Temporal changes of haematological and radiological findings of the COVID-19 infection-a review of literature

• Published in: BMC pulmonary medicine 2021-01, Vol.21 (1), p.37-16, Article 37
• Main Authors: Lim, Albert Yick Hou, Goh, Jun Leng, Chua, Mae Chui Wei, Heng, Bee Hoon, Abisheganaden, John Arputham, George, Pradeep Paul
• Format: Article
• Language: English
• Subjects: Asymptomatic; Blood; C-reactive protein; C-Reactive Protein - metabolism; Calcium-binding protein; Cell number; Clinical manifestations; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - diagnostic imaging; COVID-19 diagnostic tests; Dehydrogenases; Disease; Disease Progression; Hematology; Humans; L-Lactate dehydrogenase; L-Lactate Dehydrogenase - blood; Lactic acid; Leukocyte Count; Leukocytes (neutrophilic); Lipoproteins; Lung - diagnostic imaging; Lung diseases; Lymphocyte count; Lymphocytes; Lymphopenia; Lymphopenia - blood; Medical examination; Medical laboratories; Medical Subject Headings-MeSH; Neutrophils; Pandemics; Patients; Peripheral blood; Pneumonia; Pulmonology; Radiography, Medical; Respiratory diseases; Respiratory system; SARS-COV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Temporal trends; Troponin
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-020-01389-z

COVID-19 is a systemic viral infection which mainly targets the human respiratory system with many secondary clinical manifestations especially affecting the hematopoietic system and haemostasis. Few studies have highlighted the prognostic value of blood findings such as lymphopenia, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, LDH, CRP, cardiac troponin, low-density lipoproteins and chest radiographic abnormality. A study of progressions of blood and radiological results may help to identify patients at high risk of severe outcomes. This systematic review aimed to assess the temporal progression of blood and radiology findings of patients with COVID-19. Comprehensive systematic literature search was conducted on Medline, Embase and Cochrane databases to identify articles published for peripheral blood investigation and radiological results of COVID-19 patients. A total of 27 studies were included in this review. The common laboratory features reported include lymphopenia, elevated levels of C-reactive proteins and lactate dehydrogenase. For radiological signs, ground-glass opacifications, consolidations, and crazy paving patterns were frequently reported. There is a correlation between lymphocyte count, neutrophil count and biomarkers such as C-reactive proteins and lactate dehydrogenase; at a later phase of the disease (more than 7 days since onset of symptoms), lymphopenia worsens while neutrophil count, C-reactive protein levels and lactate dehydrogenase levels increase. Frequencies of ground-glass opacifications and ground-glass opacifications with consolidations decrease at a later phase of the disease while that of consolidation and crazy paving pattern rises as the disease progresses. More extensive lung involvement was also seen more frequently in the later phases. The correlation between temporal progression and the reported blood and radiological results may be helpful to monitor and evaluate disease progression and severity.