EFFECT OF COVID 19 ON HEMATOLOGICAL  PARAMETERS DURING HOSPITAL ADMISSION

Hemn R Shawgery

EFFECT OF COVID 19 ON HEMATOLOGICAL PARAMETERS DURING HOSPITAL ADMISSION

Hemn R Shawgery

Abstract

Background: The COVID-19 pandemic, caused by SARS-CoV-2, has significantly impacted global health systems. This study investigates the effects of COVID-19 on hematological parameters among hospitalized patients in the Kurdistan region of Iraq, focusing on how these parameters relate to patient outcomes.

Materials & Methods: This retrospective study analyzed data from patients admitted to a COVID-19 infection hospital koya district (MAD center) in Kurdistan during 2020-2021. Hematological parameters, including blood urea, serum creatinine, hemoglobin, WBC, neutrophil, lymphocyte, and platelet counts, were recorded. Statistical analysis involved mean, standard deviation, median, interquartile range, Mann-Whitney U test, linear and logistic regression using SPSS version 27 and GraphPad Prism.

Results: Data from 210 patients were analyzed, with a median age of 66.5 years. Common comorbidities included hypertension (28.3%) and diabetes mellitus (21.3%). Significant correlations were found between D-dimer levels and WBC (rho = 0.169, p = 0.010), neutrophil count (rho = 0.152, p = 0.021), blood urea (rho = 0.145, p = 0.027), and hospital stay (rho = 0.178, p = 0.007). Conversely, D-dimer negatively correlated with PCV (rho = -0.135, p = 0.040). Logistic regression revealed that higher SPO2 with (OR = 0.941, p = 0.006) and without oxygen (OR = 0.961, p = 0.008) decreased the odds of adverse outcomes, while increased CRP (OR = 1.006, p = 0.014) and serum ferritin (OR = 1.001, p = 0.011) were associated with worse outcomes.

Conclusion: Monitoring hematological parameters such as D-dimer, CRP, and serum ferritin is crucial in managing COVID-19 patients. These parameters is needed for follow up of patients with COVID-19 pneumonia and gives clue to severity of infection and its mortality.

Keywords

COVID-19, hematological parameters, D-dimer, SPO2, CRP, serum ferritin, patient outcomes, Kurdistan, hospital admission.

Full Text:

PDF

References

Blbas SSI, Ahmad HA, Hawezy DJ, Shawgery H, Bahadin HN. Seroprevalence of Severe Acute Respiratory Syndrome-Coronavirus-2 Immunoglobulin M and Immunoglobulin G Antibodies among the Population of Koya University. Aro-the Sci J Koya Univ. 2021;9(2):51–7. https://doi.org/ 10.14500/aro.10831

Muralidar S, Ambi SV, Sekaran S, Krishnan UM. The emergence of COVID-19 as a global pandemic: Understanding the epidemiology, immune response and potential therapeutic targets of SARS-CoV-2. Biochimie. 2020;179:85–100. https://doi.org/10.1016/j.biochi.2020.09.018

Abu-Faraj ZO. Understanding COVID-19 and some Effective Means for Combating it. LinkedIn. 2020;29:1–15.

Sawicka B, Aslan I, Della Corte V, Del Gaudio G, Nevola G, Periasamy A, et al. The coronavirus global pandemic and its impacts on society. In: Coronavirus Drug Discovery: Volume 1: SARS-CoV-2 (COVID-19) Prevention, Diagnosis, and Treatment. Elsevier; 2022. p. 267–311. https://doi.org/10.1016/B978-0-323-85156-5.00037-7

Kennelly CE, Nguyen ATP, Sheikhan NY, Strudwick G, Ski CF, Thompson DR, et al. The lived experience of long COVID: A qualitative study of mental health, quality of life, and coping. PLoS One. 2023;18(10 October):e0292630. https://doi.org/10.1371/journal.pone.0292630

Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu S V., et al. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis. 2021;21(1):1–47. https://doi.org/10.1186/s12879-021-06357-4

Krstic K, Westerman R, Chattu VK, Ekkert N V., Jakovljevic M. Corona-triggered global macroeconomic crisis of the early 2020s. Vol. 17, International Journal of Environmental Research and Public Health. MDPI; 2020. p. 1–9. https://doi.org/10.3390/ijerph17249404

Kumar C. Emerging Human Resource Challenges in a Pandemic World: The Survival Strategies and Future Roadmaps for Growth and Sustenance. SSRN Electron J. 2023;25:102–25. https://doi.org/10.2139/ssrn.4319034

Dilshad ZZ, Ahmed SO, Rahman B. The Effect of COVID-19 on the Kurdistan Region Government (KRG) Economy. J Knowl Econ. 2024;15(1):3423–38. https://doi.org/10.1007/s13132-023-01130-1

Nemec HM, Ferenczy A, Christie III BD, Ashley DW, Montgomery A. Correlation of D-dimer and outcomes in COVID-19 patients. Am Surg. 2022;88(9):2115–8. https://doi.org/10.1177/00031348221091940

