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Freidoon M, Soleimanifar N, Sayadi N, Mojtahedi H, Assadiasl S. CBC Differences between Survived and Deceased COVID-19 Patients: A Cohort Study. Med J Islam Repub Iran 2023; 37:97. [PMID: 38021390 PMCID: PMC10657269 DOI: 10.47176/mjiri.37.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 12/01/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic showed the importance of simple, low-cost, and accessible tests for patient triage. Complete Blood Count (CBC) can be considered a good option for predicting the prognosis of COVID-19 and daily follow-up of hospitalized patients. CBC tests of 100 COVID-19 patients admitted to the general ward or intensive care unit (ICU) were monitored for ten days. Routine laboratory tests were also performed. In addition, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated at the time of admission. The WBC count of the ICU-admitted patients was significantly lower than in the non-ICU-admitted group (P = 0.008). The mean lymphocyte percentage of deceased patients was significantly lower than in the survived patients (P = 0.041), whereas the mean neutrophil percentage of the former group was higher than the latter ( P = 0.012). Moreover, the mean monocyte percentage of the survivors was significantly more than that of non-survivors (P = 0.003). However, there was no significant difference in mean platelet counts, hemoglobin levels, and red blood cell count between the studied groups. A lower WBC, lymphocyte percentage, and monocyte percentage, in addition to a higher neutrophil percentage, may indicate a poor prognosis in moderate to severe COVID-19 patients.
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Affiliation(s)
- Mahboobeh Freidoon
- Nephrology Department of Shohaday-e Tajrish Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran
| | - Narjes Soleimanifar
- Molecular Immunology Research Center, Tehran University of Medical
Sciences, Tehran, Iran
| | - Naghmeh Sayadi
- Nephrology Department of Shohaday-e Tajrish Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran
| | - Hanieh Mojtahedi
- Molecular Immunology Research Center, Tehran University of Medical
Sciences, Tehran, Iran
| | - Sara Assadiasl
- Molecular Immunology Research Center, Tehran University of Medical
Sciences, Tehran, Iran
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Aghbash PS, Rasizadeh R, Shirvaliloo M, Nahand JS, Baghi HB. Dynamic alterations in white blood cell counts and SARS-CoV-2 shedding in saliva: an infection predictor parameter. Front Med (Lausanne) 2023; 10:1208928. [PMID: 37396915 PMCID: PMC10313227 DOI: 10.3389/fmed.2023.1208928] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The recent coronavirus (COVID-19) outbreak posed a global threat and quickly escalated to a pandemic. However, accurate information on potential relationships between SARS-CoV-2 shedding in body fluids, especially saliva, and white blood cell (WBC) count is limited. In the present study we investigated the potential correlation between alterations in blood cell counts and viral shedding in saliva in a cohort of COVID-19 patients. Method In this preliminary clinical research, 24 age-matched COVID-19 patients without comorbidities, 12 (50%) men and 12 (50%) women, were followed up for a period of 5 days to investigate whether changes in the level of viral shedding in saliva might parallel with temporal alterations in WBC count. Viral shedding in saliva was qualitatively measured by performing SARS-CoV-2 rapid antigen tests on patient saliva samples, using SARS-CoV-2 Rapid Antigen Test Kit (Roche, Basel, Switzerland). These patients were classified into two groups with sputum and non-sputum cough. WBCs counts including leukocyte (LYM), neutrophil (NEU), and LYM counts were recorded for each patient on days 1, 3, and 5. Results The results of the present study showed that the levels of WBC, LYM, and NEU as well as erythrocyte sedimentation rate (ESR) increased significantly on the 5th day compared to the first day in both groups with sputum. However, the levels of C-reactive protein (CRP), Neutrophil-to-Lymphocyte Ratio (NLR) and lactate dehydrogenase (LDH) did not show significant changes. Conclusion This study proves that investigating the change in the number of blood LYMs as well as laboratory parameters such as CRP, LDH, and ESR as biomarkers is an accurate indicator to detect the amount of viral shedding in people with sputum and non-sputum. The results of our study denote that the measured parameters exhibit the intensity of viral shedding in people with sputum.
