Berina Hasanefendić, Armina Dedić, Sanela Hajro, Emir Sehercehajic, Almedina Hajrović, Rubina Alimanović-Alagić, Velda Smajlbegović, Lejla Ibričević-Balić



Introduction: COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 and causes a series of respiratory symptoms. Considering the appearance and development of symptoms, the course of COVID-19 can go from mild to severe. Depending on the course of COVID-19, the laboratory parameters change a lot, trying to defend the organism against the foreign pathogen and all the changes it causes.Therefore, the aim of this study is to observe the differences between biochemical, hematological and coagulation parameters depending on the disease stage of COVID-19 patients. Material and methods: We conducted a  cross-sectional study which included 160 COVID-19 patients from Sarajevo, Bosnia and Herzegovina. Biochemical, hematological and coagulation analyses were performed. Results: COVID-19 patients with a severe clinical course have higher average values of fibrinogen (6.53±4.47,p<0.001), D-dimer (6.89±7.81, p<0.001), APTT (32.05±5.96, p=0.002), eosinophil (0.66±0.09, p=0.002) and CRP (93.42±75.86, p= 0.023), and lower values of lymphocytes (1.04±0.98, p<0.001), monocytes (0.45±0.3, p<0.001), compared to COVID-19 patients with a mild clinical course. COVID-19 patients with a severe clinical course had higher average values of neutrophils (10.12±5.80, p=0.002) and lower values of reactive lymphocytes (0.02±0.03, p<0.001) compared to COVID-19 patients with a mild clinical course. Conclusion: Biochemical, hematological and coagulation parameters can be a sensitive and specific biomarker for distinction of mild and severe COVID-19.



COVID-19, laboratory parameters, clinical course



  1. Ganesh B, Rajakumar T, Malathi M, Manikandan N, Nagaraj J, Santhakumar A, et al. Epidemiology and pathobiology of SARS-CoV-2 (COVID-19) in comparison with SARS, MERS: An updated overview of current knowledge and future perspectives. Clin Epidemiol Glob Health. 2021;10:100694.doi: 10.1016/j.cegh.2020.100694.
  2. Hottz, ED, Bozza, PT. Platelet-leukocyte interactions in COVID-19: Contributions to hypercoagulability, inflammation, and disease severity. Res Pract Thromb Haemost. 2022; 6(3):e12709.doi: 10.1002/rth2.12709.
  3. Sethuraman N, Jeremiah SS, Ryo A. Interpreting Diagnostic Tests for SARS-CoV-2. JAMA. 2020;323(22):2249–51.doi: 10.1001/jama.2020.8259.
  4. Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med. 2020;288(2):192-206. doi: 10.1111/joim.13091.
  5. Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 – A systematic review. Life Sci. 2020;254:117788.doi: 10.1016/j.lfs.2020.117788.
  6. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47. doi: 10.1002/ajh.25829.
  7. Chandler CM, Reid MC, Cherian S, Sabath DE, Edlefsen KL. Comparison of blood counts and markers of inflammation and coagulation in patients with and without COVID-19 presenting to the emergency department in Seattle, WA. Am J Clin Pathol. 2021;156(2):185-97.doi: 10.1093/ajcp/aqab052.
  8. Khourssaji M, Chapelle V, Evenepoel A, Belkhir L, Yombi JC, van Dievoet MA et al. A biological profile for diagnosis and outcome of COVID-19 patients. Clin Chem Lab Med. 2020;58(12):2141-50.doi: 10.1515/cclm-2020-0626.
  9. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032.
  10. Jamil SW, Ilyas M, Ahmad N, Bakri S, Hardjianti T, Parewangi ML, et al. Coagulation profile and outcomes of COVID-19 patients at Wahidin Sudirohusodo hospital, Makassar, Indonesia. Open-Access Maced J Med Sci. 2022;10(B):1097-101.doi:10.3889/oamjms.2022.9109.
  11. Paliogiannis P, Mangoni AA, Dettori P, Nasrallah GK, Pintus G, Zinellu A. D-Dimer concentrations and COVID-19 severity: a systematic review and meta-analysis. Front. Public Health. 2020;8:432.doi: 10.3389/fpubh.2020.00432.
  12. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clin Chim Acta. 2020;506:145–8.doi: 10.1016/j.cca.2020.03.022.
  13. Rostami-Far Z, Rahmani K, Mansouri K, Khadem Erfan M B, Shaveisi-Zadeh F, Nikkhoo B. Complete blood count as an indicator of COVID-19 disease severity. J Clin Res Paramed Sci. 2022;11(2):e133320.https://doi.org/10.5812/jcrps-133320>
  14. Yuan X, Huang W, Ye B, Chen C, Huang R, Wu F, et al. Changes of hematological and immunological parameters in COVID-19 patients. Int J Hematol. 2020;112(4):553-9.doi: 10.1007/s12185-020-02930-w
  15. Layla KN, Yeasmin S, Khan SA, Shaila KN, Azad AB, Ahmad R, et al. White blood cell profile among different clinical stages of COVID-19 patients. European Journal of Medical and Health Sciences. 2021;3(5),73–6. doi:10.24018/ejmed.2021.3.5.1051
  16. Zhang L, Huang B, Xia H, Fan H, Zhu M, Zhu L, et al. Retrospective analysis of clinical features in 134 coronavirus disease 2019 cases. Epidemiol Infect. 2020;148:e199.doi: 10.1017/S0950268820002010
  17. Soraya GV, Ulhaq ZS. Crucial laboratory parameters in COVID-19 diagnosis and prognosis: An updated meta-analysis. Med Clin (Barc). 2020;155(4):143–51.doi: 10.1016/j.medcli.2020.05.017
  18. Camp JV, Jonsson CB. A role for neutrophils in viral respiratory disease. Front Immunol. 2017;8:550.doi: 10.3389/fimmu.2017.00550
  19. Nasrollahi H, Talepoor AG, Saleh Z, Eshkevar Vakili M, Heydarinezhad P, Karami N, et al. Immune responses in mildly versus critically ill COVID-19 patients. Front Immunol. 2023;14:1077236. doi: 10.3389/fimmu.2023.1077236.
  20. Toori KU, Qureshi MA, Chaudhry A. Lymphopenia: A useful predictor of COVID-19 disease severity and mortality. Pak J Med Sci. 2021;37(7):1984-8. doi: 10.12669/pjms.37.7.4085.
  21. Kim ES, Chin BS, Kang CK, Kim NJ, Kang YM, Choi JP, et al. Clinical course and outcomes of patients with Severe Acute Respiratory Syndrome Coronavirus 2 infection: a preliminary report of the first 28 patients from the Korean cohort study on COVID-19. J Korean Med Sci. 2020;35(13):e142. doi: 10.3346/jkms.2020.35.e142.
  22. Asghar MS, Haider Kazmi SJ, Ahmed Khan N, Akram M, Ahmed Khan S, Rasheed U, et al. Clinical profiles, characteristics, and outcomes of the first 100 admitted COVID-19 patients in Pakistan: a single-center retrospective study in a tertiary care hospital of Karachi. Cureus. 2020;12(6):e8712. doi: 10.7759/cureus.8712.


  • There are currently no refbacks.


Copyright (c) 2023 Berina Hasanefendić, Armina Dedić, Sanela Hajro, Emir Sehercehajic, Almedina Hajrović, Rubina Alimanović-Alagić, Velda Smajlbegović, Lejla Ibričević-Balić

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

Scroll to Top