ABSTRACT
Content: The current COVID - 19 global pandemic, caused by the novel coronavirus, SARS-CoV-2, is going through a second wave in many countries and has resulted in an unprecedented mortality and morbidity. The typical clinical presentation includes flu-like symptoms, such as fever, cough and asthenia, and also COVID-19 specific anosmia;however, the symptom spectrum spreads from being asymptomatic, to a severe acute respiratory distress syndrome, to multiple organ failure. Aim: The aim of this study is to evaluate the abnormalities seen in the full blood count parameters of patients with positive qPCR test for SARS-CoV-2 infections. Method: This was a retrospective analysis of all full blood count parameters from patients who tested positive for SARS-CoV-2 following a qPCR test, and were admitted to hospital with symptoms in the first wave of COVID-19, from March 2020 to June 2020. 12 different parameters were assessed for any abnormalities, including: haemoglobin (Hb), white blood cell count (WCC), neutrophil, lymphocytes, eosinophils, basophils, platelets, Mean Cell Volume (MCV), Mean Cell Haemoglobin (MCH), haematocrit (HCT), and red blood cell distribution width (RDW). Inclusion criteria for the study were: admission to hospital, positive qPCR test, no known malignancy or HIV, and no current immunosuppressive or chemo- therapy. The full blood count parameters from all patients admitted with suspected SARS-CoV-2 infection were extracted from the analyser. Only the patients with positive qPCR test were selected for the study. Results: Samples from a total of 278 patients (162 male and 116 female) were analysed. The median age of patients was 76 (range from 1 year to 99 years). Abnormal WBC count with a predominant leucocytosis was seen in 27% of patients. 1.4% patients had abnormal RBC, while 41% had abnormal Hb, with 18% of patients with Hb <100 gm/l. HCT was abnormal in 60% of patients. Furthermore, abnormal neutrophil and lymphocyte counts were detected in 43% and 54% patients respectively. Lymphopenia and thrombocytopenia were seen in 52% and 13% of patients respectively. No evidence of reduced total white cell count was seen. Abnormal monocytes were seen in 15% of patients. There was no striking eosinophilia, but rather a decrease in circulating eosinophils in 82% of patients. Overall, the changes were more pronounced in HCT, lymphocyte and eosinophil counts. Conclusion: Significant abnormalities in full blood count parameters seen in COVID-19 patients could possibly help to elucidate the pathogenesis of SARS-CoV-2 infection along with other biomedical parameters. These abnormal parameters can be modelled to a risk stratifying algorithm to predict the severity of the COVID-19 infection in a hospital setting.