Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital

Authors

  • Luis F. Gonzalez-Mosquera , M.D. Nassau University Medical Center
  • Sandra Gomez-Paz, M.D. Nassau University Medical Center
  • Eric Lam, D.O. Nassau University Medical Center
  • Diana Cardenas-Maldonado, M.D. Nassau University Medical Center
  • Joshua Fogel, Ph.D. Brooklyn College
  • Vishnu Adi, D.O. Nassau University Medical Center
  • Sofia Rubinstein, M.D. Nassau University Medical Center

DOI:

https://doi.org/10.17161/kjm.vol15.15699

Keywords:

Blood cells, neutrophils, blood platelets, COVID-19, mortality, length of stay

Abstract

Introduction. COVID-19 affects the hematologic system. We evaluate the impact of hematologic involvement of different blood cell line parameters of white blood cells including absolute neutrophil count (ANC), hemoglobin, and platelets in COVID-19 patients and their association with hospital mortality and length of stay (LOS). 

Methods. This is a retrospective study of 475 patients with confirmed positive COVID-19 infection and hematologic abnormalities in the metropolitan New York City area.

Results. Increased (ANC) (OR:1.20; 95% CI:1.02-1.42, p<0.05) increased days to hematologic involvement (OR:4.44, 95% CI:1.42-13.90; p<0.05), and persistence of hematologic involvement at discharge (OR:2.87, 95% CI:1.20, 6.90, p<0.05) were associated with higher mortality. Higher hemoglobin at admission (OR:0.77, 95% CI:0.60-0.98, p<0.001) and platelets peak (OR:0.995, 95% CI 95%:0.992-0.997, p<0.001) were associated with decreased mortality. Patients with higher white blood cell peak (B=0.46, SE=0.07, p<0.001) and higher hemoglobin at admission (B=0.05, SE=0.01, p<0.001) were associated with higher LOS. Those with higher hemoglobin nadir (B=-0.06, SE=0.01, p<0.001), higher platelets nadir (B=-0.001, SE=<0.001, p<0.001), and hematologic involvement at discharge/death (B=-0.06, SE=0.03, p<0.05) were associated with lower LOS.

Conclusions. These findings can be used by clinicians to better risk-stratify patients with hematologic involvement in COVID-19 and tailor therapies to potentially improve patient outcomes.

Author Biographies

Luis F. Gonzalez-Mosquera , M.D., Nassau University Medical Center

Department of Medicine

Sandra Gomez-Paz, M.D., Nassau University Medical Center

Department of Medicine, Division of Gastroenterology

Eric Lam, D.O., Nassau University Medical Center

Department of Medicine

Diana Cardenas-Maldonado, M.D., Nassau University Medical Center

Department of Medicine

Joshua Fogel, Ph.D., Brooklyn College

Department of Business Management

Vishnu Adi, D.O., Nassau University Medical Center

Department of Medicine

Sofia Rubinstein, M.D., Nassau University Medical Center

Department of Medicine, Division of Nephrology and Hypertension

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Published

2022-01-11

Issue

Section

Original Research