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Affiliation(s)
- Parisa Shiri Aghbash
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reyhaneh Rasizadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Shirvaliloo
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javid Sadri Nahand
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Shin HW, James A, Feng T, Chow L, Foronjy R. Comparing the demographics and laboratory biomarkers of the COVID-19 Omicron wave and the Alpha wave in a predominantly Afro-Caribbean patient population in New York City. Pneumonia (Nathan) 2022; 14:8. [PMID: 36424653 PMCID: PMC9694573 DOI: 10.1186/s41479-022-00099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/24/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is a knowledge gap of specific characteristics linked to disease severity of the different COVID-19 waves, especially in underserved populations. We compared the demographic and clinical factors associated with SARS-CoV-2-infected patients admitted to the intensive care unit (ICU) during the Omicron and Alpha waves. METHODS An observational study comparing two COVID-19 waves was conducted in Brooklyn, NY. Twenty-seven ICU admitted patients with a positive COVID-19 test result during the period of November 1, 2021, to January 31, 2022, ("Omicron wave") were compared to 271 COVID-19 patients who received ICU consults during the Alpha wave, the period from March 28, 2020, to April 30, 2020. RESULTS The Omicron wave had a 55.6% mortality rate compared to a 67.2% mortality rate in the Alpha wave. For the non-survivors, there were more females (66.7%) in the Omicron wave, while the trend was reversed in the Alpha wave (38.5%). Most of the patients seen were Black (> 85%) in both waves. A bivariate comparison of the two waves found that patients in the Omicron wave had overall significantly lower ALT levels (p = 0.03) and higher monocyte % (p = 0.005) compared to the patients in the Alpha wave. In the multivariate analysis, adjusting for age and sex, increasing levels of HCO3- were significantly associated with reduced mortality in the Omicron wave (OR: 0.698; 95% CI: 0.516 - 0.945; p = 0.02). Also, multivariable analyses using both waves combined found that neutrophil % was significantly associated with increased mortality (OR: 1.05; 95% CI: 1.02 - 1.09; p = 0.006) while lymphocyte % was significantly associated with reduced mortality (OR: 0.946; 95% CI: 0.904 - 0.990; p = 0.018). CONCLUSIONS The COVID-19-positive ICU patients in the Omicron wave experienced less severe outcomes than those of the Alpha wave. In contrast to the Alpha variant, the Omicron variant exhibited enhanced infectivity and disease severity in females.
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Affiliation(s)
- Hye Won Shin
- grid.189747.40000 0000 9554 2494College of Medicine, State University of New York, Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203 USA
| | - Alecia James
- grid.189747.40000 0000 9554 2494Department of Epidemiology and Biostatistics, School of Public Health, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - Theresa Feng
- grid.189747.40000 0000 9554 2494Department of Anesthesiology, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - Lillian Chow
- grid.262863.b0000 0001 0693 2202Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - Robert Foronjy
- grid.262863.b0000 0001 0693 2202Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203 USA
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Merchant SA, Nadkarni P, Shaikh MJS. Augmentation of literature review of COVID-19 radiology. World J Radiol 2022; 14:342-351. [PMID: 36186515 PMCID: PMC9521431 DOI: 10.4329/wjr.v14.i9.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/26/2022] [Accepted: 08/21/2022] [Indexed: 02/08/2023] Open
Abstract
We suggest an augmentation of the excellent comprehensive review article titled "Comprehensive literature review on the radiographic findings, imaging modalities, and the role of radiology in the coronavirus disease 2019 (COVID-19) pandemic" under the following categories: (1) "Inclusion of additional radiological features, related to pulmonary infarcts and to COVID-19 pneumonia"; (2) "Amplified discussion of cardiovascular COVID-19 manifestations and the role of cardiac magnetic resonance imaging in monitoring and prognosis"; (3) "Imaging findings related to fluorodeoxyglucose positron emission tomography, optical, thermal and other imaging modalities/devices, including 'intelligent edge' and other remote monitoring devices"; (4) "Artificial intelligence in COVID-19 imaging"; (5) "Additional annotations to the radiological images in the manuscript to illustrate the additional signs discussed"; and (6) "A minor correction to a passage on pulmonary destruction".
