Hematologic, hepatic, and renal function changes in hospitalized patients with Middle East respiratory syndrome coronavirus

Background: There are no longitudinal data on the changes in hematologic, hepatic, and renal function findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Methods: This is a retrospective cohort study of 16 MERS-CoV patients, to describe the hematological, hepatic, and renal findings of patients with MERS-CoV. Results: During the 21 days of observation, there was no significant change in the hepatic panel or creatinine tests. There was a significant increase in the mean +/- SD of the white blood cell count from 8.3 +/- 4.6 to 14.53 +/- 7 (P value = 0.001) and an increase in mean +/- SD of the absolute neutrophil count from 6.33 +/- 4.2 to 12 +/- 5.5 (P value = 0.015). Leukocytosis was observed in 31% (5/16) of the patients on day 1 and in 80% (4/5) on day 21. Transient leukopenia developed in 6% (1/16) of the patients on day 1 and in 13% (1/8) on day 8. None of the patients had neutropenia. Lymphopenia was a prominent feature with a rate of 44% (7/16) of the patients on day 1 and 60% (3/5) on day 21. Lymphocytosis was not a feature of MERS-CoV infection. Thrombocytopenia developed in 31% (5/16) of the patients on day 1 and 40% (2/5) on day 21. Thrombocytosis was not a prominent feature and was observed in 6% (1/16) of the patients on day 1 and 17% (1/6) on day 9. Conclusions: Patients with MERS-CoV infection showed variable hematologic parameters over time. Lymphocytosis and neutropenia were not features of MERS-CoV infection.