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Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study

PURPOSE: Unraveling the pathophysiology of COVID-19 disease is of crucial importance for designing treatment. The purpose of this study is to investigate the effects of the disease on erythrocytes (RBCs) and to correlate the findings with disease severity. MATERIALS AND METHODS: Hospitalized patient...

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Autores principales: Bouchla, Anthi, Kriebardis, Anastasios G., Georgatzakou, Hara T., Fortis, Sotirios P., Thomopoulos, Thomas P., Lekkakou, Leoni, Markakis, Konstantinos, Gkotzias, Dimitrios, Panagiotou, Aikaterini, Papageorgiou, Effie G., Pouliakis, Abraham, Stamoulis, Konstantinos E., Papageorgiou, Sotirios G., Pappa, Vasiliki, Valsami, Serena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812589/
https://www.ncbi.nlm.nih.gov/pubmed/35126186
http://dx.doi.org/10.3389/fphys.2021.825055
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author Bouchla, Anthi
Kriebardis, Anastasios G.
Georgatzakou, Hara T.
Fortis, Sotirios P.
Thomopoulos, Thomas P.
Lekkakou, Leoni
Markakis, Konstantinos
Gkotzias, Dimitrios
Panagiotou, Aikaterini
Papageorgiou, Effie G.
Pouliakis, Abraham
Stamoulis, Konstantinos E.
Papageorgiou, Sotirios G.
Pappa, Vasiliki
Valsami, Serena
author_facet Bouchla, Anthi
Kriebardis, Anastasios G.
Georgatzakou, Hara T.
Fortis, Sotirios P.
Thomopoulos, Thomas P.
Lekkakou, Leoni
Markakis, Konstantinos
Gkotzias, Dimitrios
Panagiotou, Aikaterini
Papageorgiou, Effie G.
Pouliakis, Abraham
Stamoulis, Konstantinos E.
Papageorgiou, Sotirios G.
Pappa, Vasiliki
Valsami, Serena
author_sort Bouchla, Anthi
collection PubMed
description PURPOSE: Unraveling the pathophysiology of COVID-19 disease is of crucial importance for designing treatment. The purpose of this study is to investigate the effects of the disease on erythrocytes (RBCs) and to correlate the findings with disease severity. MATERIALS AND METHODS: Hospitalized patients (n = 36) with COVID-19 and control group of healthy volunteers (n = 18) were included in the study. Demographic data, clinical, laboratory and chest Computed Tomography (CT) findings at time of admission were recorded. Laboratory measurements included: Hemoglobin (H b), indirect billirubin, LDH, D-Dimers, and plasma free hemoglobin (plasma free-Hb). On RBCs were performed: osmotic fragility (MCF), Free-Hb after mechanical stress (Free-Hb-MECH), intracellular RBC concentration of calcium ions (iCa(2+)), intracellular ROS (iROS), G6PD, intracellular active caspase-3 (RBC-caspase-3), IgG immunoglobulins (RBC-IgGs), which are bound on RBCs’ senescent neo-antigen proteins and RBC surface phosphatidylserine (RBC-PS). RESULTS: The percentage of males was 50 and 66% and the mean age was 65.16 ± 14.24 and 66.33 ± 13.48 years among patients and controls respectively (mean ± SD, p = 0.78). Upon admission patients’ PO(2)/FiO(2) ratio was 305.92 ± 76.75 and distribution of infiltration extend on chest CT was: 0–25% (N = 19), 25–50%: (N = 7), and 50–75% (N = 9). Elevated hemolysis markers (LDH and plasma free-Hb) were observed in patients compared to the control group. Patients’ RBCs were more sensitive to mechanical stress, and exhibited significantly elevated apoptotic markers (iCa(2+), RBC-PS). Plasma free Hb levels correlated with the extend of pulmonary infiltrates on chest CT in COVID-19 patients. Surprisingly, patients’ RBC-iROS were decreased, a finding possibly related with the increased G6PDH levels in this group, suggesting a possible compensatory mechanism against the virus. This compensatory mechanism seemed to be attenuated as pulmonary infiltrates on chest CT deteriorated. Furthermore, RBC-IgGs correlated with the severity of pulmonary CT imaging features as well as the abnormality of lung function, which are both associated with increased disease severity. Lastly, patients’ D-Dimers correlated with RBC surface phosphatidylserine, implying a possible contribution of the red blood cells in the thrombotic diathesis associated with the SARS-CoV-2 disease. CONCLUSION: This pilot study suggests that SARS-CoV-2 infection has an effect on red blood cells and there seems to be an association between RBC markers and disease severity in these patients.
