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Can Hematological Ratios Predict Outcome of COVID-19 Patients? A Multicentric Study.
Aly, Mai M; Meshref, Taghreed S; Abdelhameid, Marwa A; Ahmed, Shimaa A; Shaltout, Asmaa S; Abdel-Moniem, Alaa Eldin; Hamad, Dina A.
  • Aly MM; Clinical Hematology Unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
  • Meshref TS; Critical Care Unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
  • Abdelhameid MA; Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt.
  • Ahmed SA; Department of Internal Medicine, Faculty of Medicine, Qena University, Qena, Egypt.
  • Shaltout AS; Department of Medical Microbiology & Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
  • Abdel-Moniem AE; Critical Care Unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
  • Hamad DA; Critical Care Unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
J Blood Med ; 12: 505-515, 2021.
Article in English | MEDLINE | ID: covidwho-1302063
ABSTRACT

INTRODUCTION:

Coronaviruses belong to a large family that leads to respiratory infection of various severity. Hematological ratios are indicators of inflammatory response widely used in viral pneumonia with affordability in developing countries.

PURPOSE:

Study the role of the neutrophil lymphocyte ratio (NLR), derived NLR ratio (d-NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR) in predicting the outcome of COVID-19 Egyptian patients.

METHODS:

A retrospective study on 496 COVID-19 Egyptian patients, managed in four tertiary centers, grouped into non-severe, severe, and critical. Patients' laboratory assessment including total leucocyte count (TLC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count (AMC), NLR, d-NLR, LMR and, PLR were reported as well as C reactive protein (CRP), D-dimer and serum ferritin.

RESULTS:

TLC, ANC, AMC, NLR, d-NLR and, PLR were highest in the critical group (p<0.001 for all except AMC p=0.033), while this group had the least ALC and LMR (p=0.049 and <0.001, respectively). Higher CRP and d-dimer levels were reported in the critical group (p<0.001). At the same time, higher ferritin was found in the severe group more than the critical and non-severe groups (p<0.001, p=0.005, respectively). We calculated the optimal cut-off values of the hematological ratio; NLR (3.5), d-NLR (2.86), PLR (192), and LMR (3). D-NLR had the highest specificity (89.19%), while NLR had the highest sensitivity (71.38%). By univariate logistic regression, age, DM, HTN, cardiovascular diseases, COPD, NLR, d-NLR, LMR and PLR, CRP, steroid, oxygen aids, and mechanical ventilation were associated with the severity of COVID-19. Still, only age, NLR, CRP, and oxygen aid were independent predictors in multivariate logistic regression.

CONCLUSION:

NLR is a predictor for severity in COVID-19. LMR, d-NLR, and PLR may assist in risk stratification.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Language: English Journal: J Blood Med Year: 2021 Document Type: Article Affiliation country: JBM.S316681

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Language: English Journal: J Blood Med Year: 2021 Document Type: Article Affiliation country: JBM.S316681