Changes in White Blood Cells, D-Dimer and Lactate Dehydrogenase Level in Covid-19 Patients
A Comparative Study
DOI:
https://doi.org/10.48112/bcs.v1i4.276Abstract

Coronavirus is a new pandemic disease that began in Wuhan, China, and has since spread over the globe. The number of COVID-19 cases reported daily in Iraq has slowly increased. This study aims to investigate the effect of Covid-19 on the normal range of White Blood Cells (WBC), D-Dimer, and Lactate Dehydrogenase (LDH). This study looked at 65 patients who had tested positive for SARS-CoV-2 using polymerase chain reaction analysis. Patients with mild symptoms and a normal CT scan for the chest were separated into three groups: those with mild symptoms and a normal CT scan for the chest, those with intermediate disease presenting with fever and cough, other respiratory symptoms, and those with severe disease. At the time of the study, all patients' data were collected from Al-Diwaniyah Teaching hospital admission for parameters of White blood cell count, lactate dehydrogenase (LDH) levels, and D-Dimer levels, from December 27, 2020, to April 1, 2021. The WBC count, D-Dimer, and LDH in the patients with COVID-19 were higher than that of the control group (8.15 X109/L versus 390 ng/ml and 593 U/L), respectively, and the difference was highly significant (p < 0.001). There was no significant difference in WBC count and LDH among patients according to the severity (p > 0.05). A larger leukocyte count, D-Dimer, and LDH increased the risk of death. These signs can reliably predict a patient's prognosis while in the hospital. Our study's best lab marker was LDH.
Keywords:
white blood cells, D-Dimer, LDH, COVID-19Metrics
References
Chen, X. Y., Huang, M. Y., Xiao, Z. W., Yang, S., & Chen, X. Q. (2020). Lactate dehydrogenase elevations is associated with severity of COVID-19: a meta-analysis. Critical Care, 24(1), 1-3. https://doi.org/10.1186/s13054-020-03161-5
Chhetri, S., Khamis, F., Pandak, N., Al Khalili, H., Said, E., & Petersen, E. (2020). A fatal case of COVID-19 due to metabolic acidosis following dysregulate inflammatory response (cytokine storm). IDCases, 21, e00829. https://doi.org/10.1016/j.idcr.2020.e00829
Conte, G., Cei, M., Evangelista, I., Colombo, A., Vitale, J., Mazzone, A., & Mumoli, N. (2021). The meaning of D-dimer value in COVID-19. Clinical and Applied Thrombosis/Hemostasis, 27, https://doi.org/10.1177/10760296211017668
Conti, P., Ronconi, G., Caraffa, A. L., Gallenga, C. E., Ross, R., Frydas, I., & Kritas, S. K. (2020). Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies. J Biol Regul Homeost Agents, 34(2), 327-331.
Cure, E., & Cure, M. C. (2020). Can dapagliflozin have a protective effect against COVID-19 infection? A hypothesis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4), 405-406. https://doi.org/10.1016/j.dsx.2020.04.024
Dey, J., & Mukherjee, S. (2021). Wireless COVID-19 telehealth: Leukocytes encryption guided by amino acid matrix. Wireless Personal Communications, 120(2), 1769-1789. https://doi.org/10.1007/s11277-021-08534-9
Fazio, S., Tufano, A., & de Simone, G. (2022, February). Sustained high D-dimer in outpatients who have recovered from mild to moderate coronavirus disease 2019 (COVID-19). In Seminars in Thrombosis and Hemostasis (Vol. 48, No. 01, pp. 115-117). Thieme Medical Publishers, Inc.. https://doi.org/10.1055/s-0041-1729857
Gupta, N., Zhao, Y. Y., & Evans, C. E. (2019). The stimulation of thrombosis by hypoxia. Thrombosis Research, 181, 77-83. https://doi.org/10.1016/j.thromres.2019.07.013
Han, H., Xu, Z., Cheng, X., Zhong, Y., Yuan, L., Wang, F., ... & Xia, Y. (2020). Descriptive, retrospective study of the clinical characteristics of asymptomatic COVID-19 patients. MSphere, 5(5), e00922-20. https://doi.org/10.1128/mSphere.00922-20
Hardy, M., Lecompte, T., Douxfils, J., Lessire, S., Dogné, J. M., Chatelain, B., ... & Mullier, F. (2020). Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory. Thrombosis Journal, 18(1), 1-16. https://doi.org/10.1186/s12959-020-00230-1
Henry, B. M., De Oliveira, M. H. S., Benoit, S., Plebani, M., & Lippi, G. (2020). Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM), 58(7), 1021-1028. https://doi.org/10.1515/cclm-2020-0369
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., ... & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 395(10223), 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
Javanian, M., Bayani, M., Shokri, M., Sadeghi-Haddad-Zavareh, M., Babazadeh, A., Yeganeh, B., ... & Ebrahimpour, S. (2020). Clinical and laboratory findings from patients with COVID-19 pneumonia in Babol North of Iran: a retrospective cohort study. Romanian Journal of Internal Medicine, 58(3), 161-167. https://doi.org/10.2478/rjim-2020-0013
