Blood Count, Markers of Inflammation and Coagulation factors in COVID-19 versus non COVID-19 patients having Medical Emergency in Qena University Hospital

Abstract

Background: Inflammation play a key role for COVID-19 infection and its adverse outcomes. Objectives: The study aimed to evaluate different systemic inflammatory indices as a predictor of COVID-19 infection. Patients and Methods: A cross-sectional study conducted on patients suspected of having COVID-19. PCR was done and laboratory tests including CBC, coagulation profile, D-dimer, CRP, and diverse of established systemic inflammatory ratios were evaluated on admission [Neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR), lymphocyte/monocyte ratio(LMR), systemic immune-inflammation index(SII), lymphocyte-to-CRP ratio (LCR), prognostic index (PI), Neutrophil platelet score (NPS), systemic inflammatory response syndrome (SIRS), and platelet/monocyte Neutrophil ratio. Results: We included 128 patients, 56 males (43.75%) and 72 females (56.25%), 48 (37.5%) had positive PCR, and 80 (62.5%) had negative PCR. PCR (+) patients had significantly higher NLR (median: 7.37, range: 0.5:158), MLR (median: 0.56, range: 0.03:4.7), and PLR (median: 274.15, range: 13.2:1475) compared to PCR (-) patients (median: 3.46, range: 0.2:24), (median: 0.333, range: 0.03:3.5), (median: 116.7, range: 50.8:878.1) respectively, (P=0.001). PCR (+) patients had a significantly higher PI (p< 0.00001) and NPS (P=0,004). D-Dimer had the highest Area Under Curve (0.979), followed by CRP (0.950), INR (0.919), PC (0.920), PT (0.831), Neutrophil % (0.710), and inflammatory indices PLR (0.748), SII (0.724), NLR (0.698), SIRS (0.674), LMR (0.668), LCR (0.651), and P2/MS (0.605). Conclusion: The calculated inflammatory indices, and the prognostic index can be used to estimate the degree of COVID-19 disease, and combined assessments for multiple inflammatory scores are more accurate in predicting disease severity and offer clinical benefits.

Keywords

• lymphocyte to c-reactive protein ratio nlr plr
• prognostic index
• systemic inflammation-based prognostic scores