Hematologic Disorders Associated with COVID-19: a Review

Overview

Journal Ann Hematol

Specialty Hematology

Date 2021 Jan 8

PMID 33415422

Citations 51

Authors

Mandeep Singh Rahi

Vishal Jindal

Sandra-Patrucco Reyes

Kulothungan Gunasekaran

Ruby Gupta

Ishmael Jaiyesimi

Affiliations

Soon will be listed here.

Abstract

Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2. Primarily an infection of the lower respiratory tract, it is now well known to cause multisystem abnormalities. Hematologic manifestations constitute a significant area of concern. Severe acute respiratory syndrome coronavirus 2 infects monocytes and endothelial cells leading to a complex downstream cascade, cytokine storm, and eventual intravascular thrombosis. Coronavirus disease 2019 causes lymphopenia, neutrophilia, and thrombocytopenia. Prophylactic anticoagulation is vital in patients with coronavirus disease 2019, as its effect on the coagulation system is associated with significant morbidity and mortality. The disease can cause both arterial and venous thromboses, especially pulmonary embolism and pulmonary microthrombi. A high index of suspicion is indispensable in recognizing these complications, and timely institution of therapeutic anticoagulation is vital in treating them. Virus-induced disseminated intravascular coagulation is uncommon but shares some similarities to sepsis-induced disseminated intravascular coagulation. Marked elevations in hematologic biomarkers such as lactate dehydrogenase, D-dimer, ferritin, and C-reactive protein are associated with worse outcomes. Understanding the pathophysiology and recognizing factors associated with poor prognosis are crucial in improving patient outcomes with coronavirus disease 2019.

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References

Bashash D, Hosseini-Baharanchi F, Rezaie-Tavirani M, Safa M, Dilmaghani N, Faranoush M . The Prognostic Value of Thrombocytopenia in COVID-19 Patients; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2020; 8(1):e75. PMC: 7587988. View

Lippi G, Plebani M, Henry B . Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020; 506:145-148. PMC: 7102663. DOI: 10.1016/j.cca.2020.03.022. View

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J . Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18):1708-1720. PMC: 7092819. DOI: 10.1056/NEJMoa2002032. View

Henry B, de Oliveira M, Benoit S, Plebani M, Lippi G . Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020; 58(7):1021-1028. DOI: 10.1515/cclm-2020-0369. View

Tang N, Bai H, Chen X, Gong J, Li D, Sun Z . Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020; 18(5):1094-1099. PMC: 9906401. DOI: 10.1111/jth.14817. View

Jiang Y, Zhao G, Song N, Li P, Chen Y, Guo Y . Blockade of the C5a-C5aR axis alleviates lung damage in hDPP4-transgenic mice infected with MERS-CoV. Emerg Microbes Infect. 2018; 7(1):77. PMC: 5915580. DOI: 10.1038/s41426-018-0063-8. View

Papageorgiou C, Jourdi G, Adjambri E, Walborn A, Patel P, Fareed J . Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies. Clin Appl Thromb Hemost. 2018; 24(9_suppl):8S-28S. PMC: 6710154. DOI: 10.1177/1076029618806424. View

Bowles L, Platton S, Yartey N, Dave M, Lee K, Hart D . Lupus Anticoagulant and Abnormal Coagulation Tests in Patients with Covid-19. N Engl J Med. 2020; 383(3):288-290. PMC: 7217555. DOI: 10.1056/NEJMc2013656. View

Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L . Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia. J Infect Dis. 2020; 221(11):1762-1769. PMC: 7184346. DOI: 10.1093/infdis/jiaa150. View

10.

Liu Y, Du X, Chen J, Jin Y, Peng L, Wang H . Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020; 81(1):e6-e12. PMC: 7195072. DOI: 10.1016/j.jinf.2020.04.002. View

11.

Iba T, Levy J, Raj A, Warkentin T . Advance in the Management of Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation. J Clin Med. 2019; 8(5). PMC: 6572234. DOI: 10.3390/jcm8050728. View

12.

Yu B, Li X, Chen J, Ouyang M, Zhang H, Zhao X . Evaluation of variation in D-dimer levels among COVID-19 and bacterial pneumonia: a retrospective analysis. J Thromb Thrombolysis. 2020; 50(3):548-557. PMC: 7286212. DOI: 10.1007/s11239-020-02171-y. View

13.

Zhang C, Wang X, Li S, Twelkmeyer T, Wang W, Zhang S . NKG2A is a NK cell exhaustion checkpoint for HCV persistence. Nat Commun. 2019; 10(1):1507. PMC: 6447531. DOI: 10.1038/s41467-019-09212-y. View

14.

Lin Z, Long F, Yang Y, Chen X, Xu L, Yang M . Serum ferritin as an independent risk factor for severity in COVID-19 patients. J Infect. 2020; 81(4):647-679. PMC: 7313486. DOI: 10.1016/j.jinf.2020.06.053. View

15.

Henry B, Vikse J, Benoit S, Favaloro E, Lippi G . Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis. Clin Chim Acta. 2020; 507:167-173. PMC: 7195008. DOI: 10.1016/j.cca.2020.04.027. View

16.

Long H, Nie L, Xiang X, Li H, Zhang X, Fu X . D-Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID-19 and Poor Prognosis. Biomed Res Int. 2020; 2020:6159720. PMC: 7301188. DOI: 10.1155/2020/6159720. View

17.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z . Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. PMC: 7270627. DOI: 10.1016/S0140-6736(20)30566-3. View

18.

Ackermann M, Verleden S, Kuehnel M, Haverich A, Welte T, Laenger F . Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020; 383(2):120-128. PMC: 7412750. DOI: 10.1056/NEJMoa2015432. View

19.

Cui S, Chen S, Li X, Liu S, Wang F . Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020; 18(6):1421-1424. PMC: 7262324. DOI: 10.1111/jth.14830. View

20.

Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F . Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020; 369:m2094. PMC: 7500538. DOI: 10.1136/bmj.m2094. View