Hematological Abnormalities in COVID-19: A Narrative Review

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  • 1 Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;
  • 2 Department of Zoology and Environment Sciences, Faculty of Science, University of Colombo, Colombo, Sri Lanka;
  • 3 Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka;
  • 4 Department of Haematology-Oncology, National University Cancer Institute, National University Health System Singapore, Singapore, Singapore;
  • 5 Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka

COVID-19 is caused by SARS-CoV-2. Although pulmonary manifestations have been identified as the major symptoms, several hematological abnormalities have also been identified. This review summarizes the reported hematological abnormalities (changes in platelet, white blood cell, and hemoglobin, and coagulation/fibrinolytic alterations), explores their patho-mechanisms, and discusses its management. Common hematological abnormalities in COVID-19 are lymphopenia, thrombocytopenia, and elevated D-dimer levels. These alterations are significantly more common/prominent in patients with severe COVID-19 disease, and thus may serve as a possible biomarker for those needing hospitalization and intensive care unit care. Close attention needs to be paid to coagulation abnormalities, and steps should be taken to prevent these occurring or to mitigate their harmful effects. The effect of COVID-19 in patients with hematological abnormalities and recognized hematological drug toxicities of therapies for COVID-19 are also outlined.

Author Notes

Address correspondence to Suranjith L. Seneviratne, Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, HK Dharmadasa Mawatha, Colombo, Sri Lanka. E-mail: suran200@yahoo.co.uk

Authors’ addresses: Asma Rahman, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka, E-mail: asma.rahman28@gmail.com. Roshan Niloofa, Department of Zoology and Environment Sciences, Faculty of Science, University of Colombo, Colombo, Sri Lanka, E-mail: rosh86niloo@gmail.com. Umesh Jayarajah, Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka, E-mail: umeshe.jaya@gmail.com. Sanjay De Mel, Department of Haematology- Oncology, National University Cancer Institute, National University Health System Singapore, Singapore, Singapore, and Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka, E-mail: wspdm199@yahoo.com. Visula Abeysuriya and Suranjith L. Seneviratne, Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka, E-mails: visulasrilanka@hotmail.com and suran200@yahoo.co.uk.

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