About: Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study

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About: Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study
Creator	Xu, Min Hu, Yu Wang, Zhihui Tang, Lu Yin, Ping Wang, Yadan Gao, Yong Cai, Liqiong Liao, Danying Wang, Hongbo Xia, Jiahong Mei, Heng Deng, Jun Luo, Lili Zhou, Fen
source	Elsevier; Medline; PMC
abstract	BACKGROUND: COVID-19 is an ongoing global pandemic. Changes in haematological characteristics in patients with COVID-19 are emerging as important features of the disease. We aimed to explore the haematological characteristics and related risk factors in patients with COVID-19. METHODS: This retrospective cohort study included patients with COVID-19 admitted to three designated sites of Wuhan Union Hospital (Wuhan, China). Demographic, clinical, laboratory, treatment, and outcome data were extracted from electronic medical records and compared between patients with moderate, severe, and critical disease (defined according to the diagnosis and treatment protocol for novel coronavirus pneumonia, trial version 7, published by the National Health Commission of China). We assessed the risk factors associated with critical illness and poor prognosis. Dynamic haematological and coagulation parameters were investigated with a linear mixed model, and coagulopathy screening with sepsis-induced coagulopathy and International Society of Thrombosis and Hemostasis overt disseminated intravascular coagulation scoring systems was applied. FINDINGS: Of 466 patients admitted to hospital from Jan 23 to Feb 23, 2020, 380 patients with COVID-19 were included in our study. The incidence of thrombocytopenia (platelet count <100 × 10(9) cells per L) in patients with critical disease (42 [49%] of 86) was significantly higher than in those with severe (20 [14%] of 145) or moderate (nine [6%] of 149) disease (p<0·0001). The numbers of lymphocytes and eosinophils were significantly lower in patients with critical disease than those with severe or moderate disease (p<0·0001), and prothrombin time, D-dimer, and fibrin degradation products significantly increased with increasing disease severity (p<0·0001). In multivariate analyses, death was associated with increased neutrophil to lymphocyte ratio (≥9·13; odds ratio [OR] 5·39 [95% CI 1·70–17·13], p=0·0042), thrombocytopenia (platelet count <100 × 10(9) per L; OR 8·33 [2·56–27·15], p=0·00045), prolonged prothrombin time (>16 s; OR 4·94 [1·50–16·25], p=0·0094), and increased D-dimer (>2 mg/L; OR 4·41 [1·06–18·30], p=0·041). Thrombotic and haemorrhagic events were common complications in patients who died (19 [35%] of 55). Sepsis-induced coagulopathy and International Society of Thrombosis and Hemostasis overt disseminated intravascular coagulation scores (assessed in 12 patients who survived and eight patients who died) increased over time in patients who died. The onset of sepsis-induced coagulopathy was typically before overt disseminated intravascular coagulation. INTERPRETATION: Rapid blood tests, including platelet count, prothrombin time, D-dimer, and neutrophil to lymphocyte ratio can help clinicians to assess severity and prognosis of patients with COVID-19. The sepsis-induced coagulopathy scoring system can be used for early assessment and management of patients with critical disease. FUNDING: National Key Research and Development Program of China.
has issue date	2020-07-10(xsd:dateTime)
bibo:doi	10.1016/s2352-3026(20)30217-9
bibo:pmid	32659214
has license	no-cc
sha1sum (hex)	7369be07ea47a7e60832bb8d2eead1ed1116b171
schema:url	https://doi.org/10.1016/s2352-3026%2820%2930217-9
resource representing a document's title	Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study
has PubMed Central identifier	PMC7351397
has PubMed identifier	32659214
schema:publication	Lancet Haematol
resource representing a document's body	covid:7369be07ea47a7e60832bb8d2eead1ed1116b171#body_text
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