Role of hematological parameters and biochemical markers as a predictor of severity of COVID-19 patients

Abstract

Background: The etiological agent for pandemic COVID-19 is severe acute respiratory syndrome corona virus 2. Hematological and biochemical parameters are the indicators of inflammation and coagulopathy. Aims and Objectives: The present study aimed to determine how effectively the hematological parameters and biochemical markers can help predict the severity of critically ill COVID-19 patients. Materials and Methods: The current retrospective cohort study was conducted among 200 COVID-19 patients admitted in the Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India. In our lab’s computerized system, certain hematological and biochemical parameters of the patients were retrieved and recorded. Receiver operating characteristics (ROC) curve analysis was done to evaluate the diagnostic accuracy of hematological and biochemical parameters. Results: Total leukocyte count (TLC), absolute lymphocyte count (ALC), neutrophil to lymphocyte ratio (NLR), D-dimer, and serum ferritin had a significant relationship with severity among ICU patients (P<0.05). ALC, D-dimer, and serum ferritin can be used to predict the severity of COVID patients with area under the ROC-AUC curve values of 0.717, 0.725, and 0.710, respectively. Platelet to lymphocyte ratio, lymphocyte to monocyte ratio, and C-reactive protein were not useful to predict the severity of COVID illness. Conclusion: Hb concentration, TLC, NLR, D-dimer, and serum ferritin were significantly raised in critically ill COVID patients. ROC curve analysis showed that ALC, serum ferritin, and D-dimer were able to predict the severity of COVID illness effectively. Conclusively, these parameters can be used to track the prognosis of patients.

A retrospective study of hematological and biochemical parameters in coronavirus disease 2019 (COVID-19) patients in Vietnam

“…Regarding the change in biochemical parameters of COVID-19 patients in this study, 83.1% of patients had CRP levels above the reference threshold, in which the death group had higher CRP concentrations than the discharged group (p<0.001). Some studies have shown that CRP levels are closely related to disease severity [22], but other research has concluded that CRP levels are not helpful for predicting the severity of COVID-19 [24]. The proportion of patients with ferritin concentrations over 1,000 ng/mL in the death group was higher than in the discharged group (77.9% vs. 36.2%; p<0.001).…”

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Can Predict the Severity in COVID-19 Patients from Ethiopia: A Retrospective Study

“…The total platelet count at patient admission 201 (5-528) was increased to 228 (4-531) at discharge (p = 0.027), total leukocyte count (TLC) from 7 (3.4-33) to 9 (1.3-19) (p = 0.005), and absolute lymphocyte count (ALC) from 1 (0.07-301) to 2 (0.5-39) (p = 0.002). Hemoglobin (HB) level at patient admission 14 (4-12.5) was decreased to 13 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) at discharge (p = 0.002), absolute neutrophil count (ANC) from 9 (24-97) to 8 (1-95) (p = 0.004), absolute monocyte count (AMC) from 6 (1-208) to 5 (1-21) (p = 0.001), NLR from 14 (0.4-47) to 9 (0.01-43) (p = 0.001), and PLR from 27 (0.18-232) to 26 (0.94-101) (p = 0.044) (Table 2).…”

“…When compared to people with non-severe cases of COVID-19, patients with severe cases usually have lower leukocyte counts, smaller proportions of monocytes, eosinophils, and basophils, as well as higher NLR. 7 , 9 , 10 Although it is most useful for managing COVID-19 patients, especially in developing countries, not many studies have been done in Africa, primarily Ethiopia. More research is required to determine the appropriate NLR, MLR, and PLR values and their predictive value.…”