key: cord-343927-s54n1cmn
authors: Sayad, Babak; Afshar, Zeinab Mohseni; Mansouri, Feizollah; Rahimi, Zohreh
title: Leukocytosis and alteration of hemoglobin level in patients with severe COVID‐19: Association of leukocytosis with mortality
date: 2020-10-14
journal: Health Sci Rep
DOI: 10.1002/hsr2.194
sha: 
doc_id: 343927
cord_uid: s54n1cmn

nan

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for coronavirus disease 2019 (COVID-19). The clinical characteristics of COVID-19 pandemic announced by the World Health Organization (WHO) in March 2020 1 may be presented by a severe form of pneumonia in some patients (10%-15%) which might progress toward acute respiratory distress syndrome, multi-organ failure and death. 2 The clinical laboratory provides important information related to the COVID-19 diagnosis, prognosis, and response to therapy. 3 In severely affected patients with COVID-19, leukocytosis was more prevalent as it was observed in11.4% severe COVID-19 patients compared to 4.8% in patients with mild to moderate disease. 3 For the first time we report white blood cells (WBCs) count and hemoglobin (Hb) level among patients with severe COVID-19 from Among all severely affected patients the mean WBCs count was 9.1 ± 4.9×10 9 /L (8.9 ± 4.9 × 10 9 /L in males and 9.4 ± 5 × 10 9 /L in females). In survivors the WBCs count was 7.6 ± 3.5 × 10 9 /L compared to 10.5 ± 5.6 × 10 9 /L (P = .008) in non-survivors. Comparing survivors with non-survivors indicated among non-survivors 16 out of 39 patients (41%) had WBCs count upper normal range (>11 × 10 9 /L).

However, only 4 out of 35 (11.4%) survived patients had WBCs count more than 11 × 10 9 /L (χ 2 = 8.2, P = .004, OR = 1.16 (CI 1.03-1.3, P = .015). Also, the WBCs count was 10.5 ± 6 × 10 9 /L in patients required intubation compared to 8.3 ± 4.1 × 10 9 /L (P = .098) in those patients did not require intubation. Furthermore, higher WBCs count was detected in patients with comorbidities (hypertension, diabetes mellitus, coronary artery disease, cancer, renal transplantation, chronic obstructive pulmonary disease, and osteomyelitis) than those without comorbidities (9.5 ± 4.9 vs 8.2 ± 4.8 × 10 9 /L, P = 0.27; Table 1 ). There were seven patients with leukopenia (1-3.8 × 10 9 /L) that four of them Among patients with COVID-19 from Kermanshah Province the mortality rate was grater in individuals with higher Hb levels. However, the level of Hb was lower in patients required tracheal intubation compared to patients did not require intubation.

In summary, our study indicated a significant association between leukocytosis and the rate of mortality in patients with COVID-19.

Also, our findings indicated the higher rate of mortality among COVID-19 patients with higher Hb level. However, lower Hb level was detected in patients required tracheal intubation that its mechanism needs to be elucidated.

The authors declare they have no conflict of interest. Zohreh Rahimi (corresponding author) had full access to all of the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis.

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Although our study was an observational study, verbal consent was obtained from patients or from the next-of-kin. 

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Leukocytosis and alteration of hemoglobin level in patients with severe COVID-19: Association of leukocytosis with mortality