The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.

Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with moderate COVID-19 disease, including those with a...

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Autores principales:	Paula M Peçanha-Pietrobom, Giuseppe Gianini Figueirêdo Leite, James Hunter, Paulo R Abrão Ferreira, Marcelo N Burattini, Nancy Bellei, Jaquelina Sonoe Ota-Arakaki, Reinaldo Salomao
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8731afedd1c94ebd9ee63865c810c0cd
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spelling	oai:doaj.org-article:8731afedd1c94ebd9ee63865c810c0cd2021-12-02T20:19:10ZThe clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.1932-620310.1371/journal.pone.0258987https://doaj.org/article/8731afedd1c94ebd9ee63865c810c0cd2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258987https://doaj.org/toc/1932-6203Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with moderate COVID-19 disease, including those with a history of kidney transplantation, and examined the ability of changes in routine hematologic laboratory parameters to predict and mirror the patients' clinical course regarding the severity of their condition (classified as critical vs. non-critical) and in-hospital mortality or hospital discharge. Among the 68 patients, 20 (29%) were kidney transplanted patients (KT), and they had much higher mortality than non-kidney transplanted patients in this cohort (40% X 8.3%). Lymphocytes, neutrophils and neutrophils/lymphocytes ratio (NLR) at admission and platelets as well as the red blood cells parameters hemoglobin, hematocrit, and RDW by the time of hospital discharge or death clearly differentiated patients progressing to critical disease and those with clinical recovery. Patients with deteriorating clinical courses presented elevated and similar NLRs during the first week of hospitalization. However, they were dramatically different at hospital discharge, with a decrease in the survivors (NLR around 5.5) and sustained elevation in non-survivors (NLR around 21). Platelets also could distinguish survivors from non-survivors among the critical patients. In conclusion, routine hematologic tests are useful to monitor the clinical course of COVID-19 patients admitted with moderate disease. Unexpectedly, changes in hematologic tests, including lymphopenia, were not predictive of complicated outcomes among KT recipients.Paula M Peçanha-PietrobomGiuseppe Gianini Figueirêdo LeiteJames HunterPaulo R Abrão FerreiraMarcelo N BurattiniNancy BelleiJaquelina Sonoe Ota-ArakakiReinaldo SalomaoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0258987 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Paula M Peçanha-Pietrobom Giuseppe Gianini Figueirêdo Leite James Hunter Paulo R Abrão Ferreira Marcelo N Burattini Nancy Bellei Jaquelina Sonoe Ota-Arakaki Reinaldo Salomao The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
description	Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with moderate COVID-19 disease, including those with a history of kidney transplantation, and examined the ability of changes in routine hematologic laboratory parameters to predict and mirror the patients' clinical course regarding the severity of their condition (classified as critical vs. non-critical) and in-hospital mortality or hospital discharge. Among the 68 patients, 20 (29%) were kidney transplanted patients (KT), and they had much higher mortality than non-kidney transplanted patients in this cohort (40% X 8.3%). Lymphocytes, neutrophils and neutrophils/lymphocytes ratio (NLR) at admission and platelets as well as the red blood cells parameters hemoglobin, hematocrit, and RDW by the time of hospital discharge or death clearly differentiated patients progressing to critical disease and those with clinical recovery. Patients with deteriorating clinical courses presented elevated and similar NLRs during the first week of hospitalization. However, they were dramatically different at hospital discharge, with a decrease in the survivors (NLR around 5.5) and sustained elevation in non-survivors (NLR around 21). Platelets also could distinguish survivors from non-survivors among the critical patients. In conclusion, routine hematologic tests are useful to monitor the clinical course of COVID-19 patients admitted with moderate disease. Unexpectedly, changes in hematologic tests, including lymphopenia, were not predictive of complicated outcomes among KT recipients.
format	article
author	Paula M Peçanha-Pietrobom Giuseppe Gianini Figueirêdo Leite James Hunter Paulo R Abrão Ferreira Marcelo N Burattini Nancy Bellei Jaquelina Sonoe Ota-Arakaki Reinaldo Salomao
author_facet	Paula M Peçanha-Pietrobom Giuseppe Gianini Figueirêdo Leite James Hunter Paulo R Abrão Ferreira Marcelo N Burattini Nancy Bellei Jaquelina Sonoe Ota-Arakaki Reinaldo Salomao
author_sort	Paula M Peçanha-Pietrobom
title	The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
title_short	The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
title_full	The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
title_fullStr	The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
title_full_unstemmed	The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
title_sort	clinical course of hospitalized moderately ill covid-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8731afedd1c94ebd9ee63865c810c0cd
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The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.

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