Haematological parameters in COVID-19 and their association with severity and mortality

ABSTRACT

Background: Since the COVID-19 global pandemic emerged, the worldwide medical fraternity has been facing multiple challenges regarding its management. Patients with severe/critical illness have a poor prognosis. Hence, early detection and assessment of disease severity is vital to offer timely management. Recent studies indicate that altered haematological parameters may predict the disease severity and mortality. We aimed to investigate associations between haematological parameters and disease severity in patients with SARS CoV 2 infection. Objectives: This study was undertaken to find out the optimal cut-off values of haematological parameters that may significantly relate to the clinical severity of COVID-19 and to evaluate their utility as parameters to predict mortality. Methods: It was a hospital based prospective cohort study, conducted over a period of 4 months, fromMay, 2020 to August, 2020 at a level 3 designated COVID-19 facility in Uttar Pradesh. In our cohort, there were a total of 211 patients out of which 125 were non-ICU admissions and 86 were ICU admissions. Cases were classified as severe, moderate andmild based on their oxygen requirements and ICU care needs. Results: The mean age of non-ICU patients was 47.1 ± 16.2 years, ICU survivors, were aged 57.4 ± 11.4, and ICU non-survivors were aged 57.3 ± 15.2. There was no mortality in the non-ICU group. Of the 86 ICU admissions, 69 were male, of which 27 were non-survivors and 17 were female, of whom 5 were non-survivors. Amongst the deceased patients, there was a significant leucocytosis (P < 0.001), neutrophilia (P < 0.001) and increased NLR (P = 0.026). The pooled analysis revealed that the NLR cut-off of > 3.85 was associated with severity and prediction for ICU admission, while NLR of > 5.2857 was associated with mortality. Conclusion: In conclusion, advanced age, male sex, a high white blood cell count, neutrophilic leucocytosis or neutrophilia along with the elevated NLR were significantly associated with both the clinical severity and mortality. © 2021, Indian Academy of Clinical Medicine. All rights reserved.