Hematological Alterations Associated with Long COVID-19

Overview

Journal Front Physiol

Date 2023 Aug 11

PMID 37565145

Authors

Guilherme C Lechuga

Carlos M Morel

Salvatore Giovanni De-Simone

Affiliations

Soon will be listed here.

Abstract

Long COVID-19 is a condition characterized by persistent symptoms lasting beyond the acute phase of COVID-19. Long COVID-19 produces diverse symptomatology and can impact organs and systems, including the hematological system. Several studies have reported, in COVID-19 patients, hematological abnormalities. Most of these alterations are associated with a higher risk of severe disease and poor outcomes. This literature review identified studies reporting hematological parameters in individuals with Long COVID-19. Findings suggest that Long COVID-19 is associated with a range of sustained hematological alterations, including alterations in red blood cells, anemia, lymphopenia, and elevated levels of inflammatory markers such as ferritin, D-dimer, and IL-6. These alterations may contribute to a better understanding of the pathophysiology of Long COVID-19 and its associated symptoms. However, further research is needed to elucidate the underlying mechanisms and potential treatments for these hematological changes in individuals with Long COVID-19.

Citing Articles

Identification of an immunological signature of long COVID syndrome.

Guerrera G, Sambucci M, Timperi E, Picozza M, Misiti A, Placido R Front Immunol. 2025; 15():1502937.

PMID: 39845978 PMC: 11750999. DOI: 10.3389/fimmu.2024.1502937.

Unveiling the hidden link: elevated platelets and T cell subsets in 5% of moderate COVID-19 patients 48 days post-onset.

An H, Li T, Yang L, Zhang X, Hu H, Zhang C Front Cell Infect Microbiol. 2024; 14:1498491.

PMID: 39628664 PMC: 11611820. DOI: 10.3389/fcimb.2024.1498491.

Red Blood Cell Morphology Is Associated with Altered Hemorheological Properties and Fatigue in Patients with Long COVID.

Grau M, Presche A, Kruger A, Bloch W, Haiduk B Biology (Basel). 2024; 13(11).

PMID: 39596903 PMC: 11592038. DOI: 10.3390/biology13110948.

Comparison of pathogenicity and host responses of emerging porcine reproductive and respiratory syndrome virus variants in piglets.

Zhang W, Wang X, Zhang H, Pan Y, Ma W, Xu Y J Virol. 2024; 98(11):e0154223.

PMID: 39445829 PMC: 11575335. DOI: 10.1128/jvi.01542-23.

Association of iron deficiency anaemia with the hospitalization and mortality rate of patients with COVID‑19.

Jalal M, Algamdi M, Alkayyal A, Altayar M, Mouminah A, Alamrani A Med Int (Lond). 2024; 4(6):69.

PMID: 39301327 PMC: 11411605. DOI: 10.3892/mi.2024.193.

References

Bai F, Tomasoni D, Falcinella C, Barbanotti D, Castoldi R, Mule G . Female gender is associated with long COVID syndrome: a prospective cohort study. Clin Microbiol Infect. 2021; 28(4):611.e9-611.e16. PMC: 8575536. DOI: 10.1016/j.cmi.2021.11.002. View

Kernan K, Carcillo J . Hyperferritinemia and inflammation. Int Immunol. 2017; 29(9):401-409. PMC: 5890889. DOI: 10.1093/intimm/dxx031. View

Davis H, Assaf G, McCorkell L, Wei H, Low R, Reem Y . Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 2021; 38:101019. PMC: 8280690. DOI: 10.1016/j.eclinm.2021.101019. View

Anai M, Akaike K, Iwagoe H, Akasaka T, Higuchi T, Miyazaki A . Decrease in hemoglobin level predicts increased risk for severe respiratory failure in COVID-19 patients with pneumonia. Respir Investig. 2020; 59(2):187-193. PMC: 7682330. DOI: 10.1016/j.resinv.2020.10.009. View

Ostergaard L . SARS CoV-2 related microvascular damage and symptoms during and after COVID-19: Consequences of capillary transit-time changes, tissue hypoxia and inflammation. Physiol Rep. 2021; 9(3):e14726. PMC: 7849453. DOI: 10.14814/phy2.14726. View

