Hematological alterations associated with long COVID-19

Abstract

Long COVID-19 is a condition characterized by persistent symptoms lasting beyond the acute phase of COVID-19. Long COVID-19 produces diverse symptomatology and can impact organs and systems, including the hematological system. Several studies have reported, in COVID-19 patients, hematological abnormalities. Most of these alterations are associated with a higher risk of severe disease and poor outcomes. This literature review identified studies reporting hematological parameters in individuals with Long COVID-19. Findings suggest that Long COVID-19 is associated with a range of sustained hematological alterations, including alterations in red blood cells, anemia, lymphopenia, and elevated levels of inflammatory markers such as ferritin, D-dimer, and IL-6. These alterations may contribute to a better understanding of the pathophysiology of Long COVID-19 and its associated symptoms. However, further research is needed to elucidate the underlying mechanisms and potential treatments for these hematological changes in individuals with Long COVID-19.

Keywords: COVID-19; SARS-CoV-2; hematology; long COVID-19; post-acute sequelae; red blood cells.

FIGURE 1

Mechanism involved in Long COVID. Studies have identified the main factor in persistent symptoms that characterize Long COVID. Mechanisms include vascular dysfunction and formation of micro clots that lead to thrombosis, immune dysregulation with increased pro-inflammatory response and autoreactive immunity driven by molecular mimicry and bystander activation of lymphocytes, the persistence of viral replication and SARS-CoV-2 proteins circulation, and reactivation of human latent herpes viruses.