he clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantatio

Author(s)

Pecanha-Pietrobom, Paula M. ^[1] ; Figueiredo Leite, Giuseppe Gianini ^[1] ; Hunter, James ^[1] ; Abrao Ferreira, Paulo R. ^[1] ; Burattini, Marcelo N. ^[1] ; Bellei, Nancy ^[1] ; Ota-Arakaki, Jaquelina Sonoe ^[2] ; Salomao, Reinaldo ^[1]

Affiliation

^[1] Univ Fed Sao Paulo, Div Infect Dis, Escola Paulista Med, Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo, Div Resp Dis, Escola Paulista Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: PLoS One; v. 16, n. 11 NOV 18 2021.
• Web of Science Citations: 0

Abstract

Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with moderate COVID-19 disease, including those with a history of kidney transplantation, and examined the ability of changes in routine hematologic laboratory parameters to predict and mirror the patients' clinical course regarding the severity of their condition (classified as critical vs. non-critical) and in-hospital mortality or hospital discharge. Among the 68 patients, 20 (29%) were kidney transplanted patients (KT), and they had much higher mortality than non-kidney transplanted patients in this cohort (40% X 8.3%). Lymphocytes, neutrophils and neutrophils/lymphocytes ratio (NLR) at admission and platelets as well as the red blood cells parameters hemoglobin, hematocrit, and RDW by the time of hospital discharge or death clearly differentiated patients progressing to critical disease and those with clinical recovery. Patients with deteriorating clinical courses presented elevated and similar NLRs during the first week of hospitalization. However, they were dramatically different at hospital discharge, with a decrease in the survivors (NLR around 5.5) and sustained elevation in non-survivors (NLR around 21). Platelets also could distinguish survivors from non-survivors among the critical patients. In conclusion, routine hematologic tests are useful to monitor the clinical course of COVID-19 patients admitted with moderate disease. Unexpectedly, changes in hematologic tests, including lymphopenia, were not predictive of complicated outcomes among KT recipients. (AU)

• FAPESP's process: 20/05110-2 - Prospective cohort study to assess clinical, virological and host response aspects in patients with COVID-19
• Grantee: Reinaldo Salomão
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/21052-0 - Sepsis: mechanisms, therapeutic targets and epidemiology
• Grantee: Reinaldo Salomão
• Support Opportunities: Research Projects - Thematic Grants