Evaluation of hematological parameters and inflammatory markers in children with COVID-19

Abstract

Background The aim of this study was to evaluate hematological parameters in children with COVID-19 and determine the effects of inflammatory biomarkers on the assessment of hospitalization. Methods This retrospective single-center study was performed on 633 children with COVID-19 between March 2020 and January 2021. The study population was separated into two groups: inpatients ( n = 83) and outpatients ( n = 550). Univariate and multivariate logistic regression was applied to identify risk factors for hospitalization. Results Lymphopenia ( n = 228, 36%) was found mainly to be a hematological abnormality in all cases. Compared with outpatients, inpatients had significantly higher white blood cell (WBC) ( p = 0.005), lymphocyte ( p < 0.001), and platelet counts ( p = 0.036), and significantly higher red cell distribution width ( p = 0.001), C-reactive protein (CRP) ( p = 0.003), procalcitonin ( p = 0.001), d -dimer ( p < 0.001), and lymphocyte to monocyte ratio values ( p = 0.004). On the other hand, they had significantly lower values of hemoglobin ( p < 0.001), neutrophil to lymphocyte ratio ( p = 0.024), platelet lymphocyte ratio ( p = 0.001), derivated neutrophil to lymphocyte ratio ( p = 0.037), and mean platelet volume to lymphocyte ratio ( p < 0.001). ROC analysis showed that WBC, CRP, and procalcitonin cutoff values were the best discriminated between inpatients and outpatients. The results for the areas under the curve of WBC, CRP, and procalcitonin used to assess patients’ hospitalization were 0.595 (95% CI 0.519–0.670, p = 0.005), 0.599 (95% CI 0.527–0.672, p = 0.003), and 0.599 (95% CI 0.525–0.673, p = 0.004), respectively. Conclusion We suggest that high WBC and procalcitonin levels can be used as independent predictors of hospitalization in children with COVID-19.

Biomarker Changes in Pediatric Patients With COVID-19: A Retrospective Study from a Single Center Database

“…On the other hand, the study of Rezaei et al, on 52 patients, reported an increase in lymphocytic values in opposition to the previously mentioned study, in moderate and mild cases (50). In the study by Alkan et al, (2021), performed on a pediatric group of 633 patients with COVID-19 between March 2020 to January 2021, lymphopenia was also found present in approximately 36% of cases (28). The difference between the present study and the study of Guang et al, can be explained by the small number of patients and the age difference.…”

“…The study of Alkan et al (2021) involving 550 pediatric cases of COVID-19, presented the analysis of a complete laboratory biomarker panel and indicated all the possible and eventual changes in biomarkers upon infection with SARS-CoV-2. They reported decreases in the levels of lymphocytes (36%), leukocytes (19.2%), and a significant increase in D-Dimers (17.9%) and reactive C protein (20.7%) (28).…”

“…Together with clinical manifestations, it is mandatory to assess laboratory markers, which change according to the setting and the development of the inflammatory process. An increase in D-dimers, C-reactive protein and white blood cells, neutrophils, and lymphocyte count is expected in patients infected with SARS-CoV-2 (28). The study of Alkan et al (2021) involving 550 pediatric cases of COVID-19, presented the analysis of a complete laboratory biomarker panel and indicated all the possible and eventual changes in biomarkers upon infection with SARS-CoV-2.…”

Covid-19 Disease in Pediatric Emergency Room: The Dilemma of Cycle Threshold Value

“…Similarly, in our study, this rate was found to be 84%. Lympopenia, another laboratory finding, was 14-36% in a few studies [8, 9, 12, 20]. Yayla et al in their study, lymphopenia was observed at a rate of 14% [9].…”

Alteraciones hematológicas como consecuencia de COVID-19 y sus vacunas

“…En niños, el estudio de Alkan y colaboradores [15], en donde se compararon los parámetros hematológicos en me-nores hospitalizados versus aquellos evaluados en consulta externa, reportó que el riesgo de hospitalización era 6,4 veces mayor para los niños con leucocitosis, y que este parámetro podría utilizarse como un factor predictor independiente de hospitalización en los niños con COVID-19. Por el contrario, en el estudio de Arikan y colaboradores [16], en niños con una mediana de edad de 9 años, se encontró que la neutropenia (47,9%) era el parámetro anormal más común en los niños, seguido de linfocitosis (22,4%) y leucopenia (20,7%).…”