Hematologic indices as an available tool in the diagnosis of adverse course of COVID-19

Abstract

Aim. To study the prognostic significance of hematologic indices: neutrophils/lymphocytes (N/L), platelets/lymphocytes (P/L) and lymphocytes/C-reactive protein (L/CRP) in relation to the complicated course of new coronavirus infection (COVID-19), as well as their correlation with COVID-19 course severity indices and endothelial dysfunction marker sVCAM-1. Materials and methods. 103 patients with new coronavirus infection (COVID-19) were included in the study. Based on the data of multispiral computed tomography (CT) of the chest organs, all patients were divided into 3 groups: CT group 1 – 30 patients, CT group 2 – 62 patients and CT group 3 – 11 patients. Results. The values of N/L and P/L were significantly higher in patients of CT group 3 compared to patients of CT group 1 and CT group 2. L/CRP index, on the contrary, significantly decreased with increasing CT-degree of lung lesion. The concentration of endothelial dysfunction marker sVCAM-1 was significantly higher in patients of CT-3 and 2 groups compared to patients of CT-1 group – 272.7 [267.4; 342.6] ng/mL and 212.5 [90.3; 335.6] ng/mL vs 120.0 [75.3; 189.2] ng/mL. Significant correlations of the studied hematologic indices with clinical, laboratory and instrumental characteristics of COVID-19 severity were found. P/L and L/CRP indices were associated with sVCAM-1 concentration in blood (r=0.28 and -0.33 respectively; p0.05). The values of N/L2.53 and L/CRP≤0.043 are predictors of the development of cytokine storm in the examined patients. Conclusion. Hematologic indices N/L, P/L and L/CRP are correlated with clinical, laboratory and instrumental characteristics of COVID-19 severity, presence of endothelial dysfunction (P/L and L/CRP) and allow predicting the development of cytokine storm (N/L and L/CRP).

Keywords

• covid-19
• cytokine storm
• predictors
• hematologic indices
• neutrophils
• lymphocytes
• platelets
• svcam-1