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Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital

INTRODUCTION: COVID-19 affects the hematologic system. This article evaluated the impact of hematologic involvement of different blood cell line parameters of white blood cells including absolute neutrophil count (ANC), hemoglobin, and platelets in COVID-19 patients and their association with hospit...

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Autores principales: Gonzalez-Mosquera, Luis F., Gomez-Paz, Sandra, Lam, Eric, Cardenas-Maldonado, Diana, Fogel, Joshua, Adi, Vishnu, Rubinstein, Sofia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of Kansas Medical Center 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8765500/
https://www.ncbi.nlm.nih.gov/pubmed/35106117
http://dx.doi.org/10.17161/kjm.vol15.15699
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author Gonzalez-Mosquera, Luis F.
Gomez-Paz, Sandra
Lam, Eric
Cardenas-Maldonado, Diana
Fogel, Joshua
Adi, Vishnu
Rubinstein, Sofia
author_facet Gonzalez-Mosquera, Luis F.
Gomez-Paz, Sandra
Lam, Eric
Cardenas-Maldonado, Diana
Fogel, Joshua
Adi, Vishnu
Rubinstein, Sofia
author_sort Gonzalez-Mosquera, Luis F.
collection PubMed
description INTRODUCTION: COVID-19 affects the hematologic system. This article evaluated the impact of hematologic involvement of different blood cell line parameters of white blood cells including absolute neutrophil count (ANC), hemoglobin, and platelets in COVID-19 patients and their association with hospital mortality and length of stay (LOS). METHODS: This was a retrospective study of 475 patients with confirmed positive COVID-19 infection and hematologic abnormalities in the metropolitan New York City area. RESULTS: Elevated absolute neutrophil count (OR: 1.20; 95% CI: 1.02–1.42; p < 0.05) increased days of hematologic involvement (OR: 4.44; 95% CI: 1.42–13.90; p < 0.05), and persistence of hematologic involvement at discharge (OR: 2.87; 95% CI: 1.20–6.90; p < 0.05) was associated with higher mortality. Higher hemoglobin at admission (OR: 0.77; 95% CI:0.60–0.98; p < 0.001) and platelets peak (OR: 0.995; 95% CI: 0.992–0.997; p < 0.001) were associated with decreased mortality. Patients with higher white blood cell peak (B = 0.46; SE = 0.07; p < 0.001) and higher hemoglobin at admission (B = 0.05; SE = 0.01; p < 0.001) were associated with higher LOS. Those with higher hemoglobin nadir (B = −0.06; SE = 0.01; p < 0.001), higher platelets nadir (B = −0.001; SE = < 0.001; p < 0.001), and hematologic involvement at discharge or death (B = −0.06; SE = 0.03; p < 0.05) were associated with lower LOS. CONCLUSIONS: These findings can be used by clinicians to better risk-stratify patients with hematologic involvement in COVID-19 and tailor therapies potentially to improve patient outcomes.
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spelling pubmed-87655002022-01-31 Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital Gonzalez-Mosquera, Luis F. Gomez-Paz, Sandra Lam, Eric Cardenas-Maldonado, Diana Fogel, Joshua Adi, Vishnu Rubinstein, Sofia Kans J Med Original Research INTRODUCTION: COVID-19 affects the hematologic system. This article evaluated the impact of hematologic involvement of different blood cell line parameters of white blood cells including absolute neutrophil count (ANC), hemoglobin, and platelets in COVID-19 patients and their association with hospital mortality and length of stay (LOS). METHODS: This was a retrospective study of 475 patients with confirmed positive COVID-19 infection and hematologic abnormalities in the metropolitan New York City area. RESULTS: Elevated absolute neutrophil count (OR: 1.20; 95% CI: 1.02–1.42; p < 0.05) increased days of hematologic involvement (OR: 4.44; 95% CI: 1.42–13.90; p < 0.05), and persistence of hematologic involvement at discharge (OR: 2.87; 95% CI: 1.20–6.90; p < 0.05) was associated with higher mortality. Higher hemoglobin at admission (OR: 0.77; 95% CI:0.60–0.98; p < 0.001) and platelets peak (OR: 0.995; 95% CI: 0.992–0.997; p < 0.001) were associated with decreased mortality. Patients with higher white blood cell peak (B = 0.46; SE = 0.07; p < 0.001) and higher hemoglobin at admission (B = 0.05; SE = 0.01; p < 0.001) were associated with higher LOS. Those with higher hemoglobin nadir (B = −0.06; SE = 0.01; p < 0.001), higher platelets nadir (B = −0.001; SE = < 0.001; p < 0.001), and hematologic involvement at discharge or death (B = −0.06; SE = 0.03; p < 0.05) were associated with lower LOS. CONCLUSIONS: These findings can be used by clinicians to better risk-stratify patients with hematologic involvement in COVID-19 and tailor therapies potentially to improve patient outcomes. University of Kansas Medical Center 2022-01-11 /pmc/articles/PMC8765500/ /pubmed/35106117 http://dx.doi.org/10.17161/kjm.vol15.15699 Text en © 2022 The University of Kansas Medical Center https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Gonzalez-Mosquera, Luis F.
Gomez-Paz, Sandra
Lam, Eric
Cardenas-Maldonado, Diana
Fogel, Joshua
Adi, Vishnu
Rubinstein, Sofia
Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital
title Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital
title_full Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital
title_fullStr Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital
title_full_unstemmed Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital
title_short Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital
title_sort hematologic involvement as a predictor of mortality in covid-19 patients in a safety net hospital
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8765500/
https://www.ncbi.nlm.nih.gov/pubmed/35106117
http://dx.doi.org/10.17161/kjm.vol15.15699
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