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Recent Advances in Inflammation & Allergy Drug Discovery

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ISSN (Print): 2772-2708
ISSN (Online): 2772-2716

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Research Article

COVID-19 Associated Pancytopenia (CAP): A Clinical Impact

Author(s): Jitendra Singh, Anju Dinkar*, Nilesh Kumar and Kailash Kumar

Volume 17, Issue 1, 2023

Published on: 22 December, 2022

Page: [71 - 78] Pages: 8

DOI: 10.2174/2772270817666221207094122

Price: $65

Abstract

Background: SARS-CoV-2 infection has mild and asymptomatic to critical clinical course affecting mainly the lungs. Few case reports of COVID-19-associated pancytopenia are reported, but a series of 18 cases is not described in the literature to date.

Aims and Objectives: This study aimed to investigate pancytopenia in COVID-19 and its correlation with severity and to explore the detailed clinical and biochemical information in COVID-19- associated pancytopenia. This study also highlights pancytopenia's rarity and prognostic value among COVID-19 patients.

Materials and Methods: This was a retrospective observational study conducted in a tertiary care centre at a level 3 COVID care facility that included adults of either sex having positive RT PCR for COVID-19 from October 2020 to May 2021. Data were collected from the online outpatient department and hospitalized patients.

Results: A total of 18 cases were included in the study; 13 were males (72.2%). The mean age was calculated as 48.56 years. Cases were categorized as severe 13 (72.2%) and non-severe 5 (27.8%) disease on the first day of pancytopenia. The most common presentations were fever 18 (100%) and cough 18 (100%), followed by generalized weakness 16 (88.9%), breathlessness 15 (83.3%), and diarrhoea 10 (55.6%). One case died in the severe disease group. The mean of haemoglobin, leukocyte count, and platelets in severe vs non-severe disease were calculated as 8.59 vs 8.74, 2339 vs 2578, and 77769 vs 88600, respectively.

Conclusion: Pancytopenia was more prevalent in severe disease and age group 40-60 years. CAP was most likely due to secondary bone marrow suppression. It has no prognostic value for disease outcomes.

