Baseline Peripheral Blood Counts and Outcomes in Patients Presenting with COVID-19 (preprint)

ABSTRACT

Background: SARS COV-2 pandemic has significant impact on hematopoietic system. Objective: To report the incidence and pattern of baseline hematological parameters in patients with COVID-19 and their association with severity of disease and outcome. Methods: Retrospective observational study. Results: A total of 440 patients were included in the study. The mean age of the study cohort was 47.5 years. Fifty percent of patients had at least 1 comorbidity. ICU stay was required in 125 (39.6%) patients. Overall mortality in the study cohort was 3.52%. The average age of patients who died was significantly higher than that of patients who were alive (65.1 years vs 46.5 years; p= 0.000). DM, HTN, CAD and CKD were all associated with higher incidence of ICU stay and mortality. Lymphopenia < 1x109 was observed in 24.3% and eosinopenia was noted in 44.3% patients. Leukocytosis>11x109 was seen in 8.2 % of patients. The median neutrophil lymphocyte ratio (NLR) of whole cohort was 2.63. NLR, Lymphopenia, eosinopenia, leucocytosis, D dimer, lactate dehydrogenase (LDH), ferritin and IL6 levels all were associated with need for ICU transfer and mortality. Hemoglobin, red cell distribution width (RDW), PT and aPTT correlated with need for ICU transfer but not with mortality. Ferritin cutoff >751 ng/ml and IL6 levels >64pg/ml was able to identify all deaths. Ferritin (0.989) and IL-6 (0.985) had very high negative predictive value. Conclusions: Peripheral blood counts at time of hospitalization is a simple tool to predict outcomes in patients admitted with Covid-19.