COVID-19’lu Hastalarda Görülen Hematolojik Parametreler
Yıl 2020,
, 48 - 50, 24.07.2020
Hüsniye Neşe Yaralı
,
Ayça Koca Yozgat
Öz
SARS-CoV-2 primer olarak solunum yolu enfeksiyonuna neden olmakla birlikte hematopoietik ve immun sistemlerini de etkileyebilmektedir. Enfekte olan hastalarda, lenfositler, nötrofiller, monositler ve trombositlerde kantitatif ve kalitatif değişiklikler bildirilmektedir. Bu değişiklikler ile hastalığın şiddeti arasında ilişki olduğu da gösterilmiştir. Lenfopeni, SARS-CoV-2 ile enfekte erişkin hastalarda en sık görülen bulgu iken çocuklarda çok daha az görülmektedir. Şiddetli enfeksiyonu olan hastalarda lökositoz saptanabilir, hafif-orta şiddette enfeksiyonu olan hastalarda ise lökositoz daha nadirdir. Klinik ile uyumlu olarak trombositopeni veya trombositoz da görülebilmektedir. Hastaların periferik yaymalarında özellikle nötrofil ve trombositlerde displastik morfolojik değişikler saptanabilir.
Kaynakça
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- 2. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 — 11 March 2020. March 11, 2020. https://www.who.int/dg/speeches/detail/whodirector-general-s-opening-remarks-at-the-media-briefing-oncovid-19—11-march-2020 (accessed March 12, 2020)
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- 4. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. JAMA. 2020 [Epub ahead of print]. https://doi.org/10.1001/jama.2020.2648
- 5. Liang W, Guan W, Chen R, Wang W, Li J, Xu K et al Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21:335–7.
- 6. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395: 565–74
- 7. Li T, Lu H, Zhang W. Clinical observation and management of COVID-19 patients. Emerg Microbes Infect 2020; 9: 687-90.
- 8. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020 Feb 28. [Epub ahead of print] doi: 10.1056/NEJMoa2002032
- 9. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565–574
- 10. Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020 Feb 24; 12(1): 8.
- 11. Singh S, Sharma A, Arora SK. High producer haplotype (CAG) of -863C/A, -308G/A and -238G/A polymorphisms in the promoter region of TNF-alpha gene associate with enhanced apoptosis of lymphocytes in HIV-1 subtype C infected individuals from North India. PLoS One 2014; 9: e98020.
- 12. Liao YC, Liang WG, Chen FW, Hsu JH, Yang JJ, Chang MS. IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha. J Immunol 2002; 169: 4288-97.
- 13. Aggarwal S, Gollapudi S, Gupta S. Increased TNF-alpha-induced apoptosis in lymphocytes from aged humans: changes in TNF-alpha receptor expression and activation of caspases. J Immunol 1999; 162: 2154-61.
- 14. Chan JF, Zhang AJ, Yuan S, et al. Simulation of the clinical and pathological manifestations of Coronavirus Disease 2019 (COVID-19) in golden Syrian hamster model: implications for disease pathogenesis and transmissibility. Clin Infect Dis 2020 Mar 26.
- 15. Fischer K, Hoffmann P, Voelkl S, et al. Inhibitory effect of tumor cell-derived lactic acid on human T cells. Blood 2007 May 1; 109: 3812-9.
- 16. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 Feb 15; 395: 497-506.
- 17. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
- 18. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020 Feb 7.
- 19. Wu C, Chen X, Cai Y, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med 2020 Mar 13.
- 20. Deng Y, Liu W, Liu K, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study. Chin Med J (Engl) 2020 Mar 20.
- 21. Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020.
- 22. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med. 2020.
- 23. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID19) and other viral outbreaks. Clin Chem Lab Med. 2020
- 24. Shi S, Qin M, Shen B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol 2020 Mar 25.
- 25. Guo T, Fan Y, Chen M, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol 2020 Mar 27.
- 26. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta 2020 Mar 13; 506: 145-8.
