Alterations of haematological parameters in patients COVID 19 and correlation between the different variants

ABSTRACT

Background SARS-CoV-2, which appeared in December 2019 in Wuhan, China (1) in the first pandemic wave (from February 24 to June 11, 2020) infected more than 236,000 people, in the second wave (from September 14 to December 31, 2020) the number of infected was more than 1,822,000 (2). During the first wave, in our P.O., the number of deceased, as well as hospitalizations in intensive care were higher. Purpose of the work In our study we evaluated haematological alterations in hospitalized COVID 19 patients and, often in critical condition, for a hyperinflammatory state secondary to cytokine storm related to alterations of CD4/CD8 T lymphocytes. Materials and methods In the period between March and December 2020, 160 patients (97 males, 63 females average age 63.33 years + / -10.2) were enrolled in the COVID department of the P.O. S.Giuliano, because they were positive for the molecular swab in RT-PCR for SARS CoV-2. For each patient, blood count with smear, routine blood chemistry tests and in particular c-reactive protein, ferritin, ves, LDH, procalcitonin, troponin, fibrinogen, D-Dimer were performed. Results In COVID 19 patients with more severe symptoms, there was an increase in the value of white blood cells with an average of 20.0+/-5.0X103/microlitre (increase in neutrophils and monocytes, reduction in lymphocytes with NLR>5.92). Cytofluorimetric analysis has shown that CD3 T lymphocytes are significantly reduced. Patients with more severe syntoms showed a significant increase in C-Reactive Protein (10.6+/-7.5mg/dl), Troponin (433+/-400pg/ml), Myoglobin (3700+/-3000ng/ml),Fibrinogen(800+/-500mg/ dl),D-Dimer(800-5800ng/ml),Ferritin(950+/-450ng/ ml),LDH (850+/-250U/L)) Discussions and conclusions From our study it is evident that the hematological parameters associated with specific biomarkers of inflammation are useful to identify and differentiate covid positive patients with more severe and critical pathology even in the second pandemic wave. The severity of the pathology is positively correlated with the percentage values of neutrophils and NLR and negatively with the percentage of lymphocytes.