Study of hematological parameters in patients with coronavirus disease 2019 in Basra

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a novel infectious disease that is caused by SARS-CoV-2, a newly emergent coronavirus, was first recognized in Wuhan, China, in December 2019. Genetic sequencing of the virus suggests that it is a betacoronavirus closely linked to the SARS virus. COVID-19 disease associated with hematological parameter changes like changes in complete blood picture and coagulopathy. Numerous observational studies have suggested that the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte proportion and the platelet-to-lymphocyte ratio (PLR) are inflammatory markers. OBJECTIVES: The aim was to study the changes in hematological parameters in patients with COVID-19 in relation to the severity and outcome of the disease. PATIENTS AND METHODS: A prospective study had been done during the period of 3 months that extends from March to May 2020. From 543 patients admitted to the Basra Teaching Hospital COVID-19 wards, 112 medical reports of patients had been randomly selected. The demographic and blood test results for each patient were collected and followed the patient disease severity and the outcome. None of the selected patients had chronic disease or chronic use of medicine (s) that might affect the blood indices. Further analysis and statistics were done by SPSS software. RESULTS: The study showed that females were more than males 56.25% and 43.75%n respectively. Severity categorization showed that majority of cases were mild (88, 78.58%). Furthermore, the study reveals that 11 (9.82%) had leukocytosis, 6 (5.4%) of patients with leukopenia, 6 (5.36%) of patients with lymphopenia, and 16 (14.28%) of patients with neutrophilia. Seven patients (6.25%) had thrombocytosis while 6 patients (5.36%) presented with thrombocytopenia. Neutrophil/lymphocyte ratio in this study showed 28/112 (25%) patients with N/L ratio ≥3.1. Of those patients with high N/L, 39.29% were aged ≥65 years. All the patients with severe disease had high N/L (P = 0.000). The study showed that PLR ≥ 626 was found in 13.39% (15/112) of the studied patients, all of them had either severe (73.3%) or moderate (26.67%) disease which was highly significant when compared to low ratio (P=0.000). CONCLUSION: The study showed that the severity of COVID19 was associated with lymphopenia, monocytosis, and elevated NLR and PLR values. On the other hand, both values (NLR and PLR) could be used as hematological predictors for disease severity and the outcome of patients with COVID-19.

Keywords

• coronavirus disease 2019
• hematological parameters
• basrah
• leukocytosis
• lymphopenia
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio