Features of Hematological and Hemostasiological Parameters in Coronavirus Infection COVID-19 and Community-Acquired Pneumonia

Against the background of priority attention paid to the COVID-19 pandemic, there are also cases of community-acquired pneumonia of a different genesis. Identification of the features of lung lesions in such diseases is relevant during the spread of seasonal respiratory infections. The comparative study of the dynamics of hematological and hemostasiological parameters of blood in patients with pneumonia of various origins is of interest in terms of searching for predictors of the prognosis of the diseases development.Aim. To compare the features of clinical symptoms, hematological and hemostasiological parameters in patients with pneumonia caused by COVID-19 and in patients with community-acquired pneumonia.Materials and methods. During cross-sectional study two groups were formed: group 1 consisted of 92 patients diagnosed with moderate community-acquired pneumonia caused by COVID-19 infection; group 2 included 40 patients diagnosed with moderate community-acquired bilateral polysegmental pneumonia.Results. It was found that patients with COVID-19 had an older age (69 vs 39.3 years), a lower body temperature at admission (37.5 vs 38.85 °C), a lower percentage of reduced oxygen saturation (less than 89 % in 5.4 % of cases vs 10 % of cases). In most cases, the average values of some hematological parameters in patients with COVID-19 did not go beyond the reference range. Leukopenia (below 4 × 109 cells/l) and lymphopenia (below 1.1 × 109 cells/l) were observed in 26 % and 38 % of cases respectively; thrombocytopenia (less than 100 × 109 cells/l) – in 12.2 % of cases; hyperfibrinogenemia (more than 4 g/l) – in 65.3 % of cases. A direct correlation was found between platelet levels and leukocytes (R = 0.53; p < 0.001) and lymphocytes (R = 0.29; p = 0.06). Compared with the patients of the group 2,on average, patients with COVID-19 had significantly lower levels of leukocytes and lymphocytes (2.5 times each; p < 0.001) and an increased level of fibrinogen (by 45 %; p < 0.001).Conclusion. In patients with pneumonia caused by COVID-19, we revealed the particular features of clinical symptoms, hematological and hemostasiological blood parameters compared to community-acquired nonspecific pneumonia

Features of peripheral blood cellular immunity parameters in patients with lung damage up to 30 % in COVID-19

Background. The stability of human organism for different kind of infection, including SARS-CoV-2 is significantly defined by the immune system. The mechanisms of the cellular immunity to the SARS-CoV-2 are not exactly defined and are under study. The aim. To study the features of cell immunity parameters in patients with lung damage up to 30 % in COVID-19. Material and methods. 73 people were examined during the 2020–2021 pandemic. The study group consisted of 31 patients with lung damage up to 30 % with COVID-19, the comparison group consisted of 42 people not infected with SARS-CoV-2. A complete clinical blood count was carried out using a Medonic M20 hematological analyzer (Boule Medical, Sweden), the level of lymphocyte subpopulations was determined using a FACS Calibur cytometer (BD, USA) and FITC- and phycoerythrin-labeled monoclonal antibodies (Sorbent, Russia). Differences were considered statistically significant at p < 0.05. Results. Patients with COVID-19 with lung damage according to computed tomography (CT) ≤ 30 % before the treatment had a restructuring in the ratio of lymphocyte subpopulations in 67.7 % of cases. Lymphopenia (< 1.1 × 109 cells/l) was detected in 34.4 % of patients: a decrease in the absolute count of CD3+ lymphocytes by 30.8 %, CD3+CD4+ – by 35 %, CD3+CD8+ – by 6.7 % (p < 0.05), CD16+CD56+ natural killer (NK) cells – by 29.4 % (p = 0.009). The level of CD95+ lymphocytes in COVID-19 is 3.2 times higher than in healthy individuals. Elevated levels of HLA-DR+- (> 20 %) and CD3+ HLADR+ lymphocytes (> 6 %) are recorded in 60 % and 86.7 % of patients, respectively. Elevated levels of CD19+ B lymphocytes (> 17 %) in COVID-19 are 2.6 times more common than in healthy individuals. Correlation dependences of the count of NK cells with a wide range of T lymphocyte subpopulations were revealed. Conclusion. Cellular immunity indicators in COVID-19 have a number of features that can serve as predictors of the progression of the severity of the disease