Authors
Seran Hakki, Sean Nevin, Emily Conibear, Kieran J Madon, Joe Fenn, Jakob Jonnerby, Nieves Derqui, Aleksandra Koycheva, Rhia Kundu, Hamish Houston, Timesh D Pillay, Alexandra L Kondratiuk, Janakan Sam Narean, Kimone L Fisher, Robert Varro, Constanta Luca, Samuel Evetts, Peter Kelleher, Onn Min Kon, Graham P Taylor, Ajit Lalvani
Published in
PloS one. Volume 21. Issue 7. Pages e0353142. Epub Jul 09, 2026.
Abstract
Full blood count (FBC) provides a range of cellular haematological parameters and serves as a routinely available basic immune profile. While FBC has been widely used to monitor moderate-to-severe COVID-19 in hospitalised settings, its temporal dynamics in mild, community-managed cases remain poorly characterised, despite these constituting the majority of global infections.
In a prospective cohort study, we tracked the cellular haematological profiles of 93 recently exposed, immunologically naïve individuals with mild COVID-19 and no underlying co-morbidities, recruited to the Integrated Network for Surveillance, Trials and Investigations into COVID-19 Transmission (INSTINCT) study. Blood samples were collected on D0, D7, D14 and D28 and subsequently aligned to infection-timepoints based on the day of first detected PCR positivity, and analysed using mixed-effects models.
Over 30% of cases exhibited transient, clinically defined neutropenia (mean (95% CI): First PCR-Positive (FP) 2.47x109/L (2.26-2.68) vs convalescence 3.34 x109/L (2.98-3.7); p = 0.0013). Over 20% exhibited lymphopenia (FP 1.38x109/L (1.28-1.48) vs convalescence 1.79x109/L (1.79-2.01); p = 0.0013). Additionally, we observed a notable elevation in platelet count, peaking approximately two weeks after initial infection (mean (95% CI): FP + 14 283x109/L (254-311) vs convalescence 237x109/L (222-252); p = 0.0013).
Transient neutropenia and lymphopenia occurred in approximately one-third and one-fifth of mild COVID-19 cases, respectively, and were followed by a delayed increase in platelet count. This study provides a descriptive, prospective dataset of full blood count parameters spanning early infection to convalescence in immunologically naïve individuals with mild SARS-CoV-2 infection. These data may support mathematical modelling of within-host cellular haematological dynamics and have potential clinical relevance for understanding typical trajectories of routine blood parameters during mild disease.
PMID:
42424307
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.
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