COVID-19-associated neutrophilia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Oluwabusola Fausat Adogba, MD[2]

Synonyms and Keywords: WBC changes in COVID-19, SARS-COV2 related neutrophilia

Overview

Coronavirus disease 2019 (COVID-19) first emerged in Wuhan,China in late 2019. On March 12, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. There is no established system for the classification regarding COVID-19 associated neutrophilia. Research suggests COVID-19 associated neutrophilia could be the cause of the severe symptoms of COVID-19, including acute respiratory distress syndrome (ARDS) and can be linked to the Neutrophil Extracellular Traps (NETs). Acute respiratory distress syndrome (ARDS), pulmonary inflammation, thick mucus secretions in the airways, extensive lung damage, and blood clots are suggested to be a result of the action of neutrophils. When neutrophils detect pathogens, they can expel their DNA in a web laced with toxic enzymes (called a Neutrophil Extracellular Trap) to attack them. These NETs capture and digest the unwanted pathogen. However, in cases of ARDS, (COVID-19 manifestation) they cause damage to the lungs and other organs. People of any age with certain underlying medical conditions are at increased risk for severe illness from COVID-19. Recent studies have shown the association of a high neutrophil-to-lymphocyte ratio (NLR) to severe forms of COVID-19 disease.

Historical Perspective

Classification

Pathophysiology

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Differentiating COVID-19 related Neutrophilia from other Diseases

Epidemiology and Demographics

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  • For COVID-19 Physical examination click here.

Laboratory findings

Electrocardiogram

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Treatment

Medical therapy

Immune-Based Therapy:

Except in the context of a clinical trial, the panel recommends against the use of other immunomodulators, such as :

Surgery

Primary Prevention

Secondary Prevention

References

  1. "WHO Western Pacific | World Health Organization".
  2. Ciccullo, Arturo; Borghetti, Alberto; Zileri Dal Verme, Lorenzo; Tosoni, Alberto; Lombardi, Francesca; Garcovich, Matteo; Biscetti, Federico; Montalto, Massimo; Cauda, Roberto; Di Giambenedetto, Simona (2020). "Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line". International Journal of Antimicrobial Agents: 106017. doi:10.1016/j.ijantimicag.2020.106017. ISSN 0924-8579.
  3. Walker, Ulrich A; Warnatz, Klaus (2006). "Idiopathic CD4 lymphocytopenia". Current Opinion in Rheumatology. 18 (4): 389–395. doi:10.1097/01.bor.0000231908.57913.2f. ISSN 1040-8711.
  4. "WHO Coronavirus Disease (COVID-19) Dashboard | WHO Coronavirus Disease (COVID-19) Dashboard".
  5. "People Who Are at Higher Risk for Severe Illness | Coronavirus | COVID-19 | CDC".
  6. Egeblad, Mikala; Zuo, Yu; Weber, Andrew; Yost, Christian C.; Spicer, Jonathan D.; Schwartz, Robert E.; Salvatore, Steven; Rousseau, Simon; Renaud, Stephane; Rayes, Roni; McAllister, Florencia; Looney, Mark R.; Loda, Massimo; Knight, Jason S.; Huynh, Caroline; Guerci, Philippe; Daßler-Plenker, Juliane; Crawford, James M.; Cools-Lartigue, Jonathan; Borczuk, Alain; Baxter-Stoltzfus, Amelia; Adrover, Jose M.; Barnes, Betsy J. (2020). "Targeting potential drivers of COVID-19: Neutrophil extracellular traps". Journal of Experimental Medicine. 217 (6). doi:10.1084/jem.20200652. ISSN 0022-1007.
  7. "Symptoms of Coronavirus | CDC".
  8. Zhong, Jixin; Tang, Jungen; Ye, Cong; Dong, Lingli (2020). "The immunology of COVID-19: is immune modulation an option for treatment?". The Lancet Rheumatology. 2 (7): e428–e436. doi:10.1016/S2665-9913(20)30120-X. ISSN 2665-9913.