Evaluation of Hematological Parameters in Coronavirus Disease 2019 Patients with Aspergillus Rhinosinusitis, Northeastern Iran

Document Type : Original Article

Authors

1 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran and Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
Aspergillus rhinosinusitis is a potentially lethal complication in patients with underlying immunodeficiencies. Critical laboratory findings, such as lymphopenia and leukocytosis, were highly reported in coronavirus disease 2019 (COVID-19) patients. Based on the correlation between COVID-19 and fungal infections, this study was designed to evaluate the hematologic parameters in COVID-19 patients associated with Aspergillus rhinosinusitis in northeaster Iran.
Materials and Methods:
During eight months and among 80 COVID-19 patients suspected of fungal rhinosinusitis, in two tertiary referral hospitals of Mashhad, hematological parameters, such as white blood cell (WBC) count, of 14 patients affected to COVID-19 with Aspergillus rhinosinusitis were precisely evaluated to check leukopenia and leukocytosis.
Results:
The patients showed a range of 42 to 67 years old and a median age of 59. Of the 14 patients, 8 (57.4%) had diabetes mellitus, 9 (64.2%) died, and two patients has normal leukocyte count. The three, two, and one patients showed leukocytosis, lymphopenia, and leukopenia, respectively. The combination of leukocytosis and lymphopenia was significant in four patients. However, leukopenia and lymphopenia were observed in just one subject. Moreover, leukopenia, lymphopenia, and neutropenia were detected together in one case.
Conclusion:
Aspergillus rhinosinusitis had high mortality among COVID-19 patients. Moreover, the high rate of diabetes mellitus was a severe predisposing factor for COVID-19-associated Aspergillus rhinosinusitis. Leukocytosis (neutrophilia) and lymphopenia were the most common hematological abnormalities among COVID-19 patients with Aspergillus rhinosinusitis.

Keywords

References

  1. Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S, Baghbanzadeh M, Aghamohammadi N, Zhang W, Haque U: The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? International journal of epidemiology 2020, 49(3):717-726.
  2. Li C, Pan S: Analysis and causation discussion of 185 severe acute respiratory syndrome dead cases. Zhongguo wei zhong bing ji jiu yi xue= Chinese critical care medicine= Zhongguo weizhongbing jijiuyixue 2003, 15(10):582-584.
  3. Hosseinikargar N, Basiri R, Asadzadeh M, Najafzadeh MJ, Zarrinfar H: First report of invasive Aspergillus rhinosinusitis in a critically ill COVID‐19 patient affected by acute myeloid leukemia, northeastern Iran. Clinical case reports 2021, 9(10).
  4. Mohamed A, Rogers TR, Talento AF: COVID-19 associated invasive pulmonary aspergillosis: diagnostic and therapeutic challenges. Journal of fungi 2020, 6(3):115.
  5. Gao H-N, Lu H-Z, Cao B, Du B, Shang H, Gan J-H, Lu S-H, Yang Y-D, Fang Q, Shen Y-Z: Clinical findings in 111 cases of influenza A (H7N9) virus infection. New England Journal of Medicine 2013, 368(24):2277-2285.
  6. Guo L, Wei D, Zhang X, Wu Y, Li Q, Zhou M, Qu J: Clinical features predicting mortality risk in patients with viral pneumonia: the MuLBSTA score. Frontiers in microbiology 2019:2752.
  7. Pal R, Singh B, Bhadada SK, Banerjee M, Bhogal RS, Hage N, Kumar A: COVID‐19‐associated mucormycosis: an updated systematic review of literature. Mycoses 2021, 64(12):1452-1459.
  8. Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP: Pathogenesis of mucormycosis. Clinical Infectious Diseases 2012, 54(suppl_1):S16-S22.
  9. Waldorf AR: Pulmonary defense mechanisms against opportunistic fungal pathogens. Immunology series 1989, 47:243-271.
  10. Diamond RD, Haudenschild C, Erickson 3rd N: Monocyte-mediated damage to Rhizopus oryzae hyphae in vitro. Infection and immunity 1982, 38(1):292-297.
  11. Chinn R, Diamond RD: Generation of chemotactic factors by Rhizopus oryzae in the presence and absence of serum: relationship to hyphal damage mediated by human neutrophils and effects of hyperglycemia and ketoacidosis. Infection and immunity 1982, 38(3):1123-1129.
  12. Dong N, Yang X, Ye L, Chen K, Chan EW-C, Yang M, Chen S: Genomic and protein structure modelling analysis depicts the origin and infectivity of 2019-nCoV, a new coronavirus which caused a pneumonia outbreak in Wuhan, China. BioRxiv 2020.
  13. Fan BE, Lim KGE, Chong VCL, Chan SSW, Ong KH, Kuperan P: COVID‐19 and Mycoplasma pneumoniae coinfection. American journal of hematology 2020.
  14. Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D, Xu Y, Tian Z: Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cellular & molecular immunology 2020, 17(5):533-535.
  15. Saurabh A, Dey B, Raphael V, Barman B, Dev P, Tiewsoh I, Lyngdoh BS, Dutta K: Evaluation of Hematological Parameters in Predicting Intensive Care Unit Admission in COVID-19 Patients. SN Comprehensive Clinical Medicine 2022, 4(1):1-5.
  16. Zeng F, Li L, Zeng J, Deng Y, Huang H, Chen B, Deng G: Can we predict the severity of coronavirus disease 2019 with a routine blood test. Pol Arch Intern Med 2020, 130(5):400-406.

 

 

Journal of Patient Safety & Quality Improvement
Volume 10, Issue 1
January 2022
Pages 19-24

Files

Share

How to cite

Statistics