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spelling pubmed-88125892022-02-04 Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study Bouchla, Anthi Kriebardis, Anastasios G. Georgatzakou, Hara T. Fortis, Sotirios P. Thomopoulos, Thomas P. Lekkakou, Leoni Markakis, Konstantinos Gkotzias, Dimitrios Panagiotou, Aikaterini Papageorgiou, Effie G. Pouliakis, Abraham Stamoulis, Konstantinos E. Papageorgiou, Sotirios G. Pappa, Vasiliki Valsami, Serena Front Physiol Physiology PURPOSE: Unraveling the pathophysiology of COVID-19 disease is of crucial importance for designing treatment. The purpose of this study is to investigate the effects of the disease on erythrocytes (RBCs) and to correlate the findings with disease severity. MATERIALS AND METHODS: Hospitalized patients (n = 36) with COVID-19 and control group of healthy volunteers (n = 18) were included in the study. Demographic data, clinical, laboratory and chest Computed Tomography (CT) findings at time of admission were recorded. Laboratory measurements included: Hemoglobin (H b), indirect billirubin, LDH, D-Dimers, and plasma free hemoglobin (plasma free-Hb). On RBCs were performed: osmotic fragility (MCF), Free-Hb after mechanical stress (Free-Hb-MECH), intracellular RBC concentration of calcium ions (iCa(2+)), intracellular ROS (iROS), G6PD, intracellular active caspase-3 (RBC-caspase-3), IgG immunoglobulins (RBC-IgGs), which are bound on RBCs’ senescent neo-antigen proteins and RBC surface phosphatidylserine (RBC-PS). RESULTS: The percentage of males was 50 and 66% and the mean age was 65.16 ± 14.24 and 66.33 ± 13.48 years among patients and controls respectively (mean ± SD, p = 0.78). Upon admission patients’ PO(2)/FiO(2) ratio was 305.92 ± 76.75 and distribution of infiltration extend on chest CT was: 0–25% (N = 19), 25–50%: (N = 7), and 50–75% (N = 9). Elevated hemolysis markers (LDH and plasma free-Hb) were observed in patients compared to the control group. Patients’ RBCs were more sensitive to mechanical stress, and exhibited significantly elevated apoptotic markers (iCa(2+), RBC-PS). Plasma free Hb levels correlated with the extend of pulmonary infiltrates on chest CT in COVID-19 patients. Surprisingly, patients’ RBC-iROS were decreased, a finding possibly related with the increased G6PDH levels in this group, suggesting a possible compensatory mechanism against the virus. This compensatory mechanism seemed to be attenuated as pulmonary infiltrates on chest CT deteriorated. Furthermore, RBC-IgGs correlated with the severity of pulmonary CT imaging features as well as the abnormality of lung function, which are both associated with increased disease severity. Lastly, patients’ D-Dimers correlated with RBC surface phosphatidylserine, implying a possible contribution of the red blood cells in the thrombotic diathesis associated with the SARS-CoV-2 disease. CONCLUSION: This pilot study suggests that SARS-CoV-2 infection has an effect on red blood cells and there seems to be an association between RBC markers and disease severity in these patients. Frontiers Media S.A. 2022-01-20 /pmc/articles/PMC8812589/ /pubmed/35126186 http://dx.doi.org/10.3389/fphys.2021.825055 Text en Copyright © 2022 Bouchla, Kriebardis, Georgatzakou, Fortis, Thomopoulos, Lekkakou, Markakis, Gkotzias, Panagiotou, Papageorgiou, Pouliakis, Stamoulis, Papageorgiou, Pappa and Valsami. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Bouchla, Anthi
Kriebardis, Anastasios G.
Georgatzakou, Hara T.
Fortis, Sotirios P.
Thomopoulos, Thomas P.
Lekkakou, Leoni
Markakis, Konstantinos
Gkotzias, Dimitrios
Panagiotou, Aikaterini
Papageorgiou, Effie G.
Pouliakis, Abraham
Stamoulis, Konstantinos E.
Papageorgiou, Sotirios G.
Pappa, Vasiliki
Valsami, Serena
Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study
title Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study
title_full Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study
title_fullStr Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study
title_full_unstemmed Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study
title_short Red Blood Cell Abnormalities as the Mirror of SARS-CoV-2 Disease Severity: A Pilot Study
title_sort red blood cell abnormalities as the mirror of sars-cov-2 disease severity: a pilot study
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812589/
https://www.ncbi.nlm.nih.gov/pubmed/35126186
http://dx.doi.org/10.3389/fphys.2021.825055
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