ABSTRACT
Background: The elevated neutrophil to lymphocyte ratio (NLR) is significantly associated with the mortality and severity of patients with infectious diseases in general.Recent studies have suggested that NLR could be an effective predictor for the mortality of patients with COVID-19 Objective: to assess NLR that can be used as prognostic marker in COVID-19 in order to help physicians to set up early treatment strategies. Methods:A cross-sectional study in isolation hospital of Zagazig University Hospitals after approval by institutional research board (IRB) conducted on 48 confirmed COVID-19 patients,we divided patients into two groups according to severity of symptoms into (mild and severe) Severe patients met at least one of the following conditions: (1) Shortness of breath, RR >= 30 times/min, (2) Oxygen saturation (Resting state) <= 93%. All patients underwent a laboratory investigation with assessment of NLR. Results:There is statistically significant negative correlation between NLR and each of lymphocyte, platelet count, and serum albumin.Regarding respiratory rate and oxygen saturation, there is statistically significant positive correlation between NLR and respiratory rate, whereas negative correlation between NLR and oxygen saturation (r= 0.676, -0.632) respectively.NLR was found to be the strongest predictor 92.3%, accuracy 85.4% (p<0.001). So, according to our study NLR could discriminate COVID-19 severe patients from mild patients. The optimal cutoff of NLR in prediction of severe disease was >= 5.1464 in our study. Conclusion: Elevated NLR was an independent prognostic biomarker for COVID-19 patients. Therefore, the usable NLR are recommended as practical tools to assess prognosis and to evaluate the severity of clinical symptoms in COVID-19 patients.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has killed millions of individuals and has led to the largest economic contraction since the Great Depression. The antiviral effects of vitamin D can hinder viral replication directly, and also be effective in an anti-inflammatory and immunomodulatory way. Objective: This study aimed to estimate the serum levels of free 25 hydroxycholecalciferol (25(OH)-D) in patients with COVID-19 infection in correlation to clinical manifestations and severity in multicenter tertiary-care hospitals, Egypt. Subject and Methods: This cross-sectional study included 150 confirmed patients with COVID-19 by using RT-PCR for detection of the viral RNA. The COVID-19 patients were classified into four groups of mild (n=40) moderate (n=40), severe (n=40), and critical (n=30) based on disease severity. Serum concentrations of 25(OH)-D were tested using enzyme-linked immunosorbent assay (ELISA). Results According to the current study results, all included patients (n=150) had a low level of serum levels of 25(OH)-D (11.46±4.47) in COVID-19 patients compared to normal levels. Interestingly, the levels of serum 25(OH)-D were significantly low in severe (9.5±2.71) and critical (6.26±2.58) groups compared to mild (16.37±2.62) and moderate (12.3±2.62) groups. Also, there was a significant positive correlation between serum 25(OH)-D levels and hemoglobin, platelets, albumin, and SPO2 values. On the other hand, there was a significant negative correlation between serum 25(OH)-D levels and LDH, C reactive protein, D dimer, and ferritin levels. Conclusions: Patients with COVID-19 in particular patients with severe and critical COVID-19 had a significantly low level of serum 25(OH)-D compared to mild and moderate cases, in addition, PSO2 and D dimer were independently correlated with serum 25(OH)-D, thus low serum 25(OH)-D level could be a predictor of severe and critical COVID-19. © 2021, Ain Shams University Faculty of Medicine. All rights reserved.