- 27. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, Shang YThrombocytopenia and its association with mortality in patients with COVID-19.J Thromb Haemost. 2020 Apr 17. doi: 10.1111/jth.14848. [Epub ahead of print]
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Hematologic Parameters of Patients with COVID-19 Infection
Yıl 2020,
, 48 - 50, 24.07.2020
Hüsniye Neşe Yaralı
,
Ayça Koca Yozgat
Öz
SARS-CoV-2 causes primarily respiratory tract infection, but can also affect hematopoietic and immune systems. Quantitative and qualitative changes in lymphocytes, neutrophils, monocytes and platelets, are reported in infected patients. These changes are related to the severity of the disease. Lymphopenia is the most common finding in adult patients infected with SARS-CoV-2, while it is much less common in children. Leukocytosis can be detected in patients with severe infection, but rare in patients with mild to moderate infection. Thrombocytopenia or thrombocytosis can also be seen in accordance with the clinic. Dysplastic morphological changes in neutrophils and platelets can be detected in peripheral smear of patients.
Kaynakça
- 1. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020 Feb 20; 382: 727-33.
- 2. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 — 11 March 2020. March 11, 2020. https://www.who.int/dg/speeches/detail/whodirector-general-s-opening-remarks-at-the-media-briefing-oncovid-19—11-march-2020 (accessed March 12, 2020)
- 3. Kannan S, Shaik Syed Ali P, Sheeza A, Hemalatha K. COVID-19 (novel coronavirus 2019) — recent trends. Eur Rev Med Pharmacol Sci 2020; 24(4): 2006–2011
- 4. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. JAMA. 2020 [Epub ahead of print]. https://doi.org/10.1001/jama.2020.2648
- 5. Liang W, Guan W, Chen R, Wang W, Li J, Xu K et al Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21:335–7.
- 6. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395: 565–74
- 7. Li T, Lu H, Zhang W. Clinical observation and management of COVID-19 patients. Emerg Microbes Infect 2020; 9: 687-90.
- 8. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020 Feb 28. [Epub ahead of print] doi: 10.1056/NEJMoa2002032
- 9. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565–574
- 10. Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020 Feb 24; 12(1): 8.
- 11. Singh S, Sharma A, Arora SK. High producer haplotype (CAG) of -863C/A, -308G/A and -238G/A polymorphisms in the promoter region of TNF-alpha gene associate with enhanced apoptosis of lymphocytes in HIV-1 subtype C infected individuals from North India. PLoS One 2014; 9: e98020.
- 12. Liao YC, Liang WG, Chen FW, Hsu JH, Yang JJ, Chang MS. IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha. J Immunol 2002; 169: 4288-97.
- 13. Aggarwal S, Gollapudi S, Gupta S. Increased TNF-alpha-induced apoptosis in lymphocytes from aged humans: changes in TNF-alpha receptor expression and activation of caspases. J Immunol 1999; 162: 2154-61.
- 14. Chan JF, Zhang AJ, Yuan S, et al. Simulation of the clinical and pathological manifestations of Coronavirus Disease 2019 (COVID-19) in golden Syrian hamster model: implications for disease pathogenesis and transmissibility. Clin Infect Dis 2020 Mar 26.
- 15. Fischer K, Hoffmann P, Voelkl S, et al. Inhibitory effect of tumor cell-derived lactic acid on human T cells. Blood 2007 May 1; 109: 3812-9.
- 16. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 Feb 15; 395: 497-506.
- 17. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
- 18. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020 Feb 7.
- 19. Wu C, Chen X, Cai Y, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med 2020 Mar 13.
- 20. Deng Y, Liu W, Liu K, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study. Chin Med J (Engl) 2020 Mar 20.
- 21. Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020.
- 22. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med. 2020.
- 23. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID19) and other viral outbreaks. Clin Chem Lab Med. 2020
- 24. Shi S, Qin M, Shen B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol 2020 Mar 25.
- 25. Guo T, Fan Y, Chen M, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol 2020 Mar 27.
- 26. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta 2020 Mar 13; 506: 145-8.
- 27. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, Shang YThrombocytopenia and its association with mortality in patients with COVID-19.J Thromb Haemost. 2020 Apr 17. doi: 10.1111/jth.14848. [Epub ahead of print]
- 28. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507-13.