Evaluation of the Relationship Between Clinical Findings and Neutrophil-Lymphocyte Ratio and Mean Platelet Volume in COVID-19 PCR-Positive Children

ABSTRACT

Objective: In this study, we aimed to evaluate the importance of predicting the severity of the disease by measuring the hematological parameters such as the neutrophil-lymphocyte ratio and mean platelet volume, are positively correlated or not. We used COVID-19 PCR positive children who applied to the pediatrics outpatient clinic of our hospital for measurement. Material and Methods: Our study was designed retrospectively and included 136 children aged 6-18 years who applied to the pediatrics outpatient clinic of our hospital between 29 March 2020 and 31 November 2020. Sixty-eight of these children were found to be healthy and COVID-19 negative, while the other 68 were positive. COVID-19 PCR-positive patients were divided into four groups, each consisting of 17 patients, as asymptomatic infection, acute upper respiratory tract infection, mild pneumonia and severe pneumonia. Results: The three most common clinical findings in COVID-19 PCR positive patients are;cough was present in 44 (64.7%), fever in 37 (54.4%), and tachypnea in 17 (25%). Neutrophil count, neutrophil-lymphocyte ratio and mean platelet volume were found to be statistically significantly higher in COVID-19 PCR positive children compared to negative ones (p< 0.05). The lymphocyte count was found to be significantly lower in COVID-19 PCR positive children (p< 0.05). When the subgroups of COVID-19 PCR positive patients are evaluated;as the clinical severity increased between the groups, a significant increase was found in neutrophil count and neutrophil-lymphocyte ratio (p< 0.05). A significant decrease was observed in the lymphocyte count with the increase in clinical severity (p< 0.05). There was no significant difference between subgroups in the mean platelet volume of COVID-19 patients, consistent with clinical severity (p> 0.05). Conclusion: In our study, increased neutrophil count and neutrophil-lymphocyte ratio and decreased lymphocyte count were found to be associated with the clinical severity of COVID-19 disease. It is thought that these parameters can be used as good markers to predict the severity of COVID-19 disease. Although mean platelet volume was found to be significantly higher in COVID-19 PCR positive cases, it was not significantly associated with the clinical severity of the disease. Therefore, it was concluded that mean platelet volume is not a good prognostic predictor of the clinical course of the disease.