tetano
Editor, Senior Moderator
Hematology
. 2024 Dec;29(1):2311006.
doi: 10.1080/16078454.2024.2311006. Epub 2024 Feb 2. Indicators of stress hematopoiesis in the blood predict COVID-19 progression in patients over 65 years old
Miodrag Vučić[SUP] 1 2 [/SUP], Jelena Milenkovic[SUP] 3 [/SUP], Boris Djindjic[SUP] 3 4 [/SUP], Vladana Stojiljkovic[SUP] 5 6 [/SUP], Dijana Stojanovic[SUP] 3 [/SUP], Branka Djordjevic[SUP] 5 [/SUP], Maja Milojkovic[SUP] 3 [/SUP], Sanja Velickovic[SUP] 2 [/SUP]
Affiliations
Objectives: Advanced age is a well-established risk factor for severe coronavirus disease 2019 (COVID-19). Exacerbated inflammation affects multiple organs, among which hematopoiesis responds by increased output of various cells. We aimed to determine the association between COVID-19 progression and large immature cell (LIC) counts, changes in erythrocyte and platelet distribution widths (RDW, PDW) with reference to patients' age.
Methods: A total of 755 patients with complete blood cell (CBC) analysis in the first 24 h of hospitalization were enrolled. Patients were divided into two groups: under and above 65 years of age.
Results: The LIC counts were different in both groups (p < 0.003). However, only the senior patients had markedly different values of RDW and PDW (p < 0.001). The receiver operating characteristic (ROC) curve analysis provided increased LIC (AUC = 0.600), RDW (AUC = 0.609), PDW (AUC = 0.556), and platelet to LIC ratio (AUC = 0.634) as significant in discriminating outcome in the older group. Importantly, these results were not repeated in the younger patients. In the elderly, the progression was predicted with LIC cut-off at ≥ 0.305 × 109/L (OR = 3.166) and RDW over 12.15% (OR = 2.081).
Discussion: Aging is characterized by a decline in immunological competence with a compromised control of inflammation leading to a proinflammatory state. This background together with the actions of pathogens may lead to emergency myelopoiesis.
Conclusion: Our results point to the important differences between age groups regarding CBC-related parameters of stress hematopoiesis during severe infection. Higher LIC, RDW and PDW levels were reliable in the early identification of COVID-19 progression only in the elderly.
Keywords: Large immature cells; elderly; neutrophils; platelet distribution width; platelets; red cell distribution width; severe acute respiratory syndrome coronavirus 2.
. 2024 Dec;29(1):2311006.
doi: 10.1080/16078454.2024.2311006. Epub 2024 Feb 2. Indicators of stress hematopoiesis in the blood predict COVID-19 progression in patients over 65 years old
Miodrag Vučić[SUP] 1 2 [/SUP], Jelena Milenkovic[SUP] 3 [/SUP], Boris Djindjic[SUP] 3 4 [/SUP], Vladana Stojiljkovic[SUP] 5 6 [/SUP], Dijana Stojanovic[SUP] 3 [/SUP], Branka Djordjevic[SUP] 5 [/SUP], Maja Milojkovic[SUP] 3 [/SUP], Sanja Velickovic[SUP] 2 [/SUP]
Affiliations
- PMID: 38305411
- DOI: 10.1080/16078454.2024.2311006
Objectives: Advanced age is a well-established risk factor for severe coronavirus disease 2019 (COVID-19). Exacerbated inflammation affects multiple organs, among which hematopoiesis responds by increased output of various cells. We aimed to determine the association between COVID-19 progression and large immature cell (LIC) counts, changes in erythrocyte and platelet distribution widths (RDW, PDW) with reference to patients' age.
Methods: A total of 755 patients with complete blood cell (CBC) analysis in the first 24 h of hospitalization were enrolled. Patients were divided into two groups: under and above 65 years of age.
Results: The LIC counts were different in both groups (p < 0.003). However, only the senior patients had markedly different values of RDW and PDW (p < 0.001). The receiver operating characteristic (ROC) curve analysis provided increased LIC (AUC = 0.600), RDW (AUC = 0.609), PDW (AUC = 0.556), and platelet to LIC ratio (AUC = 0.634) as significant in discriminating outcome in the older group. Importantly, these results were not repeated in the younger patients. In the elderly, the progression was predicted with LIC cut-off at ≥ 0.305 × 109/L (OR = 3.166) and RDW over 12.15% (OR = 2.081).
Discussion: Aging is characterized by a decline in immunological competence with a compromised control of inflammation leading to a proinflammatory state. This background together with the actions of pathogens may lead to emergency myelopoiesis.
Conclusion: Our results point to the important differences between age groups regarding CBC-related parameters of stress hematopoiesis during severe infection. Higher LIC, RDW and PDW levels were reliable in the early identification of COVID-19 progression only in the elderly.
Keywords: Large immature cells; elderly; neutrophils; platelet distribution width; platelets; red cell distribution width; severe acute respiratory syndrome coronavirus 2.