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Affiliation(s)
| | - Prakash Nadkarni
- College of Nursing, University of Iowa, Iowa City, IA 52242, United States
| | - Mohd Javed Saifullah Shaikh
- Department of Radiology, North Bengal Neuro Centre - Jupiter MRI & Diagnostic Centre, Siliguri 734003, West Bengal, India
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Awale RB, Singh A, Mishra P, Bais PS, Vansh K, Shamim R, Ghatak T, Hashim Z, Gupta D, Nath A, Singh RK, Singh C, Pande S. Routine hematology parameters in COVID-19: A predictor of disease severity and mortality. J Family Med Prim Care 2022; 11:3423-3429. [PMID: 36387722 PMCID: PMC9648217 DOI: 10.4103/jfmpc.jfmpc_2453_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/04/2022] Open
Abstract
Background Our understanding of the pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still evolving and is limited for prognostication. The study was performed to predict severity and mortality based on hematology parameters in coronavirus disease (COVID-19). Material and Methods The study was a single-center retrospective analysis of 240 patients with COVID-19. The hematological parameters were compared between different grades of severity. The receiver operating characteristics (ROC) curve along with the Classification and Regression Trees (CART) methods were used for the analysis. Result The total leukocyte count, absolute neutrophil count, neutrophil-lymphocyte ratio (NLR), and neutrophil-monocyte ratio (NMR) were increasing along with an increase in severity; while the absolute lymphocyte count and lymphocyte-monocyte ratio (LMR) were decreasing (P < 0.001). For prediction of severity and mortality on admission, the NLR, NMR, and LMR were significant (P < 0.001). The NLR, NMR, and LMR had an area under the receiver operating characteristics curve (AUROC) of 0.86 (95% CI of 0.80-0.91), 0.822 (95% CI of 0.76-0.88), and 0.69 (95% CI of 0.60-0.79), respectively, for severity. While the NLR, NMR, and LMR had an AUROC value of 0.85 (95% CI of 0.79-0.92), 0.83 (95% CI of 0.77-0.89), and 0.67 (95% CI of 0.57-0.78), respectively, for mortality. Conclusion With the increase in severity there was an increase in the total leukocyte count and absolute neutrophil count while the absolute lymphocyte count decreased. On admission, the cut-off value of NLR >5.2, NMR >12.1, while LMR <2.4 may predict severity and mortality in COVID-19.
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Affiliation(s)
- Rupali B. Awale
- Department of Laboratory Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ashutosh Singh
- Department of Laboratory Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Prabhaker Mishra
- Department of Biostatistics and Health Informatics, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Prateek S. Bais
- Department of Anaesthesiology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Khare Vansh
- Department of Anaesthesiology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rafat Shamim
- Department of Anaesthesiology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Tanmoy Ghatak
- Department of Emergency Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Zia Hashim
- Department of Pulmonary Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Devendra Gupta
- Department of Anesthesia, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Alok Nath
- Department of Pulmonary Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ratinder K. Singh
- Department of Emergency Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Chandrakanta Singh
- Department of Emergency Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shantanu Pande
- Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Alomar FA, Alshakhs MN, Abohelaika S, Almarzouk HM, Almualim M, Al-Ali AK, Al-Muhanna F, Alomar MF, Alhaddad MJ, Almulaify MS, Alessa FS, Alsalman AS, Alaswad A, Bidasee SR, Alsaad HA, Alali RA, AlSheikh MH, Akhtar MS, Al Mohaini M, Alsalman AJ, Alturaifi H, Bidasee KR. Elevated plasma level of the glycolysis byproduct methylglyoxal on admission is an independent biomarker of mortality in ICU COVID-19 patients. Sci Rep 2022; 12:9510. [PMID: 35680931 PMCID: PMC9178541 DOI: 10.1038/s41598-022-12751-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/03/2022] [Indexed: 01/17/2023] Open
Abstract
