tetano
Editor, Senior Moderator
BMC Med
. 2024 Mar 7;22(1):105.
doi: 10.1186/s12916-024-03326-x. Characterization and trajectories of hematological parameters prior to severe COVID-19 based on a large-scale prospective health checkup cohort in western China: a longitudinal study of 13-year follow-up
Yifei Lin[SUP] #[/SUP][SUP] 1 [/SUP], Yong Yang[SUP] #[/SUP][SUP] 2 [/SUP], Nanyan Xiang[SUP] #[/SUP][SUP] 3 [/SUP], Le Wang[SUP] 4 [/SUP], Tao Zheng[SUP] 5 [/SUP], Xuejun Zhuo[SUP] 5 [/SUP], Rui Shi[SUP] 5 [/SUP], Xiaoyi Su[SUP] 6 [/SUP], Yan Liu[SUP] 7 [/SUP], Ga Liao[SUP] 8 [/SUP], Liang Du[SUP] 9 [/SUP], Jin Huang[SUP] 10 [/SUP]
Affiliations
Background: The relaxation of the "zero-COVID" policy on Dec. 7, 2022, in China posed a major public health threat recently. Complete blood count test was discovered to have complicated relationships with COVID-19 after the infection, while very few studies could track long-term monitoring of the health status and identify the characterization of hematological parameters prior to COVID-19.
Methods: Based on a 13-year longitudinal prospective health checkup cohort of ~ 480,000 participants in West China Hospital, the largest medical center in western China, we documented 998 participants with a laboratory-confirmed diagnosis of COVID-19 during the 1 month after the policy. We performed a time-to-event analysis to explore the associations of severe COVID-19 patients diagnosed, with 34 different hematological parameters at the baseline level prior to COVID-19, including the whole and the subtypes of white and red blood cells.
Results: A total of 998 participants with a positive SARS-CoV-2 test were documented in the cohort, 42 of which were severe cases. For white blood cell-related parameters, a higher level of basophil percentage (HR = 6.164, 95% CI = 2.066-18.393, P = 0.001) and monocyte percentage (HR = 1.283, 95% CI = 1.046-1.573, P = 0.017) were found associated with the severe COVID-19. For lymphocyte-related parameters, a lower level of lymphocyte count (HR = 0.571, 95% CI = 0.341-0.955, P = 0.033), and a higher CD4/CD8 ratio (HR = 2.473, 95% CI = 1.009-6.059, P = 0.048) were found related to the risk of severe COVID-19. We also observed that abnormality of red cell distribution width (RDW), mean corpuscular hemoglobin concentration (MCHC), and hemoglobin might also be involved in the development of severe COVID-19. The different trajectory patterns of RDW-SD and white blood cell count, including lymphocyte and neutrophil, prior to the infection were also discovered to have significant associations with the risk of severe COVID-19 (all P < 0.05).
Conclusions: Our findings might help decision-makers and clinicians to classify different risk groups of population due to outbreaks including COVID-19. They could not only optimize the allocation of medical resources, but also help them be more proactive instead of reactive to long COVID-19 or even other outbreaks in the future.
Keywords: COVID-19; Health checkup; Long term; Proactive health; Prospective cohort.
. 2024 Mar 7;22(1):105.
doi: 10.1186/s12916-024-03326-x. Characterization and trajectories of hematological parameters prior to severe COVID-19 based on a large-scale prospective health checkup cohort in western China: a longitudinal study of 13-year follow-up
Yifei Lin[SUP] #[/SUP][SUP] 1 [/SUP], Yong Yang[SUP] #[/SUP][SUP] 2 [/SUP], Nanyan Xiang[SUP] #[/SUP][SUP] 3 [/SUP], Le Wang[SUP] 4 [/SUP], Tao Zheng[SUP] 5 [/SUP], Xuejun Zhuo[SUP] 5 [/SUP], Rui Shi[SUP] 5 [/SUP], Xiaoyi Su[SUP] 6 [/SUP], Yan Liu[SUP] 7 [/SUP], Ga Liao[SUP] 8 [/SUP], Liang Du[SUP] 9 [/SUP], Jin Huang[SUP] 10 [/SUP]
Affiliations
- PMID: 38454462
- PMCID: PMC10921814
- DOI: 10.1186/s12916-024-03326-x
Background: The relaxation of the "zero-COVID" policy on Dec. 7, 2022, in China posed a major public health threat recently. Complete blood count test was discovered to have complicated relationships with COVID-19 after the infection, while very few studies could track long-term monitoring of the health status and identify the characterization of hematological parameters prior to COVID-19.
Methods: Based on a 13-year longitudinal prospective health checkup cohort of ~ 480,000 participants in West China Hospital, the largest medical center in western China, we documented 998 participants with a laboratory-confirmed diagnosis of COVID-19 during the 1 month after the policy. We performed a time-to-event analysis to explore the associations of severe COVID-19 patients diagnosed, with 34 different hematological parameters at the baseline level prior to COVID-19, including the whole and the subtypes of white and red blood cells.
Results: A total of 998 participants with a positive SARS-CoV-2 test were documented in the cohort, 42 of which were severe cases. For white blood cell-related parameters, a higher level of basophil percentage (HR = 6.164, 95% CI = 2.066-18.393, P = 0.001) and monocyte percentage (HR = 1.283, 95% CI = 1.046-1.573, P = 0.017) were found associated with the severe COVID-19. For lymphocyte-related parameters, a lower level of lymphocyte count (HR = 0.571, 95% CI = 0.341-0.955, P = 0.033), and a higher CD4/CD8 ratio (HR = 2.473, 95% CI = 1.009-6.059, P = 0.048) were found related to the risk of severe COVID-19. We also observed that abnormality of red cell distribution width (RDW), mean corpuscular hemoglobin concentration (MCHC), and hemoglobin might also be involved in the development of severe COVID-19. The different trajectory patterns of RDW-SD and white blood cell count, including lymphocyte and neutrophil, prior to the infection were also discovered to have significant associations with the risk of severe COVID-19 (all P < 0.05).
Conclusions: Our findings might help decision-makers and clinicians to classify different risk groups of population due to outbreaks including COVID-19. They could not only optimize the allocation of medical resources, but also help them be more proactive instead of reactive to long COVID-19 or even other outbreaks in the future.
Keywords: COVID-19; Health checkup; Long term; Proactive health; Prospective cohort.