Clinical and hematological characteristics of 88 patients with COVID‐19

Zhang, Hongmei; Cao, Xiaocui; Kong, Man; Mao, Xiaoli; Huang, Lifeng; He, Panwen; Pan, Shiyao; Jin, Li; Lu, Zhongxin

doi:10.1111/ijlh.13291

Cited by 43 publications

(40 citation statements)

References 28 publications

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“…LMR was also higher in survivors but the association was not statistically significant. The LMR decreased in non-survivors in our study, which is in agreement with studies conducted by Lissoni et al and Zhang et al [13,14]. However, a significant correlation was observed with mortality when a cut-off of 2.5 was considered as a differentiating benchmark.…”

Section: Discussionsupporting

confidence: 93%

Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, and Platelet-to-Lymphocyte Ratios: Prognostic Significance in COVID-19

Bg¹,

Gosavi²,

Rao³

et al. 2021

Cureus

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Background and objective Neutrophils are primarily responsible for activating the immune system, and systemic inflammation destroys CD4+ T lymphocytes and increases suppressor CD8+ T lymphocytes, thereby leading to an increased neutrophil-to-lymphocyte ratio (NLR). An increase in the apoptosis of lymphocytes leads to lymphopenia and elevated thrombopoietin (THPO) promotes megakaryocyte production. The reflections of these inflammatory changes can be vital in gauging the progression of the disease. This study aimed at examining the prognostic value of normal and derived neutrophil-to-lymphocyte, lymphocyte-to-monocyte, platelet-to-lymphocyte, and mean platelet volume (MPV)-to-platelet count ratios in patients with coronavirus disease 2019 (COVID-19). Methodology This was a retrospective cross-sectional study conducted in the wards of Chigateri General Hospital, Davangere for a period of two months. Complete blood count was ordered for all patients at the time of admission along with confirmation of the disease by reverse transcription-polymerase chain reaction (RT-PCR). Results The final study population consisted of 100 patients. The mean age of patients who survived (43 years) was significantly lower than the mean age of non-survivors (59.1 years), with a p-value of <0.001. NLR was raised in 60% of the population and was significantly higher in patients who survived the disease, with a p-value of 0.004. The platelet-to-lymphocyte ratio (PLR) also followed a similar trend with a p-value of 0.017. Even though the lymphocyte-to-monocyte ratio (LMR) also mimicked the trend, the statistical association was not significant (p-value: 0.09). The derived NLR and MPV-to-platelets ratios were not found to be significantly associated with mortality in this study. Discussion Younger patients had better clinical outcomes in our study population compared to the geriatric age group. A significant correlation between LMR and mortality was observed when a cutoff of 2.5 was considered as a differentiating benchmark. Conflicting trends were observed in NLR and PLR in our study; however, LMR was in accordance with most other studies. The phase that a patient is in with regard to the natural history of the disease also influences the blood cell ratios. Nonetheless, all three ratios can be used as crucial screening and prognostic tools as they are readily available with the help of a complete hemogram. This is an investigation modality that is widely accessible even in remote areas and resource-limited settings. Conclusion These hematological ratios can facilitate in categorizing the disease severity and progression in patients, thereby enabling us to make appropriate and informed clinical decisions. Since the second wave of the novel coronavirus is on the verge of arrival, it is imperative to channel resources for the patients early in their disease course to ultimately prevent complications and reduce mortality.

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Section: Discussionsupporting

confidence: 93%

Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, and Platelet-to-Lymphocyte Ratios: Prognostic Significance in COVID-19

Bg¹,

Gosavi²,

Rao³

et al. 2021

Cureus

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“…Infected individuals present a range of symptoms from their total absence to headaches, fevers, coughs, loss of smell and taste, dyspnea, and death. Although the respiratory form has garnered the most attention due to high mortality rates from compromised lung function, many individuals have also experienced a mainly intestinal form resulting in nausea, cramps, and diarrhea [ 7 ].…”

Section: Viewpointmentioning

confidence: 99%

“…It has been proposed that the severity of the COVID-19 host response may be primarily due to an aberrant activation of neutrophils in the peripheral blood. Blood cells count of COVID-19 patients revealed a gradual increase in the numbers of white blood cells, the neutrophil percentage, absolute neutrophil count, and neutrophil-to-lymphocyte ratio (NLR) according to the worsening of the disease [ 7 , 8 , 12 ]. In addition, autopsied lung samples of 3 COVID-19 patients showed neutrophilic infiltration in the pulmonary capillaries, acute capillaritis with fibrin deposition, neutrophilic leakage in the alveolar space, and neutrophilic mucositis [ 13 ].…”

