Abstract
Several diseases (such as diabetes, cancer, and neurodegenerative disorders) affect the morpho-functional aspects of red blood cells, sometimes altering their normal metabolism. In this review, the hematological changes are evaluated, with particular focus on the morphology and metabolic aspects of erythrocytes. Changes in the functionality of such cells may, in fact, help provide important information about disease severity and progression. The viral infection causes significant damage to the blood cells that are altered in size, rigidity, and distribution width. Lower levels of hemoglobin and anemia have been reported in several studies, and an alteration in the concentration of antioxidant enzymes has been shown to promote a dangerous state of oxidative stress in red blood cells. Patients with severe COVID-19 showed an increase in hematological changes, indicating a progressive worsening as COVID-19 severity progressed. Therefore, monitored hematological alterations in patients with COVID-19 may play an important role in the management of the disease and prevent the risk of a severe course of the disease. Finally, monitored changes in erythrocytes and blood, in general, may be one of the causes of the condition known as Long COVID.
Highlights
The exchange of gases between the tissues and lungs and the maintenance of the acid-base balance represents the main goal played by the circulatory system
The work carried out in this review aims to highlight the combination of hematological and erythrocyte dysregulation mechanisms that favor the evolution of SARS-CoV-2 infection in order to inspire the scientific community and enhance therapeutic approaches against COVID-19
The increased level of CO-Hb could instead be related to the normal accumulation in the serum of porphyrin recorded in COVID-19 patients and to the progressive increase in bilirubin potentially linked to hemolytic anemia [38,39,52,53,56]
Summary
The exchange of gases between the tissues and lungs and the maintenance of the acid-base balance represents the main goal played by the circulatory system. Red blood cells (RBCs) are the major cellular components of the blood, and, for this reason, their role is essential to ensure the right supply of oxygen to the tissues and the concomitant excretion of carbonic dioxide (CO2 ) and to define the biophysical consistency of the blood and the efficiency of the entire bloodstream To best perform their oxygen transport function, mature RBCs are deprived of the nucleus and organelles to make way for hemoglobin (Hb), the main protein responsible for oxygen transport. The oxygen release is effectively facilitated by CO2 and 2,3-bisphosphoglyceric acid, both contributing directly to the main and most studied activity of RBCs: the oxygen transport from the lungs to tissues and carbon dioxide from the tissues to the lungs, where it will be exhaled In addition to their canonical role as gases and nutrients transporters, being cells in close contact with oxygen, RBCs possess a very efficient antioxidant system that preserves their integrity. The work carried out in this review aims to highlight the combination of hematological and erythrocyte dysregulation mechanisms that favor the evolution of SARS-CoV-2 infection in order to inspire the scientific community and enhance therapeutic approaches against COVID-19
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