Clinico-pathological changes in COVID-19 patients


  • Shrawan Kumar Department of Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
  • Pranjal Pankaj Department of Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
  • Narendra Singh Department of Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
  • Ajay Narang Department of Pathology, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
  • Pallavi Anand Department of Biochemistry, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
  • Desh Nidhi Singh Department of Microbiology, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India



COVID-19, Haematological finding, Biochemical finding


Background: Novel Corona virus is associated with the respiratory disorder. Corona virus cases disease ranging from a common cold like illness severe acute respiratory syndrome. Biochemical parameters become altered in the patients, and this has been correlated with the severity of the disease. The present study was undertaken to analyse the effect of novel corona virus infection in organs other than lungs.

Methods: The study is a retrospective studycarried out in RMCH and RC, Kanpur from July 2020 to June 2021. Haematological, biochemical and inflammatory biomarker study was conducted in 336 COVID-19 patients.

Results: Out of 336 COVID-19 patients the maximum number of patients belonged to the age group of 61-70 years. There were 75% symptomatic and 25% asymptomatic cases of confirmed COVID-19. Sore throat was the most common presentation followed by cough and dyspnoea. Other manifestations include fever, myalgia, loss of taste, loss of smell and running nose. Serum CRP and PCT concentration were observed in more severe cases 22.2% and 17% respectively. Haematological findings include decrease in total RBC count (58.33%). Symptomatic COVID-19 patients have thrombocytopenia (30.95%), lymphopenia (25%), leucocytosis (11.90%) and leucopenia 8.33%. Hepatic dysfunction and renal dysfunction was observed in 71.42% and 14.28% symptomatic cases respectively.

Conclusions: We concluded that novel corona virus is not only affecting respiratory system but also other vital organs. On the basis of haematological and biochemical findings we can predict the severity of COVID-19 infection which could be helpful for management of the disease.

Author Biography

Shrawan Kumar, Department of Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India

Department of Microbiology

Associate Professor 


World Health Organization. Coronavirus disease (COVID-19) Pandemic, WHO.Accessed from Accessed on 31 March 2020.

Sun P, Lu X, Xu C, Sun W and Pan B. Understanding of COVID-19 Based on CurrentEvidence Journal of Medical Virol. 2020;92(6):548-51.

Seidel EJ, Mohlman J, Basch CH, Fera J, Cosgrove A, Ethan D. Communicating Mental Health Support to College Students During COVID-19: An Exploration of Website Messaging Journal of Community Health.2020;1-4.

Woo PC, Lau SK, Huang Y, Yuen KY. Coronavirus diversity, phylogeny and interspecies jumping, Exp. Biol. Med. (Maywood). 2009;234(10):1117-27.

Schoeman BC. Fielding, Coronavirus envelope protein: current knowledge. Virol J. 2019;16(1):69.

Hui DS. An overview on severe acute respiratory syndrome (SARS). Monaldi Arch Chest Dis. 2005;63(3):149-57.

Bohn MK, Lippi G, Horvath A, Sethi S, Koch D, Ferrari M, et al. Molecular, serological, and biochemical diagnosis and monitoring of COVID-19: IFCC taskforce evaluation of the latest evidence. ClinChem Lab Med. 2020;58(7):1037-52.

Letelieret P. Role Of Biochemical Markers In The Monitoring Of Covid-19 Patients. J Med Biochem. 2021;40:115-28.

Sproston NR, Ashworth JJ. Role of C-reactive proteinat sites of inflammation and infection. Front Immunol. 2018;13(9):754.

Patel C. A study of the clinico-epidemiological profile of covid-19 patients admitted in a tertiary care hospital in India. Journal of Clinical and Diagnostic Research. 2021;15(4):9-13.

Hasan MJ, Chowdhury SM, Khan MA, Rahaman M, Fardous J, Adit T et al. Clinico-epidemiological characteristics of asymptomatic and symptomatic COVID-19-positive patients in Bangladesh. medRxiv. 2020.

Bhandari S, Singh A, Sharma R, Rankawat G, Banerjee S, Gupta V, et al. Characteristics, treatment outcomes and role of hydroxychloroquine among 522 COVID-19 hospitalized patients in Jaipur city: An epidemio-clinical study. J Assoc Physicians India. 2020;68(6):13-9.

Gupta N, Agrawal S, Ish P, Mishra S, Gaind R, Usha G, et al. Safdarjung Hospital COVID 2019 working group. Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India. Monaldi Archives for Chest Disease. 2020;90(1):32290644.

Aggarwal A, Shrivastava A, Kumar A, Ali A. Clinical and epidemiological features of SARS-CoV-2 patients in SARI ward of a tertiary care centre in New Delhi. Journal of The Association of Physicians of India. 2020;68(7):19-26.

Chen N. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet.2020;395:507-13.

Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB et al. Hematologic parameters in patients with COVID-19 infection.Am J Hematol. 2020;95:E131-34.

Rahmanet A. Hematological Abnormalities in COVID-19: A Narrative Review. Am J Trop Med Hyg. 2021;104(4):1188-201.

Liu W, Li H. COVID-19: attacks the 1-beta chain of haemoglobin and captures the porphyrin to inhibit human heme metabolism. ChemRxiv. 2020.

Wan S. Clinical features and treatment of COVID-19 patients in northeast Chongqing. J Med Virol. 2020;92:797-806.

Wang Z, Yang B, Li Q, Wen L, Zhang R. Clinical features of 69 cases with coronavirus disease 2019 in Wuhan, China. Clin Infect Dis. 2020;71:769-77.

Lippi G, Mattiuzzi C. Hemoglobin value may be decreased in patients with severe coronavirus disease 2019. Hematol Transfus Cell Ther. 2020;42:116-17.

XM Luo, Zhou W, Yan XJ, Guo TG, Wang BC. Prognostic value of C-reactive protein in patients with COVID-19. Clin Infect Dis. 2020;71:2174-9.

Guo T, Fan Y, Chen M, Wu X, Zhang L. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2019;5:811-8.

Li L, Li S, Xu MM, Zheng SJ, Duan ZP. Risk factors related to hepatic injury in patients with corona virus disease 2019. medRXIV. 2019.

Lu JT, Hu SF, Fan R, Liu ZH, Yin XR. ACP risk grade: A simple mortality index for patients with confirmed or suspected severe acute respiratory syndrome coronavirus 2 disease (COVID-19) during the early stage of outbreak in Wuhan, China. medRXIV. 2019.

Li Y, Zhang HT, Xiao Y, Wang ML, Guo YQ. Prediction of criticality in patients with severe Covid-19infection using three clinical features: A machine learning-based prognostic modelwith clinical data in Wuhan. medRXIV. 2020.

Feng Y, Ling Y, Bai T, Xie Y, Huang J. COVID-19 with different severities: a multicenter study of clinical features. Am J RespirCrit Care Med. 2020;201:1380-8.

Zhou F, Yu T, Du R, Fan G, Liu Y, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395:1054-62.

Wu C, Chen X, Cai Y, Xia J, Zhou X. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180:1-11.

Guidelines on Clinical Management of COVID-19. Available at: https://www. elinesonClinicalManagementofCOVID1912020.pdf. Accessed on 29 December 2020.






Original Research Articles