Análise de exames hematológicos em pacientes com covid-19: compreendendo a relação entre a doença e as alterações sanguíneas

Abstract

Early identification of an infection by SARS-CoV-2, in comparison to other upper respiratory tract infections, plays a crucial role in controlling Covid-19. Faced with this challenge, several researchers have dedicated themselves to seeking laboratory parameters that could be valuable in differentiating the virus, as well as understanding the diagnosis, prognosis, and characterization of disease-related risk. Therefore, the main objective of the present study is to evaluate the primary hematological alterations in patients affected by Covid-19 and their impact on infection and disease aggravation. It is worth noting that this is a descriptive, retrospective, documentary, exploratory research, with consultations in databases without the possibility of individual identification. The study is conducted and grounded in Resolution n. 510/2016 of the National Health Council. Among the observed parameters, hematological exams stand out with fundamental information related to the mechanism of action of SARS-CoV-2. Important findings, such as anemia, anisocytosis, increased ferritin, leukopenia, and thrombocytopenia, are strongly associated with the prognosis of severe patients. Anemia was predominantly observed in more than 68% of cases; there are no conclusive studies regarding this condition in relation to the virus, but it is believed to be associated with risk factors and possible underlying comorbidities. Regarding anisocytosis, observed in 51% of patients, it can be considered a potential marker of outcome in the course of the disease, as the RDW value tends to increase as the patient's condition worsens. The increase in ferritin, also related to decreased serum iron, is present in 53% of cases, with an average value of 520 ng/mL, demonstrating an ongoing inflammatory process. As for white blood cells, a heterogeneous manifestation is observed, where patients may present leukopenia, leukocytosis, or even a normal leukocyte count. However, the most relevant finding in this study related to the white cell series, present in 45% of patients, is leukopenia, which suggests a more critical state of the disease. Thrombocytopenia, associated with an increase in D-Dimer, can be observed in 58% of patients, caused by the release of inflammatory cytokines by the virus, which are responsible for causing damage in the coagulation process. Furthermore, it is concluded that the periodic performance of these exams allows the monitoring of the employed prophylaxis, with the main purpose of verifying the effective progress of the results, contributing to the patient's health recovery, and enabling a more accurate diagnosis for possible damage that the disease may cause.