tetano
Editor, Senior Moderator
Br J Haematol
. 2020 May 26.
doi: 10.1111/bjh.16885. Online ahead of print.
Delayed-Phase Thrombocytopenia in Patients of Coronavirus Disease 2019 (COVID-19)
Wanxin Chen[SUP] 1 [/SUP], Ziping Li[SUP] 1 [/SUP], Bohan Yang[SUP] 2 [/SUP], Ping Wang[SUP] 3 [/SUP], Qiong Zhou[SUP] 2 [/SUP], Zhiguo Zhang[SUP] 4 [/SUP], Jianhua Zhu[SUP] 5 [/SUP], Xuexing Chen[SUP] 1 [/SUP], Peng Yang[SUP] 6 [/SUP], Hao Zhou[SUP] 1 [/SUP]
Affiliations
Abstract
COVID-19 can affect the hematopoietic system. Thrombocytopenia at admission was prevalent, while late-phase or delayed-phase thrombocytopenia (occurred 14 days after symptom onset) is obscure. This retrospective single-center study screened 450 COVID-19 patients and enrolled 271 patients at the Union Hospital, Wuhan, China, from January 25th to March 9th, 2020. COVID-19 associated delayed-phase thrombocytopenia occurred in 11.8% percent of enrolling patients. The delayed-phase thrombocytopenia in COVID-19 is prone to develop in elderly patients or patients with low lymphocyte count on admission. The delayed-phase thrombocytopenia is significantly associated with increased length of hospital stay and higher mortality rate. Delayed-phase nadir platelet counts demonstrated a significantly negative correlation with B cell percentages. We also presented bone marrow aspiration pathology of three patients with delayed-phase thrombocytopenia, showing impaired maturation of megakaryocytes. We speculated that immune mediated platelet destruction might account for the delayed-phase thrombocytopenia in a group of patients. Besides, clinicians need to pay attention to the delayed-phase thrombocytopenia especially at 3-4 weeks after symptom onset.
Keywords: COVID-19; SARS-CoV-2; clinical features; cytokine; lymphocyte; thrombocytopenia.
. 2020 May 26.
doi: 10.1111/bjh.16885. Online ahead of print.
Delayed-Phase Thrombocytopenia in Patients of Coronavirus Disease 2019 (COVID-19)
Wanxin Chen[SUP] 1 [/SUP], Ziping Li[SUP] 1 [/SUP], Bohan Yang[SUP] 2 [/SUP], Ping Wang[SUP] 3 [/SUP], Qiong Zhou[SUP] 2 [/SUP], Zhiguo Zhang[SUP] 4 [/SUP], Jianhua Zhu[SUP] 5 [/SUP], Xuexing Chen[SUP] 1 [/SUP], Peng Yang[SUP] 6 [/SUP], Hao Zhou[SUP] 1 [/SUP]
Affiliations
- PMID: 32453877
- DOI: 10.1111/bjh.16885
Abstract
COVID-19 can affect the hematopoietic system. Thrombocytopenia at admission was prevalent, while late-phase or delayed-phase thrombocytopenia (occurred 14 days after symptom onset) is obscure. This retrospective single-center study screened 450 COVID-19 patients and enrolled 271 patients at the Union Hospital, Wuhan, China, from January 25th to March 9th, 2020. COVID-19 associated delayed-phase thrombocytopenia occurred in 11.8% percent of enrolling patients. The delayed-phase thrombocytopenia in COVID-19 is prone to develop in elderly patients or patients with low lymphocyte count on admission. The delayed-phase thrombocytopenia is significantly associated with increased length of hospital stay and higher mortality rate. Delayed-phase nadir platelet counts demonstrated a significantly negative correlation with B cell percentages. We also presented bone marrow aspiration pathology of three patients with delayed-phase thrombocytopenia, showing impaired maturation of megakaryocytes. We speculated that immune mediated platelet destruction might account for the delayed-phase thrombocytopenia in a group of patients. Besides, clinicians need to pay attention to the delayed-phase thrombocytopenia especially at 3-4 weeks after symptom onset.
Keywords: COVID-19; SARS-CoV-2; clinical features; cytokine; lymphocyte; thrombocytopenia.