Biomarkers to identify ICU COVID-19 patients at high risk for mortality are urgently needed for therapeutic care and management. Here we found plasma levels of the glycolysis byproduct methylglyoxal (MG) were 4.4-fold higher in ICU patients upon admission that later died (n = 33), and 1.7-fold higher in ICU patients that survived (n = 32),compared to uninfected controls (n = 30). The increased MG in patients that died correlated inversely with the levels of the MG-degrading enzyme glyoxalase-1 (r2 = - 0.50), and its co-factor glutathione (r2 = - 0.63), and positively with monocytes (r2 = 0.29). The inflammation markers, SSAO (r2 = 0.52), TNF-α (r2 = 0.41), IL-1β (r2 = 0.25), CRP (r2 = 0.26) also correlated positively with MG. Logistic regression analysis provides evidence of a significant relationship between the elevated MG upon admission into ICU and death (P < 0.0001), with 42% of the death variability explained. From these data we conclude that elevated plasma MG on admission is a novel independent biomarker that predicts mortality in ICU COVID-19 patients.
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Affiliation(s)
- Fadhel A Alomar
- Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam, 31441, Saudi Arabia.
| | - Marai N Alshakhs
- Department of Internal Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Salah Abohelaika
- Clinical Pharmacology Department, Qatif Central Hospital, Ministry of Health, Qatif, Saudi Arabia
| | - Hassan M Almarzouk
- Department of Internal Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Mohammed Almualim
- Intenstive Care Unit, Qatif Central Hospital, Ministry of Health, Qatif, Saudi Arabia
| | - Amein K Al-Ali
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahad Al-Muhanna
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed F Alomar
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mousa J Alhaddad
- Department of Internal Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
| | | | - Faisal S Alessa
- Department of Internal Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Ahmed S Alsalman
- Department of Internal Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Ahmed Alaswad
- Clinical Pharmacology Department, Qatif Central Hospital, Ministry of Health, Qatif, Saudi Arabia
| | - Sean R Bidasee
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| | - Hassan A Alsaad
- Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam, 31441, Saudi Arabia
| | - Rudaynah A Alali
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mona H AlSheikh
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed S Akhtar
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Al Mohaini
- Basic Sciences Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Al Ahsa, 31982, Saudi Arabia
| | - Abdulkhaliq J Alsalman
- Department of Clinical Pharmacy, Faculty of Pharmacy, Northern Border University, Rafha, Saudi Arabia
| | | | - Keshore R Bidasee
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA.
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Abnormal Liver Tests during Hospitalization Predict Mortality in Patients with COVID-19: A Multicenter Study from South America. Can J Gastroenterol Hepatol 2021; 2021:1622533. [PMID: 34621710 PMCID: PMC8492276 DOI: 10.1155/2021/1622533] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The role of liver function tests (LFT) as prognostic factors in patients admitted with COVID-19 has not been fully investigated, particularly outside resource-rich countries. We aimed at evaluating the prognostic value of abnormal LFT on admission and during hospitalization of patients with COVID-19. METHODS We performed a retrospective study that included 298 adult patients hospitalized for COVID-19, between 05/2020 and 02/2021, in 6 hospitals from 5 countries in South America. We analyzed demographic and comorbid variables and laboratory tests on admission and during hospitalization. LFT over twice the upper limit of normal (ALEx2) were also evaluated in relation to a variety of factors on admission and during hospitalization. De novo-ALEx2 was defined as the presence of ALEx2 at one week of hospitalization in patients without ALEx2 on admission. Patients were followed until hospital discharge or death. Multivariable analysis was used to evaluate the association between ALEx2 on admission and during hospitalization and mortality. RESULTS Of the total of 298 patients, 60% were male, with a mean age of 60 years, and 74% of patients had at least one comorbidity. Of those, 137 (46%) patients were transferred to the intensive care unit and 66 (22.1%) patients died during hospitalization. ALEx2 on admission was present in 87 (29.2%) patients and was found to be independently associated with 1-week mortality (odds ratio (OR) = 3.55; 95% confidence interval (95%CI) 1.05-12.05). Moreover, 84 (39.8%) out of 211 patients without ALEx2 at admission developed de novo-ALEx2, which was independently associated with mortality during second week of hospitalization (OR = 6.09; 95%CI 1.28-29) and overall mortality (OR = 2.93, 95%CI 1.05-8.19). CONCLUSIONS A moderate elevation of LFT during admission was associated with a poor short-term prognosis in patients hospitalized with COVID-19. In addition, moderate elevation of LFT at one week of hospitalization was an independent risk factor for overall mortality in these patients.
