key: cord-0941488-ktjv1op9 authors: Giacaman, Annesi; Henriquez, Wolfrang; Tolosa, Guillermo; Prado, Aurora; Jerez, Roxana; Reveco, Yenny; Martínez, Carlos; Baumert, Carlos; Rodríguez, Belén; Sanhueza, Basty; José Orellana, Juan; Inostroza, Jaime title: Hematological abnormalities in immunosuppressed patients with COVID-19: evidence from a single center. A cross sectional study date: 2022-05-17 journal: Int Immunopharmacol DOI: 10.1016/j.intimp.2022.108862 sha: 98af063388ffaa8ceca6b16d8e45067374b4129a doc_id: 941488 cord_uid: ktjv1op9 BACKGROUND: Changes in hematological parameters in patients with COVID-19 are emerging as important features of the disease in the general population. In the present study we aimed to explore the hematological characteristics and its prevalence proportion ratio in patients with immunosuppression with COVID-19. AIM: To explore the differences between immunosuppressed and non-immunosuppressed patients, with and without COVID-19 from a hematological perspective. METHODS: This cross-sectional study reports on the baseline complete blood count in patients attending the HHA Hospital, in Chile. The study reports descriptive characteristics of the population, including sex, age, ethnicity, corticoids and biological therapy scheme and a complete report of blood test results. A total of 476 patients were enrolled in this study from October of 2020 to April 2021. RESULTS: Findings revels a significant increment (p value≤0.001) on the median of total neutrophils and leucocytes, and in platelet-lymphocyte ratio (PLR), neutrophil- lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR) in immunosuppressed patients with COVID-19 (IS(+)) and immunocompetent patients with COVID-19 (IC(+)) compared with their respective controls. By contrast, a significant reduction on the median of lymphocytes, and eosinophiles was observed in IS(+) individuals compared with its controls. Also, the red blood cell count, hemoglobin, hematocrit, and mean corpuscular hemoglobin concentration were significantly reduced in IS(+) patients, whereas red blood cell, distribution width and mean corpuscular volume, were significantly higher in patients with COVID-19. CONCLUSION: Rapid blood tests, including, neutrophil, lymphocytes count and PLR, NLR can be used for early assessment and management of patients with immunosuppression. According to the Centers for Disease Control and Prevention (CDC) primary 113 immunodeficiencies are inherited and are defined as absence or quantitative deficiency of 114 cellular, humoral, or both components that provide immunity. While secondary 115 immunodeficiency is defined as a loss or qualitative deficiency in cellular or humoral 116 immune components that occurs because of a disease process or its therapy. Examples of 117 secondary immunodeficiency include HIV infection, active treatment for solid tumor, 118 hematopoietic malignancies, receipt of solid-organ transplant, treatment with radiation, 119 asplenia, chronic renal disease and treatment with immunosuppressive drugs. The degree 120 to which immunosuppressive drugs cause clinically significant immunodeficiency 121 generally is dose related and varies by drug. High-dose corticosteroids (i.e., ≥20mg 122 prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-123 related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely 124 immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are 125 immunosuppressive drugs [1] Immunosuppressive conditions may increase the risk of 126 severe infection and result in an increased predisposition to transmit SARSCoV-2 virus 127 [2]. 128 129 COVID-19 clinical manifestation may range from asymptomatic to more severe forms of 130 the disease characterized by acute respiratory syndrome (ARDS), including cardiac, 131 neurological, renal, and hematological abnormalities. Among the hematological 132 abnormalities, changes in platelet, white blood cell and hemoglobin [3] , and 133 coagulation/fibrinolytic alterations have been described [4] . Table 3 ). Lymphopenia was defined as 292 <1.0x 10 9 /L of the absolute count and this was observed in 64/85 (75%) of IS(+) group, 293 10/125 (8%) in IS(-) group, 55/151 (36%) in IC(+) and 2/113 (2%) in IC(-) ( Table 3) . 294 In addition, monocytopenia was defined as <1. . Therefore, assessing the role of ethnicity in the current pandemic was 330 considered and import public health concern. Our results did not find any correlation progress to more severe presentation [13] . In the results of this study, which are also National Center for 437 Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases Haematological abnormalities and risk of covid-19 infection in adult patients attending primary 443 healthcare settings COVID-19 in immunocompromised populations: 446 Implications for prognosis and repurposing of immunotherapies Hematological 450 abnormalities in COVID-19: A narrative review Role of hematological parameters in COVID-19 patients in the 455 emergency room Can routine laboratory variables predict survival in COVID-19? An artificial neural 459 network-based approach Dynamic profile and clinical implications of hematological parameters in hospitalized patients 463 with coronavirus disease 2019 The impact of ethnicity on clinical outcomes in COVID-19: A systematic review Clinical and immunologic features in severe and moderate forms of Coronavirus Disease Preliminary study to identify severe from moderate cases of COVID-19 using combined 477 hematology parameters Modulation of hemostasis in covid-19; blood platelets may be important pieces in the 481 covid-19 puzzle Haematological characteristics and risk factors in the classification and prognosis evaluation of 484 COVID-19: a retrospective cohort study IC COVID-19 (+) VCM IC COVID-19 (+) IS COVID-19 (-) IS COVID-19 (+)