Artifoni M, Danic G, Gautier G, Gicquel P, Boutoille D, Raffi F, et al. Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors. J Thromb Thrombolysis. 2020;50(1):211–6. https://doi.org/10.1007/s11239-020-02146-z

Fox SE, Akmatbekov A, Harbert JL, Li G, Quincy Brown J, Vander Heide RS. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med. 2020;8(7):681–6. https://doi.org/10.1101/2020.04.06.20050575

Yu B, Li X, Chen J, Ouyang M, Zhang H, Zhao X, et al. Evaluation of variation in D-dimer levels among COVID-19 and bacterial pneumonia: a retrospective analysis. J Thromb Thrombolysis. 2020;50(3):548–57. https://doi.org/10.1007/s11239-020-02171-y

Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324–9. https://doi.org/10.1111/jth.14859

Gounden V, Bhatt H, Jialal I. Renal Function Tests. In Treasure Island (FL); 2024.

Raisinghani N, Kumar S, Acharya S, Gadegone A, Pai V. Does aging have an impact on hemoglobin? Study in elderly population at rural teaching hospital. J Fam Med Prim Care. 2019;8(10):3345. https://doi.org/10.4103/jfmpc.jfmpc_668_19

Wei Y, Giunta S, Xia S. Hypoxia in Aging and Aging-Related Diseases: Mechanism and Therapeutic Strategies. Int J Mol Sci. 2022;23(15):8165. https://doi.org/10.3390/ijms23158165

Rafaqat S, Gluscevic S, Patoulias D, Sharif S, Klisic A. The Association between Coagulation and Atrial Fibrillation. Biomedicines. 2024;12(2):274. https://doi.org/10.3390/biomedicines12020274

Moore EE, Moore HB, Kornblith LZ, Neal MD, Hoffman M, Mutch NJ, et al. Trauma-induced coagulopathy. Nat Rev Dis Prim. 2021;7(1):30. https://doi.org/10.1038/s41572-021-00264-3

Lehmann A, Prosch H, Zehetmayer S, Gysan MR, Bernitzky D, Vonbank K, et al. Impact of persistent D-dimer elevation following recovery from COVID-19. PLoS One. 2021;16(10 October):e0258351. https://doi.org/10.1371/journal.pone.0258351

Phyo AZZ, Fransquet PD, Wrigglesworth J, Woods RL, Espinoza SE, Ryan J. Sex differences in biological aging and the association with clinical measures in older adults. GeroScience. 2024;46(2):1775–88. https://doi.org/10.1007/s11357-023-00941-z

Luks AM, Swenson ER. COVID-19 lung injury and high altitude pulmonary edema: A false equation with dangerous implications. Ann Am Thorac Soc. 2020;17(8):918–21. https://doi.org/10.1513/AnnalsATS.202004-327CME

Tobin MJ, Laghi F, Jubran A. Why COVID-19 silent hypoxemia is baffling to physicians. Am J Respir Crit Care Med. 2020;202(3):356–60. https://doi.org/10.1164/rccm.202006-2157CP

Loffredo L, Pignatelli P, Pirro M, Ceccarelli G, Oliva A, Maggio E, et al. Association between PaO2/FiO2 ratio and thrombotic events in COVID-19 patients. Intern Emerg Med. 2023;18(3):889–95. https://doi.org/10.1007/s11739-023-03196-w

Pepys MB. C-reactive protein: a critical update. J Clin Invest. 2003;112(2):299–299. https://doi.org/10.1172/JCI200318921

Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol. 2018;9(APR):754. https://doi.org/10.3389/fimmu.2018.00754

Kernan KF, Carcillo JA. Hyperferritinemia and inflammation. Int Immunol. 2017;29(9):401–9. https://doi.org/10.1093/intimm/dxx031

Wang W, Knovich MA, Coffman LG, Torti FM, Torti S V. Serum ferritin: past, present and future. Biochim Biophys Acta (BBA)-General Subj. 2010;1800(8):760–9. https://doi.org/10.1016/j.bbagen.2010.03.011

Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association Between Hypoxemia and Mortality in Patients With COVID-19. In: Mayo Clinic Proceedings. Elsevier; 2020. p. 1138–47. https://doi.org/10.1016/j.mayocp.2020.04.006

Li H, Chen S, Wang S, Yang S, Cao W, Liu S, et al. Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia. Infect Drug Resist. 2022;15:3683–91. https://doi.org/10.2147/IDR.S367012

Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018;9(6):7204–18. https://doi.org/10.18632/oncotarget.23208

Pavlou EG, Georgatzakou HT, Fortis SP, Tsante KA, Tsantes AG, Nomikou EG, et al. Coagulation abnormalities in renal pathology of chronic kidney disease: The interplay between blood cells and soluble factors. Biomolecules. 2021;11(9):1309. https://doi.org/10.3390/biom11091309

Bao W, Qi X, Li HL, Hou F, Zhang X, Wang R, et al. Correlation of D-dimer level with the inflammatory conditions: a retrospective study. AME Med J. 2017;2(3):27–27. https://doi.org/10.21037/amj.2017.02.07