A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients

Abstract

Many studies have reported hemocytometric changes in COVID-19 infection at admission and during the course of disease, but an overview is lacking. We provide a summary of the literature of hemocytometric changes and evaluate whether these changes may assist clinicians in diagnosing and predicting disease progression of COVID-19. Eighty-three out of 250 articles from December 2019 to 20 May 2020 were included from the databases, PubMed, Web of Science Core Collection, Embase, Cochrane and MedRxiv. Our review of the literature indicates that lymphopenia and an elevated neutrophil/lymphocyte ratio are the most consistent abnormal hemocytometric findings and that these alterations may augment in the course of time, especially in those with severe disease.

Laboratory parameters as predictors of mortality in COVID-19 patients on hospital admission

“…The observed differences are in line with data shown in previous studies [1][2][3][4][5]. These studies also reported that an increase in CK, LDH, CRP, AST and creatinine, together with a decreased number of lymphocytes, platelets and albumin levels are associated with a severe or fatal prognosis [1][2][3][4][5].…”

“…Increased white blood cell (WBC) count seems to be a consistent finding in severely ill patients [2,4,5]. In contrast, our data shows no significantly increased WBC counts in the non-survivor group on admission, whereas the differences between neutrophils, lymphocytes and platelets in both groups are similar as previously described [1][2][3][4][5]. Similarly, there are no differences in alanine aminotransferase (ALT) or bilirubin values between the two groups, although this has been described by others [1,2,5].…”

“…Our data is consistent with both findings and the reported mortality. Increased white blood cell (WBC) count seems to be a consistent finding in severely ill patients [2,4,5]. In contrast, our data shows no significantly increased WBC counts in the non-survivor group on admission, whereas the differences between neutrophils, lymphocytes and platelets in both groups are similar as previously described [1][2][3][4][5].…”

“…Interestingly, the number of neutrophils increased as disease progressed (data not shown). Together with the increased CRP this tendency is indicative for a superimposed bacterial infection as previously described [4]. Although it is well known that the disease causes pneumonia, little has been described about blood gas parameters of COVID-19 patients on hospital admission.…”

A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study

“…Most studies were however geographically limited, had high risk for bias, and had no validation cohort (14). C-reactive protein, ferritin, Ddimer, albumin, urea nitrogen, bilirubin and lactate dehydrogenase (LDH) levels are cited as indirect indicators of the presence and severity of COVID-19 (11,13,(15)(16)(17)(18)(19)(20), as are complete blood count (CBC) and differential count (DIFF) changes, specifically lymphopenia, neutrophilia, high neutrophil-to-lymphocyte ratio (NLR) and thrombocytopenia (15,(21)(22)(23)(24)(25). All aforementioned parameters are widely available, but their value is constrained by significant inter-patient variability and limited specificity.…”