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[1]
Young NS. Bone marrow failure syndrome including aplastic anaemia and myelodysplasia. In: Jameson JL, Kasper DL, Longo DL, Fauci AS, Hauser SL, Loscalzo J, Eds. Harrison’s principles of internal medicine. 20th ed. New York: McGraw Hill 2018; pp. 723-733.
[2]
Singh J, Dinkar A, Gupta P, Atam V. Vitamin B12 deficiency in northern India tertiary care: Prevalence, risk factors and clinical characteristics. J Family Med Prim Care 2022; 11(6): 2381-8.
[http://dx.doi.org/10.4103/jfmpc.jfmpc_650_21] [PMID: 36119310]
[3]
Dinkar A, Singh J. Dengue infection in North India: An experience of a tertiary care center from 2012 to 2017. Tzu-Chi Med J 2019; 32(1): 36-40.
[PMID: 32110518]
[4]
Cheung CKM, Law MF, Lui GCY, Wong SH, Wong RSM. Coronavirus disease 2019 (COVID-19): A haematologist’s perspective. acta haematol 2021; 144(1): 10-23.
[http://dx.doi.org/10.1159/000510178] [PMID: 32721958]
[5]
Dinkar A, Singh J, Kumar N, Kumar K. COVID-19 associated acute pancreatitis: A case series from India. Infect Disord Drug Targets 2022; 22(8): e300522205405.
[http://dx.doi.org/10.2174/1871526522666220530142359] [PMID: 35638541]
[6]
Libby P, Lüscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J 2020; 41(32): 3038-44.
[http://dx.doi.org/10.1093/eurheartj/ehaa623] [PMID: 32882706]
[7]
Prebensen C, Myhre PL, Jonassen C, et al. Severe acute respiratory syndrome coronavirus 2 RNA in plasma is associated with intensive care unit admission and mortality in patients hospitalized with coronavirus disease 2019. Clin Infect Dis 2021; 73(3): e799-802.
[http://dx.doi.org/10.1093/cid/ciaa1338] [PMID: 32888003]
[8]
Schepis T, Larghi A, Papa A, et al. SARS-CoV2 RNA detection in a pancreatic pseudocyst sample. Pancreatology 2020; 20(5): 1011-2.
[http://dx.doi.org/10.1016/j.pan.2020.05.016] [PMID: 32498972]
[9]
Cordon-Cardo C, Pujadas E, Wajnberg A, et al. COVID-19: Staging of a new disease. Cancer Cell 2020; 38(5): 594-7.
[http://dx.doi.org/10.1016/j.ccell.2020.10.006] [PMID: 33086031]
[10]
COVID-19 Clinical management: Living guidance. 2021. Available from: https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-clinical-2021-1 [Accessed on: August 19 2021].
[11]
Ufuk F, Bulgurcu E, Sari T. COVID-19 associated pancytopenia and typhlitis. Am J Emerg Med 2021; 45: 685.e1-3.
[http://dx.doi.org/10.1016/j.ajem.2020.12.049] [PMID: 33446380]
[12]
Issa N, Lacassin F, Camou F. First case of persistent pancytopenia associated with SARS-CoV-2 bone marrow infiltration in an immunocompromised patient. Ann Oncol 2020; 31(10): 1418-9.
[http://dx.doi.org/10.1016/j.annonc.2020.06.016] [PMID: 32615155]
[13]
Aggarwal A, Shrivastava A, Kumar A, Ali A. Clinical and epidemiological features of SARS-CoV-2 patients in SARI ward of a tertiary care centre in New Delhi. J Assoc Physicians India 2020; 68(7): 19-26.
[PMID: 32602676]
[14]
Liu X, Zhang R, He G. Hematological findings in coronavirus disease 2019: Indications of progression of disease. Ann Hematol 2020; 99(7): 1421-8.
[http://dx.doi.org/10.1007/s00277-020-04103-5] [PMID: 32495027]
[15]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[16]
Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020; 158(6): 1831-1833.e3.
[http://dx.doi.org/10.1053/j.gastro.2020.02.055] [PMID: 32142773]
[17]
Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID‐19 infection. Am J Hematol 2020; 95(6): E131-4.
[http://dx.doi.org/10.1002/ajh.25774] [PMID: 32129508]
[18]
Zhang G, Zhang J, Wang B, Zhu X, Wang Q, Qiu S. Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A retrospective analysis. Respir Res 2020; 21(1): 74.
[http://dx.doi.org/10.1186/s12931-020-01338-8] [PMID: 32216803]
[19]
Cao X. COVID-19: Immunopathology and its implications for therapy. Nat Rev Immunol 2020; 20(5): 269-70.
[http://dx.doi.org/10.1038/s41577-020-0308-3] [PMID: 32273594]
[20]
Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[21]
Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chem Lab Med 2020; 58(7): 1021-8.
[http://dx.doi.org/10.1515/cclm-2020-0369] [PMID: 32286245]
[22]
Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol 2020; 99(6): 1205-8.
[http://dx.doi.org/10.1007/s00277-020-04019-0] [PMID: 32296910]
[23]
Bridwell RE, Inman BL, Birdsong S, Goss S, Long B. A coronavirus disease-2019 induced pancytopenia. Am J Emerg Med 2021; 47: 324.e1-3.
[http://dx.doi.org/10.1016/j.ajem.2021.02.043] [PMID: 33653644]
[24]
Zhao Y, He J, Wang J, et al. Development of pancytopenia in a patient with COVID‐19. J Med Virol 2021; 93(3): 1219-20.
[http://dx.doi.org/10.1002/jmv.26566] [PMID: 32990983]
[25]
Lefrançais E, Ortiz-Muñoz G, Caudrillier A, et al. The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors. Nature 2017; 544(7648): 105-9.
[http://dx.doi.org/10.1038/nature21706] [PMID: 28329764]
[26]
Dinkar A, Singh J, Kumar N. Demographic, clinical, investigational characteristics of COVID-19 related Guillain-Barré syndrome with differences from typical and another virus-related Guillain-Barré syndrome. Infect Disord Drug Targets 2022; 22(7): e290422204292.
[http://dx.doi.org/10.2174/1871526522666220429134113] [PMID: 35507796]

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