Hematological Manifestations of COVID-19 and Their Prognostic Significance in an Intensive Care Unit: A Cross-Sectional Study.

ABSTRACT

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started as a pathology chiefly affecting the lower respiratory tract. It was first encountered in Wuhan, China. As an infection with an unknown etiology, it was extensively studied in order to establish its profile with respect to the probable manifestations and required medical management. The hematological profile of a patient typically affected with coronavirus disease 2019 (COVID-19) showed lymphopenia with an altered neutrophil-lymphocyte ratio, raised inflammatory markers like D-dimer, interleukin 6 (IL-6), C-reactive protein (CRP), lactate dehydrogenase, and serum ferritin. The prognostic significance of these markers has been studied in this cross-sectional study. Patients and methods Data were collected from consecutive subjects admitted in the intensive care unit of Acharya Vinobha Bhave Rural Hospital, Sawangi Meghe, Wardha, who were aged more than 16 years and were later confirmed to be positive for COVID-19 through throat/nasal swab (rapid antigen test/reverse transcription-polymerase chain reaction (RT-PCR)). Written informed consent (by signature or thumbprint) was obtained from all participants. Statistical analysis was done by using descriptive and inferential statistics with the help of the chi-square test and z-test for the difference between two means. The software used in the analysis was SPSS 27.0 (IBM Corp., Armonk, NY) and GraphPad Prism 7.0 (GraphPad Software, San Diego, CA). P<0.05 was considered as the level of significance. Results A total of 200 patients were studied. Fifty-nine point five percent (59.5%) of those who succumbed were over 50 years of age and a significant number (23.5 %) had comorbidities like diabetes mellitus, hypertension, and chronic kidney disease. There was a significant positive correlation between the mortality rate and mean platelet volume (P=0.001), neutrophil-lymphocyte ratio (P=0.001), raised D-dimer (P=0.006), serum ferritin (P=0.0001), lactate dehydrogenase (P=0.0001), and C-reactive protein (P=0.0001). Conclusion The analysis of the data collected highlights the correlation between the studied hematological manifestations of COVID 19 and their association with the severity of the disease.