Association between Early Absolute Neutrophil Count and Level of D-Dimer among Patients with COVID-19 Infection in Central Taiwan

Abstract

Thromboembolism is a critical event in patients with coronavirus disease (COVID)-19 infection and highly associated with neutrophil extracellular traps. D-dimer has been found to be an essential thromboembolism-associated biomarker; however, the association between absolute neutrophil count (ANC) and level of D-dimer in patients with COVID-19 infection remains unclear. In this study, we enrolled consecutive patients with COVID-19 admitted to Taichung Veterans General Hospital (TCVGH), a referral center in central Taiwan with 20 airborne infection isolation rooms. Spearman correlation was used to determine the association between ANC and level of D-dimer in distinct time periods. A total of 28 consecutive patients with COVID-19 infection were enrolled, and 32.1% (9/28) of them required mechanical ventilation. Patients requiring mechanical ventilation had a higher ANC (8225 vs. 3427/µL, p < 0.01) and levels of D-dimer (6.0 vs. 0.6 mg/L, p < 0.01) compared with those without mechanical ventilation. Notably, we identified five patients with image-proven thromboembolic events during the hospital course, with the number of patients with pulmonary embolism, venous thrombosis and acute ischemic stroke were 2, 1, and 2, respectively. We found that ANC within 4 days correlated with the level of D-dimer to a moderate level (r = 0.71, p < 0.05), and the association between ANC and D-dimer no longer exist after day 5. In conclusion, we found highly prevalent thromboembolic events among patients with severe COVID-19 infection in central Taiwan and identified the association between early ANC and D-dimer. More studies are warranted to elucidate the underlying mechanism.

Mortality Predictors in Severe COVID-19 Patients from an East European Tertiary Center: A Never-Ending Challenge for a No Happy Ending Pandemic

“…Studying neutrophil activation markers shows that they could help identify non-critical patients under an increased risk of developing the critical form of the disease [ 37 ]. In line with the previous results from a recent Taiwanese study [ 38 ], we observed significant correlations between D-Dimer concentration and the need for mechanical ventilation, both invasive or non-invasive, amongst our patients. Of all the patients included in the study, 105 (70%) required invasive ventilation, 100 (95%) of whom have died.…”

A Method for Expanding the Training Set of White Blood Cell Images

“…Although white blood cells only account for 0.2% of whole blood, they play an important role in protecting human health [1]. White blood cells are generally divided into neutrophils, eosinophils, basophils, monocytes, and lymphocytes [2], and changes in these cell counts can be used as the basis for diagnosing certain diseases or evaluating the therapeutic efect of certain diseases [3][4][5][6][7][8][9]. Terefore, the accuracy and efciency of white blood cell detection and classifcation are very important for the auxiliary diagnosis of diseases [10].…”