Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID‐19): A multicenter, cross‐sectional study

Background For better understanding of the pathological changes of COVID‐19, benefiting clinical management of the disease and the preparation for future waves of similar pandemics. Methods Hematology parameters from a total of 52 cases of COVID‐19 admitted for treatment in a designated hospital were retrospectively analyzed. Data were analyzed by SPSS statistical software. Results Pre‐treatment T‐cell subsets, total lymphocytes, red blood cell distribution width (RDW), eosinophils, and basophils were significantly lower than that of post‐treatment, while the inflammatory indexes neutrophils, neutrophil to lymphocyte ratio (NLR), and C‐reactive protein (CRP) levels, as well as red blood cell (RBC) and hemoglobin, were significantly reduced after treatment. The T‐cell subsets, total lymphocytes, and basophils in severely and critically ill patients were significantly lower than those in moderately ill patients. Neutrophils, NLR, eosinophils, procalcitonin (PCT), and CRP was significantly higher in severely and critically ill patients than in moderately ill patients. CD3+, CD8+, total lymphocytes, platelets, and basophils in patients older than 50 were lower than that of those younger than 50, while neutrophils, NLR, CRP, and RDW in patients older than 50 were higher than that of younger than 50. There was a positive correlation among prothrombin time (PT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in severely and critically ill patients. Conclusions T‐cell subsets, lymphocyte count, RDW, neutrophils, eosinophils, NLR, CRP, PT, ALT, and AST are important indicators in the management especially for severely and critically ill patients with COVID‐19.

Section: Discussionsupporting

confidence: 91%

Correlations of disease severity and age with hematology parameter variations in patients with COVID‐19 pre‐ and post‐treatment

Liang

Nong

Jiang

et al. 2020

“…The previous study has noticed the differences of lymphocytes and neutrophils between mild and sever patients 10,20‐22 . Also the higher neutrophils count than healthy people were found in COVID‐19 patients 23 . In our study, a clear reduction of lymphocytes and increase of neutrophils which was more intense than in mild group were observed in severe patients.…”

Section: Discussionsupporting

confidence: 67%

Peripheral blood inflammatory markers in predicting prognosis in patients with COVID‐19. Some differences with influenza A

Zhao

et al. 2020

Background To evaluate the ability of peripheral blood inflammatory markers in predicating the typing of COVID‐19, prognosis, and some differences between COVID‐19 and influenza A patients. Methods Clinical data on 285 cases laboratory‐confirmed as SARS‐CoV‐2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms. Additional 446 Influenza A outpatients’ hematologic data were enrolled for comparison. Results NLR, SII, RLR, PLR, HsCRP, and IL‐6 were significant higher and LMR was lower in severe COVID‐19 patients than in mild COVID‐19 patients ( p < .001). PLR and LMR were lower in the individuals with influenza A than those with COVID‐19 ( p < .01). COVID‐19 patients with higher levels of NLR, SII, RLR, PLR, HsCRP, and IL‐6 and lower LMR were significantly associated with the severe type. AUC of NLR (0.76) was larger while the specificity of IL‐6 (86%) and sensitivity of HsCRP (89%) were higher than other inflammatory markers in predicating the typing of COVID‐19. PT had obvious correlation with all the inflammatory markers except RPR. NLR showed positive correlations with AST, TP, BUN, CREA, PT, and D‐dimer. Patients with high IL‐6 levels have a relatively worse prognosis (HR = 2.30). Conclusion Peripheral blood inflammatory markers reflected the intensity of inflammation and associated with severity of COVID‐19.NLR was more useful to predict severity as well as IL‐6 to predict prognosis of COVID‐19. PLR and LMR were initially found to be higher in SARS‐CoV‐2 virus‐infected group than in influenza A.

“…Moreover, patients with SP developed tended to have higher MPR levels than mild patients in the early stage after admission. Recent studies indicated that monocyte‐to‐lymphocyte ratio could be used to differentiate COVID‐19 patients from healthy subjects and neutrophil to lymphocyte ratio might be a reliable marker to assess the severity of COVID‐19 18 . These suggested that the dynamic change of hemocytes was of great clinical significance and became a research hotspot.…”

Section: Discussionmentioning

confidence: 99%

Mean platelet volume/platelet count ratio predicts severe pneumonia of COVID‐19

Zhong

Peng

2020

Background Although platelet mean volume/platelet count ratio (MPR) is considered to be a crucial marker of inflammatory and infectious diseases, the relationship between MPR and novel coronavirus infectious disease 2019 (COVID‐19) remains unclear. Methods In this retrospective study, 85 patients with confirmed COVID‐19 were enrolled and divided into low and high MPR group. Data from repeated measures were compared by the generalized estimating equations. Cox regression analyses were performed to assess the impact of MPR on the incidence of severe pneumonia (SP), with inverse probability of treatment weighting (IPTW) used to reduce confounding bias. The primary outcome is the incidence of SP of COVID‐19. Results During follow‐up, 17 (20.0%) patients were developed to SP. Compared with mild patients, patients with SP developed showed a higher MPR level at baseline, day 1, day 2, and day 3 after admission (P = .005, P = .015, P = .009, and P = .032, respectively). Kaplan‐Meier method showed a higher incidence of SP in the high MPR group than the low MPR group (log‐rank test = 10.66, P = .001). After adjustment, high MPR was associated with an elevated incidence of SP (HR, 5.841, 95% CI, 1.566‐21.791, P = .009). The IPTW method also suggested that MPR was a significant factor related to the incidence of SP (HR, 8.337, 95% CI, 4.045‐17.182, P < .001). Conclusion High MPR level is an independent risk factor for severe pneumonia in patients with COVID‐19.