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Kilercik M, Demirelce Ö, Serdar MA, Mikailova P, Serteser M. A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients. PLoS One 2021; 16:e0254073. [PMID: 34351940 PMCID: PMC8341498 DOI: 10.1371/journal.pone.0254073] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/02/2021] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 virus, is a major public health concern spanning from healthy carriers to patients with life-threatening conditions. Although most of COVID-19 patients have mild-to-moderate clinical symptoms, some patients have severe pneumonia leading to death. Therefore, the early prediction of disease prognosis and severity is crucial in COVID-19 patients. The main objective of this study is to evaluate the haemocytometric parameters and identify severity score associated with SARS-CoV-2 infection. METHODS Clinical and laboratory records were retrospectively reviewed from 97 cases of COVID-19 admitted to hospitals in Istanbul, Turkey. The patient groups were subdivided into three major groups: Group 1 (Non-critical): 59 patients, Group 2 (Critical-Survivors): 23 patients and Group 3 (Critical-Non-survivors):15 patients. These data was tested for correlation, including with derived haemocytometric parameters. The blood analyses were performed the Sysmex XN-series automated hematology analyser using standard laboratory protocols. All statistical testing was undertaken using Analyse-it software. RESULTS 97 patients with COVID-19 disease and 935 sequential complete blood count (CBC-Diff) measurements (days 0-30) were included in the final analyses. Multivariate analysis demonstrated that red cell distribution width (RDW) (>13.7), neutrophil to lymphocyte ratio (NLR) (4.4), Hemoglobin (Hgb) (<11.4 gr/dL) and monocyte to neutrophil ratio (MNR) (0.084) had the highest area under curve (AUC) values, respectively in discrimination critical patients than non-critical patients. In determining Group 3, MNR (<0.095), NLR (>5.2), Plateletcount (PLT) (>142 x103/L) and RDW (>14) were important haemocytometric parameters, and the mortality risk value created by their combination had the highest AUC value (AUC = 0.911, 95% CI, 0886-0.931). Trend analysis of CBC-Diff parameters over 30 days of hospitalization, NLR on day 2, MNR on day 4, RDW on day 6 and PLT on day 7 of admission were found to be the best time related parameters in discrimination non-critical (mild-moderate) patient group from critical (severe and non-survivor) patient group. CONCLUSION NLR is a strong predictor for the prognosis for severe COVID-19 patients when the cut-off chosen was 4.4, the combined mortality risk factor COVID-19 disease generated from RDW-CV, NLR, MNR and PLT is best as a mortality haematocytometric index.
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Affiliation(s)
- Meltem Kilercik
- Acibadem Labmed Clinical Laboratories, İstanbul, Turkey
- Department of Medical Biochemistry, AcibademMehmet Ali Aydınlar University, İstanbul, Turkey
| | | | - Muhittin Abdulkadir Serdar
- Acibadem Labmed Clinical Laboratories, İstanbul, Turkey
- Department of Medical Biochemistry, AcibademMehmet Ali Aydınlar University, İstanbul, Turkey
| | | | - Mustafa Serteser
- Acibadem Labmed Clinical Laboratories, İstanbul, Turkey
- Department of Medical Biochemistry, AcibademMehmet Ali Aydınlar University, İstanbul, Turkey
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