Significance of Haematological Variates in Determining Risk of Cardiovascular Complications Post SARS-CoV-2 Infection: A Prospective Cohort Study

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) is an ongoing global pandemic. Changes in haematological variables in patients with COVID-19 are emerging as important features of the disease. These changes in haematological variables may provide significant clues in the prognosis post Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Aim: To determine the significance of various haematological variables in cardiac outcomes post SARS-CoV-2 infection. Materials and Methods: This was a prospective cohort study conducted at Prince Faisal bin Khalid Cardiac Centre, Abha, Kingdom of Saudi between March 2021 and October 2021. A total of 59 patients who were infected with SARS-CoV-2 with or without cardiac complaints were involved. Demographic, clinical, and laboratory data were recorded. Leukocyte counts, Neutrophil Counts, Lymphocyte counts, Neutrophil to Lymphocyte Ratio (NLR), platelet counts, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), and D-Dimer were assessed and compared between subjects who developed Cardiovascular Complications (CVC+ group) and the subjects who did not develop CVC post SARS-CoV-2 infection (CVCgroup). Statistical analyses were performed using R scripting language and R Studio (version 1.2.5033, Orange Blossom). For continuous variables, t-test (for normally distributed) and MannWitney U test (for non normally distributed) were employed. For categorical data, Chi-square test (c2 ) was used. A p-value <0.05 was considered significant. Results: Among all the haematological variables assessed, Neutrophil counts (p<0.0001), NLR (p<0.0001), and PT (p<0.0001) were highly significant for developing CVC post SARS-CoV-2 infection. Additionally, Leukocyte counts (p=0.028), Lymphocyte counts (p=0.0002), APTT (p=0.036), and D-dimer (p=0.022) also showed statistical significance for developing CVC post-SARSCoV 2 infection. Conclusion: Haematological testing is easily available, inexpensive, and provides almost instant results. Therefore, assessing haematological variables like Leukocyte counts, Neutrophil counts, Lymphocyte counts, NLR, PT, APTT, and D-Dimer values post SARS-CoV-2 infection can help doctors identify patients at higher risk of developing CVC and guide their interventions accordingly. This can potentially help in reducing the occurrence of cardiovascular complications.

Keywords

• acute cardiovascular syndrome
• acute respiratory distress syndrome
• catecholamine surge
• cytokine storm
• myocarditis
• renin-angiotensin-aldosterone system
• severe acute respiratory syndrome coronavirus-2