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The Magnitude of Hematological Abnormalities Among COVID-19 Patients in Addis Ababa, Ethiopia

Authors Araya S, Wordofa M, Mamo MA, Tsegay YG, Hordofa A, Negesso AE, Fasil T, Berhanu B, Begashaw H, Atlaw A, Niguse T, Cheru M, Tamir Z

Received 3 December 2020

Accepted for publication 29 January 2021

Published 2 March 2021 Volume 2021:14 Pages 545—554

DOI https://doi.org/10.2147/JMDH.S295432

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser


Shambel Araya,1,2 Moges Wordofa,1 Mintesnot Aragaw Mamo,2,3 Yakob Gebregziabher Tsegay,2– 4 Abebe Hordofa,2,5 Abebe Edao Negesso,1 Tewodros Fasil,1 Betelhem Berhanu,1 Hermela Begashaw,1 Asegdew Atlaw,2 Tirhas Niguse,1 Mahlet Cheru,1 Zemenu Tamir1

1Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 4Research and Development Center, College of Health Sciences, Defense University, Addis Ababa, Ethiopia; 5Department of Medical Laboratory, Legehare General Hospital, Addis Ababa, Ethiopia

Correspondence: Moges Wordofa Email [email protected]

Background: Coronavirus disease 2019 (COVID-19) is a systemic infection with cardiovascular, pulmonary, gastrointestinal, neurological, and hematological manifestations. Abnormal hematological findings are thought to have a role in early risk stratification and prognostication of COVID-19 patients. However, the data on hematological abnormalities associated with the disease among Ethiopian COVID-19 patients are limited.
Objective: To determine the magnitude of hematological abnormalities among COVID-19 patients admitted at Millennium COVID-19 referral treatment center, Addis Ababa, Ethiopia.
Methods: A prospective cross-sectional study was conducted among COVID-19 patients admitted to Millennium COVID-19 referral treatment center from May to July, 2020. A total of 334 COVID-19 patients were included using convenience sampling. Socio-demographic data and disease severity status of admitted patients were recorded. Three milliliters of venous blood was collected and analyzed by Beckman Coulter DXH-600 automated analyzer to determine complete blood count (CBC). The data were entered and analyzed using SPSS version 23 software. Association of age, sex, and disease severity with hematological abnormalities was analyzed using binary logistic regression. An odds ratio and 95% confidence interval were used to measure the strength of association. P-value < 0.05 was considered as statistically significant.
Results: Of 334 admitted COVID-19 patients, the majority were males (62.3%) and 69.8% had moderate disease conditions. The overall magnitude of any cytopenia and pancytopenia was 41% and 1.8%, respectively. The magnitude of anemia, thrombocytopenia, and leukopenia was 24.9%, 21.6%, and 5.4%, respectively. Lymphopenia (72.2%) was the most common hematological abnormality. COVID-19 patients with severe and critical disease were more likely to develop anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia than those with moderate disease condition, with a significant association.
Conclusion: Lymphopenia was the most common hematological abnormality observed among COVID-19 patients. Hematological abnormalities such as anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia were significantly associated with disease severity. Monitoring and evaluation of hematological parameters could provide prognostic insight into the management and risk stratification of COVID-19 patients. However, further studies are required to fully understand the utility of hematological parameters for the prognosis of COVID-19 disease.

Keywords: hematological parameters, COVID-19, disease severity

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