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. 2023 Aug 25;18(8):e0290242.
doi: 10.1371/journal.pone.0290242. eCollection 2023.

Evaluation of hematological parameters alterations in different waves of COVID-19 pandemic: A cross-sectional study

Javad Charostad  1   2 , Mohammad Rezaei Zadeh Rukerd  3 , Azadeh Shahrokhi  4 , Faezeh Afkhami Aghda  2 , Yaser Ghelmani  5   6 , Pouria Pourzand  7 , Sara Pourshaikhali  8 , Shahriar Dabiri  9 , Azam Dehghani  10 , Akram Astani  1   2 , Mohsen Nakhaie  3 , Ehsan Kakavand  11
Affiliations

Evaluation of hematological parameters alterations in different waves of COVID-19 pandemic: A cross-sectional study

Javad Charostad et al. PLoS One. .

Abstract

Background: The occurrence of variations in routine hematological parameters is closely associated with disease progression, the development of severe illness, and the mortality rate among COVID-19 patients. This study aimed to investigate hematological parameters in COVID-19 hospitalized patients from the 1st to the 5th waves of the current pandemic.

Methods: This cross-sectional study included a total of 1501 hospitalized patients with laboratory-confirmed COVID-19 based on WHO criteria, who were admitted to Shahid Sadoughi Hospital (SSH) in Yazd, Iran, from February 2020 to September 2021. Throughout, we encountered five COVID-19 surge waves. In each wave, we randomly selected approximately 300 patients and categorized them based on infection severity during their hospitalization, including partial recovery, full recovery, and death. Finally, hematological parameters were compared based on age, gender, pandemic waves, and outcomes using the Mann-Whitney U and Kruskal-Wallis tests.

Results: The mean age of patients (n = 1501) was 61.1±21.88, with 816 (54.3%) of them being men. The highest mortality in this study was related to the third wave of COVID-19 with 21.3%. There was a significant difference in all of the hematological parameters, except PDW, PLT, and RDW-CV, among pandemic waves of COVID-19 in our population. The highest rise in the levels of MCV and RDW-CV occurred in the 1st wave, in the 2nd wave for lymphocyte count, MCHC, PLT count, and RDW-SD, in the 3rd wave for WBC, RBC, neutrophil count, MCH, and PDW, and in the 4th wave for Hb, Hct, and ESR (p < 0.01). The median level of Hct, Hb, RBC, and ESR parameters were significantly higher, while the mean level of lymphocyte and were lower in men than in women (p < 0.001). Also, the mean neutrophil in deceased patients significantly was higher than in those with full recovered or partial recovery (p < 0.001).

Conclusion: The findings of our study unveiled notable variations in hematological parameters across different pandemic waves, gender, and clinical outcomes. These findings indicate that the behavior of different strains of the COVID-19 may differ across various stages of the pandemic.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. The flowchart of the participants in the study.
Fig 2
Fig 2. The time frame of each of the COVID-19 waves in Iran and its relationship with the outcomes.
Fig 3
Fig 3. The results of Kruskal-Wallis test in all of the hematological parameters.
Fig 4
Fig 4. Comparison of hematocrit, hemoglobin, red blood cell (RBC), neutrophil, lymphocyte, platelet (PLT), and erythrocyte sedimentation rate (ESR) level with age in patients with COVID-19.
See this image and copyright information in PMC

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