ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a systemic infection with cardiovascular, pulmonary, gastrointestinal, neurological, and hematological manifestations. Abnormal hematological findings are thought to have a role in early risk stratification and prognostication of COVID-19 patients. However, the data on hematological abnormalities associated with the disease among Ethiopian COVID-19 patients are limited. OBJECTIVE: To determine the magnitude of hematological abnormalities among COVID-19 patients admitted at Millennium COVID-19 referral treatment center, Addis Ababa, Ethiopia. METHODS: A prospective cross-sectional study was conducted among COVID-19 patients admitted to Millennium COVID-19 referral treatment center from May to July, 2020. A total of 334 COVID-19 patients were included using convenience sampling. Socio-demographic data and disease severity status of admitted patients were recorded. Three milliliters of venous blood was collected and analyzed by Beckman Coulter DXH-600 automated analyzer to determine complete blood count (CBC). The data were entered and analyzed using SPSS version 23 software. Association of age, sex, and disease severity with hematological abnormalities was analyzed using binary logistic regression. An odds ratio and 95% confidence interval were used to measure the strength of association. P-value <0.05 was considered as statistically significant. RESULTS: Of 334 admitted COVID-19 patients, the majority were males (62.3%) and 69.8% had moderate disease conditions. The overall magnitude of any cytopenia and pancytopenia was 41% and 1.8%, respectively. The magnitude of anemia, thrombocytopenia, and leukopenia was 24.9%, 21.6%, and 5.4%, respectively. Lymphopenia (72.2%) was the most common hematological abnormality. COVID-19 patients with severe and critical disease were more likely to develop anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia than those with moderate disease condition, with a significant association. CONCLUSION: Lymphopenia was the most common hematological abnormality observed among COVID-19 patients. Hematological abnormalities such as anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia were significantly associated with disease severity. Monitoring and evaluation of hematological parameters could provide prognostic insight into the management and risk stratification of COVID-19 patients. However, further studies are required to fully understand the utility of hematological parameters for the prognosis of COVID-19 disease.
ABSTRACT
BACKGROUND: Coagulopathy and thromboembolic events are among the complications of Corona Virus disease 2019 (COVID-19). Abnormal coagulation parameters in COVID-19 patients are important prognostic factors of disease severity. The aim of this study was to analyze coagulation profiles of hospitalized COVID-19 patients in Addis Ababa, Ethiopia. METHODS: This prospective cross-sectional study was conducted among 455 Covid-19 patients admitted at Millennium COVID-19 care and treatment center, Addis Ababa, Ethiopia from July 1- October 23, 2020. Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and International normalized ratio (INR) were determined on HUMACLOT DUE PLUS® coagulation analyzer (Wiesbaden, Germany). In all statistical analysis of results, p<0.05 was defined as statistically significant. RESULT: A prolonged prothrombin time was found in 46.8% of study participants with COVID-19 and a prolonged prothrombin time and elevated INR in 53.3% of study subjects with severe and 51% of critically COVID patients. Thrombocytopenia was detected in 22.1% of COVID-19 patients. 50.5% and 51.3% of COVID-19 patients older than 55 years had thrombocytopenia and prolonged APTT respectively. CONCLUSION: In this study, prolonged prothrombin time and elevated INR were detected in more than 50% of severe and critical COVID-19 patients. Thrombocytopenia and prolonged APTT were dominant in COVID-19 patients older than 55 years. Thus, we recommend emphasis to be given for monitoring of platelet count, PT, APTT and INR in hospitalized and admitted COVID-19 patients.