Section: Viewpointmentioning

confidence: 99%

COVID-19, leprosy, and neutrophils

Schmitz

Santos

2021

PLoS Negl Trop Dis

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Coronavirus Disease 2019 (COVID-19), a disease caused by the betacoronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has only recently emerged, while Mycobacterium leprae, the etiological agent of leprosy, has endured for more than 2,000 years. As soon as the initial reports of COVID-19 became public, several entities, including the Brazilian Leprosy Society, warned about the possible impact of COVID-19 on leprosy patients. It has been verified that COVID-19 carriers can be either asymptomatic or present varying degrees of severe respiratory failure in association with cytokine storm and death, among other diseases. Severe COVID-19 patients show increased numbers of neutrophils and serum neutrophil extracellular trap (NET) markers, in addition to alterations in the neutrophil-to-lymphocyte ratio (NLR). The absence of antiviral drugs and the speed of COVID-19 transmission have had a major impact on public health systems worldwide, leading to the almost total collapse of many national and local healthcare services. Leprosy, an infectious neurological and dermatological illness, is widely considered to be the most frequent cause of physical disabilities globally. The chronic clinical course of the disease may be interrupted by acute inflammatory episodes, named leprosy reactions. These serious immunological complications, characterized by cytokine storms, are responsible for amplifying peripheral nerve damage. From 30% to 40% of all multibacillary leprosy (MB) patients experience erythema nodosum leprosum (ENL), a neutrophilic immune-mediated condition. ENL patients often present these same COVID-19-like symptoms, including high levels of serum NET markers, altered NLR, and neutrophilia. Moreover, the consequences of a M. leprae–SARS-CoV-2 coinfection have yet to be fully investigated. The goal of the present viewpoint is to describe some of the similarities that may be found between COVID-19 and leprosy disease in the context of neutrophilic biology.

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“…Zhang et al 7 Our CBC results were divided into two groups, as 'on admission' and 'one week later' results, in this study according to the real-time condition of the patients. Eosinophils (EOs), the Neutropil/ Eosinophil Ratios (NEU/EOs), Lymphocytes (LYMs), and Platelets (PLTs) showed a significant upward trend with one week after admisson.…”

Section: Resultsmentioning

confidence: 99%

Could Eosinopenia be a simple, fast and reliable biomarker in diagnosis of Covid-19?

Katar

Demir

2020

Cumhuriyet Medical Journal

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Monitoring CBC subsets, particularly eosinophils. and inflammation markers, during admission and treatment of severe COVID-19 patients, can reveal key indicators of disease progression and stage to provide a basis for diagnosis and treatment for clinicians. Method: Our study is a retrospective case-control study. After taking aproval of Ministry of Health and Ethics Committee, the recorded clinical, laboratory and radiological data of 30 patients who were diagnosed with Covid-19, between 15 March and 15 June 2020, were compared with 30 healthy person by using appropriate statistical methods. Results: Both patients and conrols included 10 (33.3%) females and 20 (66.6%) males with a mean age of 57.2 ± 15.46 and 60.07 ± 20.59 respectively. Eosinophil counts of the patients on admission were significantly lower than the controls (p <0.001). Eosinophil counts one week after admission were increased significantly compared to the admission levels (p= 0.004). Neutrophil/Eosinophil ratio, which is a reliable indicator of 'Eosinopenia' in patients on admission was significantly higher than that of one week later (p= 0.041). EO1, NE1, NE2, PLT2/LYM2, LYM1/CRP1 and LYM2/CRP2 were the most predictive indexes. The AUCs of them were; 0.856, 0.778, 0.719, 0.738, 0.747 and 0.702 respectively, the cut-off values were; 0.04, 3.32, 3.21, 144,59, 1.99 and 7.84 respectively, the sensitivity and specificity were 66.7% and 93.3% for EO1; 53.3% and 93.3% for NE1; 46.7% and 93.3% for NE2; and 80.1% and 80.5% for PLT2/LYM2; and 100% and 66.7% for LYM1/CRP1and 100% and 53.3% for LYM2/CRP2; respectively. Conclusions: Tracking of CBC subsets, particularly Eosinophil, and CBC indexes is helpful in the early screening, diagnosis, treatment and follow up of critical COVID-19 patients.

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Clinical and hematological characteristics of 88 patients with COVID‐19

Cited by 43 publications

References 28 publications

Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, and Platelet-to-Lymphocyte Ratios: Prognostic Significance in COVID-19

Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, and Platelet-to-Lymphocyte Ratios: Prognostic Significance in COVID-19

COVID-19, leprosy, and neutrophils

Could Eosinopenia be a simple, fast and reliable biomarker in diagnosis of Covid-19?

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