COVID-19
Study Chen et al (2020)N = 99, confirmed casesRetrospective study Wang et al (2020)N = 138, confirmed cases Retrospective study Guan et al (2020)N = 1099, confirmed casesRetrospective study Li et al (2020)N = 1994, confirmed casesMeta-analysis, 10 studies Tang et al (2020)N = 449, confirmed casesProspective study Zhou et al (2020)N = 191, confirmed casesRetrospective study
Clinical features N/A Preexisting malignancy (7.2%) Preexisting malignancy (0.9%) N/A N/A Preexisting malignancy (1%)
Key findings on investigations • ↓Hb (51%)
• Neutrophilia (38%)
• ↑D-dimer (36%)
• Lymphopenia (35%)
• ↓PT (30%)
• Leukocytosis (24%)
• ↓aPTT (16%)
• Thrombocytopenia (12%)
• Leukopenia (9%)
• Thrombocytosis (4%)
• ↑aPTT (6%)
• ↑PT (5%) • Lymphopenia (70.3%),
• ↑PT (58%) • Lymphocytopenia on admission (83.2%)
• ↑D-dimer (46.4%)
• Thrombocytopenia (36.2%)
• Leukopenia (33.7%)
• DIC (0.1%) • Lymphocytopenia (64.5%)
• Leukocytopenia (29.4%) ↑D-dimer • Lymphopenia (40%)
• ↑D-dimer (42%)
Key study findings and message Various hematological abnormalities commonly seen • Leukocytosis, neutrophilia, lymphopenia, ↑D-dimer more common in ICU patients (P = 0.003, P < 0.001, P = 0.03, P < 0.001)
• Lymphopenia worsened with disease severity More severe derangements in more severe disease • Lymphocytopenia and leukocytopenia more common lab abnormalities
• Lymphocytopenia may be used as reference index for coronavirus diagnosis • 28-day mortality of heparin users and nonusers similar (P = 0.910)
• 28-day mortality of heparin users less than nonusers in patients with SIC score>/ = 4 (P = 0.29), or with D-dimer >6x normal (0.017) • Leukocytosis, ↑D-dimer, ↑PT associated with in-hospital death (P < 0.0001)
• ↓D-dimer not solely due to sepsis, but possible underlying thromboembolic event, patients should be managed as such.
(Comment by Oudkerk et al)