Hematological Predictors of COVID-19 Severity

ABSTRACT

Introduction: COVID-19 pandemic has placed the health systemworldwide in unprecedented stress, therefore, prompt identification and management of patients having severe disease is essential fortriaging of patients at the time of admission.Aims &Objectives: To identify hematological biomarkers ofCOVID-19 disease severity in patients admitted in a tertiary carehospital.Materials &Methods: A retrospective study was conducted over aperiod of 17 months (20th March 2020-19 August 2021) on 7416COVID-19 patients. Patients with cancers, pregnancy and chronichematological diseases were excluded from the study. Patients wereclassified clinically as per severity of disease as non-severe (asymptomatic, mild, moderate) or severe and their hematological parameterswere analyzed.Mann-Whitney test was used to compare between the groups. Optimal predictive cut off points for the variables were defined by receiveroperating characteristic (AUC) curve to dichotomize the variables.Univariate analysis was performed to screen out independent variables to be used in the binary logistic regression (BLR). A p valueof< = 0.05 was considered as statistically significant.Result: Age, duration of hospital stay, RBC count, WBC, Plateletcount, RDW, Neutrophils %, Absolute neutrophil count (ANC),Absolute monocyte count (AMC), NLR, PLR, NMR were statisticallyhigher whereas hemoglobin, hematocrit, MCHC, lymphocyte %,Absolute lymphocyte count (ALC), Eosinophils %, Absolute eosinophil count (AEC), Monocytes %, Basophils %, Absolute Basophilcount (ABC) and Lymphocyte Monocyte ratio (LMR) were lower insevere group. MCV and MCHC were not significant, so wereexcluded from the logistic regression model. All variables were significant in univariate analysis. Age (>42 yrs), duration of hospitalstay (>10 days), RBC count (B 4.33 106/lL),WBC count (> 7.73103/lL), RDW (>14.8%), Neutrophils (>71.7%), Eosinophils(B 0.3%), Monocytes (B 5%), ALC (B 1.01 103/lL), LMR(B 3.125) with adjusted odd ratio of 1.8, 1.5, 1.3,1.3, 1.4, 2.0, 2.1, 1.5,2.0 and 1.3 respectively were found to be significant predictors ofseverity.Conclusions: Age, duration of hospital stay, RBC count, WBC,RDW, Neutrophils %, Eosinophils %, Monocytes %, ALC, LMRshould be assessed and monitor at the earliest to halt unfavorableoutcome of mortality or morbidity.