  On multivariate logistic regression analysis WBC count>10x109/l (odds ratio [OR] 2.19 [95% CI 1.3–4.2] p=0.01), NLR>9 (OR 3.4 [95% CI 0.87–6.8], p<0.001), platelets<150x109/l (OR 3.9 [95% CI 1.4–9.8] p<0.001), CRP >100; (OR 4.1[95% CI 0.78-10.9] p<0.001) and ferritin >1000 (OR 5.3 [95% CI 1.9–13.5], p<0.001) were associated with increased risk of death in patients with COVID-19. Conclusion: Monitoring of haematological, coagulation and inflammatory parameters provide reliable, convenient, rapid and cost-effective method for predicting disease severity, complications and prognosis of COVID-19 patients.

Author Biographies

Raheel Iftikhar, AFBMTC/NIBMT

Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi

Sultan Mehmood Kamran, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Zill-e-Humayun Mirza, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Arshad Naseem, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Syed Asif Ali Shah, Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi

Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi-Pakistan

Sidra Riaz, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Imran Fazal, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Wasim Alamgir, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Farrukh Saeed, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Salman Saleem, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Rao Saad Ali, Pak Emirates Military Hospital, Rawalpindi-Pakistan

Pak Emirates Military Hospital, Rawalpindi-Pakistan

Qamar Chaudhry, Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi

Armed Forces Bone Marrow Transplant Centre, National Institute of Blood and Marrow Transplant, Rawalpindi-Pakistan

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Published

2021-06-28

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