Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1394-1401
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1394
Unexplained elevation of erythrocyte sedimentation rate in a patient recovering from COVID-19: A case report
Sheng-Lan Pu, Xiang-Yan Zhang, Dai-Shun Liu, Ba-Ning Ye, Jian-Quan Li
Sheng-Lan Pu, Department of General Medicine, The First People's Hospital of Zunyi, Zunyi 563000, Guizhou Province, China
Sheng-Lan Pu, Department of General Medicine, The Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Xiang-Yan Zhang, Respiratory Institute, Guizhou Provincial People's Hospital, Guiyang 550000, Guizhou Province, China
Xiang-Yan Zhang, Jian-Quan Li, NHC Key Laboratory of Pulmonary Immune related Disease, Guiyang 550000, Guizhou Province, China
Dai-Shun Liu, Respiratory Department, The First People's Hospital of Zunyi, Zunyi 563000, Guizhou Province, China
Dai-Shun Liu, Respiratory Department, The Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Ba-Ning Ye, Jian-Quan Li, Intensive Care Unit, Guizhou Provincial People's Hospital, Guiyang 550000, Guizhou Province, China
Author contributions: Pu SL contributed to the collection of clinical data; Zhang XY and Liu DL collected and analyzed all laboratory data in this case; Ye BN contributed to the preparation of tables and figures; Li JQ analyzed all data and contributed to the writing of the manuscript; all authors read and approved the final manuscript; Li JQ is responsible for communicating with other authors about progress, submissions of revisions, and final approval of the proof.
Supported by the Central Public-interest Scientific Institution Basal Research Fund, Chinese Academy of Medical Sciences, No. 2019PT320003; Science and Technology Support Plan Fund of Zunyi City, No. NS (2020)1; and Science Plan Fund of Zunyi City, No. HZ (2020)4.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: We confirm that the manuscript has been read and approved by all named authors, and the order of authors listed in the manuscript has been approved by all of us. All authors declare that they have no competing interests to disclose.
CARE Checklist (2016) statement: We have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Quan Li, MD, PhD, Assistant Professor, Doctor, Intensive Care Unit, Guizhou Provincial People's Hospital, No. 52 Baoshan Road, Guiyang 550000, Guizhou Province, China. 401131098@qq.com
Received: November 7, 2020
Peer-review started: November 7, 2020
First decision: December 13, 2020
Revised: December 22, 2020
Accepted: January 5, 2021
Article in press: January 5, 2021
Published online: February 26, 2021
Processing time: 91 Days and 5.4 Hours
Abstract
BACKGROUND

A disease caused by a novel coronavirus virus, named coronavirus disease 2019 (COVID-19), broke out in Wuhan, China in December 2019, and spread around the word. As of March 4, 2020, 93090 confirmed cases and 2984 deaths have been reported in more than 80 countries and territories. It has triggered global public health security. However, the features and prognosis of COVID-19 are incompletely understood.

CASE SUMMARY

We here report that the erythrocyte sedimentation rate (ESR) increased in a confirmed COVID patient. The high level of ESR sustained for a long time even after the patient recovered from COVID-19, while all results related to tumor, tuberculosis, rheumatic diseases, anemia, etc. cannot explain the abnormal elevation of ESR presented in this case.

CONCLUSION

Although the increased ESR cannot be explained by all existing evidence, it possibly links the abnormal pathologic change in some COVID-19 patients and negative prognosis, and provides the clue to dissect the mechanism of illness progressing in COVID-19 and its prognosis.

Keywords: COVID-19; Erythrocyte sedimentation rate; Prognosis; SARS-CoV-2; Joint damage; Case report

Core Tip: So far, there have been many reports on the coronavirus disease 2019 (COVID-19) around the world that present different epidemiological and clinical features. Here we report a case that had a sustaining high level of erythrocyte sedimentation rate in a patient recovering from COVID-19. The high level of erythrocyte sedimentation rate was not from the tumor, inflammation, tuberculosis, rheumatic diseases, or autoimmune diseases. Therefore, we suspected that COVID-19 possibly damaged the blood or immune system. The abnormal erythrocyte sedimentation rate would be a precursor causing the joint damage after COVID-19 infection, such as osteoarthritis in future. Our report provides the supplement to understand the features of COVID-19 and shows some clues helping understand the prognosis of severe acute respiratory syndrome coronavirus 2 infection.