Evaluation of Hematological Parameters in Coronavirus Disease 2019 Patients with Aspergillus Rhinosinusitis, Northeastern Iran

Aspergillus rhinosinusitis is a potentially lethal complication in patients with underlying immunodeficiencies. Critical laboratory findings, such as lymphopenia and leukocytosis, were highly reported in coronavirus disease 2019 (COVID-19) patients. Based on the correlation between COVID-19 and fungal infections, this study was designed to evaluate the hematologic parameters in COVID-19 patients associated with Aspergillus rhinosinusitis in northeaster Iran. During eight months and among 80 COVID-19 patients suspected of fungal rhinosinusitis, in two tertiary referral hospitals of Mashhad, hematological parameters, such as white blood cell (WBC) count, of 14 patients affected to COVID-19 with Aspergillus rhinosinusitis were precisely evaluated to check leukopenia and leukocytosis. The patients showed a range of 42 to 67 years old and a median age of 59. Of the 14 patients, 8 (57.4%) had diabetes mellitus, 9 (64.2%) died, and two patients has normal leukocyte count. The three, two, and one patients showed leukocytosis, lymphopenia, and leukopenia, respectively. The combination of leukocytosis and lymphopenia was significant in four patients. However, leukopenia and lymphopenia were observed in just one subject. Moreover, leukopenia, lymphopenia, and neutropenia were detected together in one case.Aspergillus rhinosinusitis had high mortality among COVID-19 patients. Moreover, the high rate of diabetes mellitus was a severe predisposing factor for COVID-19-associated Aspergillus rhinosinusitis. Leukocytosis (neutrophilia) and lymphopenia were the most common hematological abnormalities among COVID-19 patients with Aspergillus rhinosinusitis.