Medical Laboratory Journal (Jan 2024)

D-NLR, and neutrophil count as early predictive biomarkers of disease severity and poor disease outcome in SARS-CoV-2 infected patients from Kashmir

  • Ifrah Jan,
  • Rafiqa Eachkoti,
  • Iqra Farooq,
  • Sanah Farooq,
  • Sadaf Saleem,
  • Sabhiya Majid

Journal volume & issue
Vol. 18, no. 1
pp. 4 – 8

Abstract

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Background: The complete blood count (CBC) profile has been found extremely useful in monitoring the growth of SARS-CoV-2 infection; however, predictive CBC parameters that could be used in the management of the disease may vary in different populations. Methods: This study comparatively analyzed the CBC profile of SARS-CoV-2 patients (N = 75; confirmed positive by real-time polymerase chain reaction [PCR]) and healthy individuals (confirmed negative by real-time PCR) from Kashmir (north India). Results: Compared with healthy individuals, most of the CBC parameters (hemoglobin levels [13.43 vs 10.9 g/dL; P = 0.0001], lymphocytes [16.04% vs 30.8%; P = 0.00001], monocytes [5.53% vs 7.53%; P = 0.009], and platelet count [150 vs 186 ×103 µL; P = 0.037]) were significantly low in SARS-CoV-2 infected patients, while neutrophilia was more common in infected patients (76.77% vs 59.26%). Among derived parameters, the neutrophil-to-lymphocyte ratio (NLR; 7.31 vs 2.04; P = 0.001) and derived NLR (d-NLR; 4.43 vs 1.5; P = 0.0002) were significantly high in SARS-CoV-2 patients. Further correlation analysis revealed a significant association of neutrophilia with the severity of the disease in SARS-CoV-2 infected patients. Moreover, receiver operating characteristic (ROC) analysis of derived CBC parameters (NLR, d-NLR, and platelet‐to-lymphocyte ratio [PLR] with disease severity and disease outcome) revealed d-NLR as better predictive marker of disease severity (area under the curve [AUC] = 0.658) and disease outcome (AUC = 0.766) compared to PLR with disease severity (AUC = 0.645) and disease outcome (AUC = 0.693). Conclusion: We therefore conclude, of the CBC parameters neutrophilia as the marker of disease severity and among derived parameters, d-NLR as an early predictive biomarker of both disease severity and poor disease outcome in SARS-CoV-2 patients.

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