Kaftan, A. N., Hussain, M. K., Algenabi, A. A., Naser, F. H., & Enaya, M. A. (2021). Predictive Value of C–reactive Protein, Lactate Dehydrogenase, Ferritin and D-dimer Levels in Diagnosing COVID-19 Patients: a Retrospective Study. Acta Informatica Medica, 29(1), 45-50. https://doi.org/10.5455%2Faim.2021.29.45-50
Kanchana, S., Kanchana, S., Vijitsopa, T., Thammakumpee, K., Yamwong, S., & Sawanyawisuth, K. (2013). Clinical factors predictive of pneumonia caused by pandemic 2009 H1N1 influenza virus. The American Journal of Tropical Medicine and Hygiene, 88(3), 461. https://doi.org/10.4269%2Fajtmh.12-0132
Kermali, M., Khalsa, R. K., Pillai, K., Ismail, Z., & Harky, A. (2020). The role of biomarkers in diagnosis of COVID-19–A systematic review. Life Sciences, 254, 117788. https://doi.org/10.1016/j.lfs.2020.117788
Linkins, L. A., & Takach Lapner, S. (2017). Review of D‐dimer testing: good, Bad, and Ugly. International Journal of Laboratory Hematology, 39, 98-103. https://doi.org/10.1111/ijlh.12665
Lu, Y., Sun, K., Guo, S., Wang, J., Li, A., Rong, X., ... & Wang, S. (2020). Early warning indicators of severe COVID-19: A single-center study of cases from Shanghai, China. Frontiers in Medicine, 7, 432. https://doi.org/10.3389/fmed.2020.00432
Magro, G. (2020). Cytokine Storm: is it the only major death factor in COVID-19 patients? Coagulation role. Medical Hypotheses, 142, 109829. https://doi.org/10.1016%2Fj.mehy.2020.109829
Mura, M., Andrade, C. F., Han, B., Seth, R., Zhang, Y., Bai, X. H., ... & Liu, M. (2007). Intestinal ischemia-reperfusion-induced acute lung injury and oncotic cell death in multiple organs. Shock, 28(2), 227-238. https://doi.org/10.1097/SHK.0b013e318033e927
Shorr, A. F., Thomas, S. J., Alkins, S. A., Fitzpatrick, T. M., & Ling, G. S. (2002). D-dimer correlates with proinflammatory cytokine levels and outcomes in critically ill patients. Chest, 121(4), 1262-1268. https://doi.org/10.1378/chest.121.4.1262
Soni, M., Gopalakrishnan, R., Vaishya, R., & Prabu, P. (2020). D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(6), 2245-2249. https://doi.org/10.1016/j.dsx.2020.11.007
Sproul, E., Nandi, S., & Brown, A. (2018). Fibrin biomaterials for tissue regeneration and repair. In Peptides and proteins as biomaterials for tissue regeneration and repair (pp. 151-173). Woodhead Publishing. https://doi.org/10.1016/B978-0-08-100803-4.00006-1
Tang, N., Bai, H., Chen, X., Gong, J., Li, D., & Sun, Z. (2020). Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of thrombosis and haemostasis, 18(5), 1094-1099. https://doi.org/10.1111/jth.14817
Togacar, M., Ergen, B., & Sertkaya, M. E. (2019). Subclass separation of white blood cell images using convolutional neural network models. Elektronika ir Elektrotechnika, 25(5), 63-68. https://doi.org/10.5755/j01.eie.25.5.24358
Wong, J. P., Viswanathan, S., Wang, M., Sun, L. Q., Clark, G. C., & D'elia, R. V. (2017). Current and future developments in the treatment of virus-induced hypercytokinemia. Future Medicinal Chemistry, 9(2), 169-178. https://doi.org/10.4155/fmc-2016-0181
Yameny, A. A. (2021). Lactate dehydrogenase level as a COVID-19 biomarker. Journal of Bioscience and Applied Research, 7(1), 29-34. https://dx.doi.org/10.21608/jbaar.2021.173662
Ye, W., Chen, G., Li, X., Lan, X., Ji, C., Hou, M., ... & Yang, L. (2020). Dynamic changes of D-dimer and neutrophil-lymphocyte count ratio as prognostic biomarkers in COVID-19. Respiratory research, 21(1), 1-7. https://doi.org/10.1186/s12931-020-01428-7
Zhang, H., Wang, X., Fu, Z., Luo, M., Zhang, Z., Zhang, K., ... & Chen, Y. (2020a). Potential factors for prediction of disease severity of COVID-19 patients. MedRxiv. https://doi.org/10.1101/2020.03.20.20039818
Zhang, L., Long, Y., Xiao, H., Yang, J., Toulon, P., & Zhang, Z. (2018). Use of D‐dimer in oral anticoagulation therapy. International Journal of Laboratory Hematology, 40(5), 503-507. https://doi.org/10.1111/ijlh.12864
Zhang, L., Yan, X., Fan, Q., Liu, H., Liu, X., Liu, Z., & Zhang, Z. (2020b). D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19. Journal of thrombosis and haemostasis, 18(6), 1324-1329. https://doi.org/10.1111/jth.14859
Zhu, B., Feng, X., Jiang, C., Mi, S., Yang, L., Zhao, Z., ... & Zhang, L. (2021). Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study. BMC Infectious Diseases, 21(1), 1-5. https://doi.org/10.1186/s12879-021-06277-3

Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Biomedicine and Chemical Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.