Nader E, Nougier C, Boisson C, Poutrel S, Catella J, Martin F . Increased blood viscosity and red blood cell aggregation in patients with COVID-19. Am J Hematol. 2021; 97(3):283-292. DOI: 10.1002/ajh.26440. View

Peghin M, Palese A, Venturini M, De Martino M, Gerussi V, Graziano E . Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients. Clin Microbiol Infect. 2021; 27(10):1507-1513. PMC: 8180450. DOI: 10.1016/j.cmi.2021.05.033. View

Sa Ribero M, Jouvenet N, Dreux M, Nisole S . Interplay between SARS-CoV-2 and the type I interferon response. PLoS Pathog. 2020; 16(7):e1008737. PMC: 7390284. DOI: 10.1371/journal.ppat.1008737. View

Plays M, Muller S, Rodriguez R . Chemistry and biology of ferritin. Metallomics. 2021; 13(5). PMC: 8083198. DOI: 10.1093/mtomcs/mfab021. View

10.

Peluso M, Lu S, Tang A, Durstenfeld M, Ho H, Goldberg S . Markers of Immune Activation and Inflammation in Individuals With Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection. J Infect Dis. 2021; 224(11):1839-1848. PMC: 8643408. DOI: 10.1093/infdis/jiab490. View

11.

Williams E, Martins T, Shah K, Hill H, Coiras M, Spivak A . Cytokine Deficiencies in Patients with Long-COVID. J Clin Cell Immunol. 2023; 13(6). PMC: 9894377. View

12.

Girelli D, Marchi G, Busti F, Vianello A . Iron metabolism in infections: Focus on COVID-19. Semin Hematol. 2021; 58(3):182-187. PMC: 8305218. DOI: 10.1053/j.seminhematol.2021.07.001. View

13.

Hoffmann M, Kruger N, Schulz S, Cossmann A, Rocha C, Kempf A . The Omicron variant is highly resistant against antibody-mediated neutralization: Implications for control of the COVID-19 pandemic. Cell. 2022; 185(3):447-456.e11. PMC: 8702401. DOI: 10.1016/j.cell.2021.12.032. View

14.

Al-Saadi E, Abdulnabi M . Hematological changes associated with COVID-19 infection. J Clin Lab Anal. 2021; 36(1):e24064. PMC: 8646489. DOI: 10.1002/jcla.24064. View

15.

Montazersaheb S, Hosseiniyan Khatibi S, Hejazi M, Tarhriz V, Farjami A, Ghasemian Sorbeni F . COVID-19 infection: an overview on cytokine storm and related interventions. Virol J. 2022; 19(1):92. PMC: 9134144. DOI: 10.1186/s12985-022-01814-1. View

16.

Ganz T . Hepcidin and iron regulation, 10 years later. Blood. 2011; 117(17):4425-33. PMC: 3099567. DOI: 10.1182/blood-2011-01-258467. View

17.

Pretorius E, Vlok M, Venter C, Bezuidenhout J, Laubscher G, Steenkamp J . Persistent clotting protein pathology in Long COVID/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin. Cardiovasc Diabetol. 2021; 20(1):172. PMC: 8381139. DOI: 10.1186/s12933-021-01359-7. View

18.

Cueto-Robledo G, Porres-Aguilar M, Puebla-Aldama D, Barragan-Martinez M, Jurado-Hernandez M, Garcia-Cesar M . Severe Pulmonary Hypertension: An Important Sequel After Severe Post-Acute COVID-19 Pneumonia. Curr Probl Cardiol. 2021; 47(3):101004. PMC: 8482545. DOI: 10.1016/j.cpcardiol.2021.101004. View

19.

Caruso D, Guido G, Zerunian M, Polidori T, Lucertini E, Pucciarelli F . Post-Acute Sequelae of COVID-19 Pneumonia: Six-month Chest CT Follow-up. Radiology. 2021; 301(2):E396-E405. PMC: 8335814. DOI: 10.1148/radiol.2021210834. View

20.

Risso A, Turello M, Biffoni F, Antonutto G . Red blood cell senescence and neocytolysis in humans after high altitude acclimatization. Blood Cells Mol Dis. 2006; 38(2):83-92. DOI: 10.1016/j.bcmd.2006.10.161. View