Hematological Manifestations of COVID-19 and its correlation with outcome – A retrospective study

Abstract

Background and Aim: The objective was to study the hematological manifestations of disease caused by novel coronavirus 2019 (COVID-19) and evaluate the association between absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio, total count, and outcome. Materials and Methods: A hospital-based retrospective study was conducted on COVID-19 adult inpatients admitted between March and August 2020. The patients were classified into three groups based on outcome as mild COVID/uneventful recovery (Group 1), severe COVID/recovered (Group 2), and death (Group 3). Their clinical profile and hematological parameters were compared using both univariate and multivariate analyses. Binary and multinomial logistic regression analyses were used to analyze the chances of survival or death with respect to the variable studied. Results: The median age of nonsurvivors was 62.5 years. For unit increase in age, there were 1.03 times higher chances of severe disease (P = 0.013) and 1.04 times chances of death (P = 0.028). For every 1000/μl increase of ANC, the odds of developing severe disease rose by 1.85 (P = 0.270). For every 1000/μl increase in ALC, there were 94.7% lesser chances of death (P = 0.006) and 51.1% lesser chances of severe disease (P = 0.033). The odds of developing severe disease was 1.16 times per unit rise in NLR and the OR for death was 1.27 (P = 0.053). Conclusion: Advanced age, presence of lymphocytopenia, increased neutrophil count, and elevated NLR were associated with severe disease and high mortality due to COVID-19. Lymphocytopenia and age were the strongest predictors of severe disease and death.

Keywords

• absolute lymphocyte count
• absolute neutrophil count
• covid-19
• hematological manifestation
• mortality
• neutrophil–lymphocyte ratio