Correlation of Hematological Parameters to Cycle Threshold Value of Real Time Reverse Transcriptase-Polymerase Chain Reaction Positive COVID-19 Patients Admitted in Intensive Care Unit: Study from a Tertiary Care Center in Eastern India

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19) is a pandemic caused by the novel coronavirus SARS-CoV2, causing an enormous strain on the already burdened healthcare systems. The clinical course of COVID-19 is variable;those with a poor prognosis tend to develop severe viral pneumonia requiring ventilator support and intensive care unit (ICU) admission. Aim & Objectives: The aim of this study is to correlate the Cycle Threshold (Ct) score of RT-PCR reaction with different biomarkers like White cell count (WCC), Neutrophils%, Lymphocytes%, Monocytes%, Neutrophil-Lymphocyte ratio(NLR), Lymphocyte – Monocyte ratio (LMR), Platelet count, Prothrombin time(PT), Interleukin 6(IL-6), C-Reactive protein (CRP), Blood sugar level(BSL) .Thus enabling if a low Ct score can help early identification of patients at a high risk to progress to a severe disease. Method: A prospective analytical study conducted at a tertiary care hospital, included 114 severe COVID-19 positive patients, admitted in ICU. The medical history, comorbidities, clinical findings, and laboratory data of each patient were obtained with data analyzed to identify and correlate significant laboratory parameters leading to the severe outcome. Results: Total 114 patients were studied. The mean age of the study population was 59 years with a male predominance. Significant positive correlation of Ct values was seen with Total WBC counts (p=0.004), Neutrophil % (p=0.001), NLR (p<0.001), IL-6 (p=0.010), Procalcitonin (p=0.015) and D-dimer (p=0.041). Significant negative correlation of Ct value with Lymphocyte % (p=0.001) and monocyte % (p<0.001). And no significant correlation was seen with Age, Gender, LMR, CRP, Platelet counts, Prothrombin time and Blood Sugar levels. Conclusion: It is known that biomarkers help in identifying the disease severity and mortality and help in proper diagnosis and patient treatment. Ct scores can be used as a surrogate marker of disease severity, although further studies are required to validate the same.