The prognostic value of laboratory parameters referring to hemopoietic stress in patients with COVID-19-a single center experience

In the present study we attempted to assess whether a relationship exists between laboratory signs of hemopoietic stress and fatal outcome in coronavirus disease (COVID)-19-positive intensive care unit (ICU) and non-ICU patients. Prospectively collected data of 206 COVID-19 patients (95 ICU and 111 non-ICU) were retrospectively analyzed. Beside comparing routine laboratory parameters, the analysis focused on nucleated red blood cell count (NRBC), red cell distribution width (RCDW), immature granulocyte count (IG), mean platelet volume (MPV) and platelet distribution width (PDW). In the total COVID cohort higher NRBC, RCDW, IG, MPV and PDW values were observed in patients with fatal outcome as compared to survivors. Significant differences could be observed between non-ICU and critically ill patients in NRBC (medians and interquartile range (IQR): 10/0-20/ vs. 20/10-60/ g/L, p < 0.001), IG (0.16/0.04-0.39/ vs. 0.42 /0.20-0.75/ g/L, p < 0.001), MPV (10.9 +/- 1.2 vs. 11.4 +/- 1.2 fL,p < 0.01) and PDW (14.5/11.6-44.7/ vs. 19.9/13.7-57.7/ fL,p < 0.001), respectively. In the ICU subgroup, RDW and MPV were higher among patients who died. Severe acute respiratory syndrome after coronavirus infection (SARS-CoV-2 infection) causes perturbation of hemopoiesis. Laboratory parameters referring to hemopoietic stress may serve as useful predictors of poor outcome in hospitalized COVID-19 patients needing intensive care.