Evaluation of Inflammatory Markers in COVID-19 Disease in Children

ABSTRACT

Objective: This study aims to determine the prognostic values of bio-markers obtained from complete blood count in the diagnosis of the coronavirus disease of 2019 (COVID-19) patients who came to the pedi-atric emergency department of Diyarbakir Pediatric Hospital. Material and Methods: A total of 190 child patients with COVID-19 with definite diagnosis and 41 healthy children as a control group were included in this study. The lymphocyte count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), C-reactive protein (CRP), neu-trophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) obtained from the patients' complete blood count were evaluated.Results: A statistically significant difference was found between the pa-tient and control groups in the lymphocyte, platelet, NLR, PLR, SII, PCT, and CRP values (p= 0.001, p< 0.0001, p< 0.0001, p= 0.007, p= 0.001, p< 0.0001, and p= 0.002, respectively). A very good positive correla-tion was found between SII and NLR (r= 0.919, p< 0.0001). There was a good level of positive correlation between PLR and NLR and between SII and PLR (r= 0.746, p< 0.0001;r= 0.787, p< 0.0001, respectively), a moderate positive correlation was found between SII and CRP, between WBC and PLR, and between WBC and PLT (r= 0.432, p< 0.0001;r= 0.408, p< 0.0001;r= 0.538, p< 0.0001 respectively). The relationship between CRP and NLR and between PCT and SII was determined to be a weak positive correlation. The area under the curve for NLR, platelet, lym-phocyte was graded as moderate and for PCT very good. Cut-off points were found for the platelet count (<= 285.00;AUC= 0.740;95% CI= 0.644-0.836;p< 0.0001), lymphocyte count (<= 2.665;AUC= 0.727;95% CI= 0.633-0.821;p< 0.0001), NLR (>= 0.28;AUC= 0.707;95% CI= 0.611-0.803;p< 0.0001), and PCT (>= 0.83;AUC= 0.979;95% CI= 0.950-1.000;p< 0.0001).Conclusion: Platelet count, lymphocyte count, NLR and PCT can be used as inflammatory biomarkers that can predict prognosis in COVID-19 infec-tion in children.