Evaluation of Hematological Parameters in Predicting Intensive Care Unit Admission in COVID-19 Patients

Saurabh, Animesh; Dey, Biswajit; Raphael, Vandana; Barman, Bhupen; Dev, Priyanka; Tiewsoh, Iadarilang; Lyngdoh, Bifica Sofia; Dutta, Kaustuv

doi:10.1007/s42399-021-01115-8

Cited by 15 publications

(8 citation statements)

References 24 publications

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“…NLR represents a rapid, widely available, and inexpensive tool that could be useful in the management and early risk stratification of patients with COVID-19 [9]. Saurabh et al, in their retrospective analysis done in April-May 2021, studied the hematological parameters including Hgb, platelet count, total leukocyte count (TLC), neutrophils, lymphocytes, NLR, and absolute eosinophil count (AEC) in COVID-19 positive patients within 24 hours of admission concerning both ICU and non-ICU admissions [10]. They found that relative neutrophilia 70% (p-value 0.007), relative lymphopenia 20% (p-value 0.002), and NLR 9.1 (p-value 0.001) were all significantly associated with ICU disposition.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Observational Study of Complete Blood Count (CBC) Parameters and ICU Mortality of COVID-19 Disease in Delta Variant and Omicron Variant in a Community-Based Hospital in New York City

Yadav¹,

Yadav²,

Pokhriyal³

et al. 2023

Cureus

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Background: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is the official name of COVID-19, a respiratory infection that had the first case reported from the Hubei province of China on December 8, 2019. This virus is the main etiological agent behind the most dreaded pandemic of pneumonia that has spread to the entire world in a brief period and continues to pose a threat. The first wave corresponded with the period from February 2020 to June 2020, the Delta variant occurred around the middle of June 2021 and the Omicron wave was reported from December 2021 to February 2022.Objective: This study aims to compare the Delta and the Omicron variants of COVID-19 infection in a community-based hospital in New York City considering the comparison of ICU admissions in both variants. We aim to study the comparison of complete blood count (CBC) parameters and inflammatory markers of patients admitted to ICU stratified by two waves of COVID-19 infection. We aim to analyze the association of CBC parameters at admission and the discharge during ICU stay in both variants. We also aim to study the association of CBC parameters at admission and discharge with ICU mortality in both variants.Methods: We conducted a retrospective observational study based on data from randomly selected hospitalized patients with COVID-19 in a community-based hospital in New York City during the Delta variant and the Omicron wave. A total of 211 patients COVID-19 positive from June to July 2021 (Delta variant) and 148 patients from December to February 2022 (Omicron wave) were included in the study. A comparison was done between the basic characteristics of patients with and without ICU admissions in both variants of COVID-19. We compared the relationship of different parameters of CBC (hemoglobin (Hgb), white blood count (WBC), lymphocytes, neutrophils, and platelets) on ICU admission and further analyzed any changes associated with ICU mortality. Logistic regression was performed to evaluate the relationship of different presenting CBCs on patients' disposition to ICU.Result: A total of 211 patients (106 female) in the Delta wave (2021 variant) and 148 patients (80 female) in the Omicron wave (2022 variant) with an average ages of 60.9 ±18.10 (Delta variant) and 63.2 ± 19.10 (Omicron variant) were included in this study. There were 45 patients (21.3%) in the Delta wave and 42 patients (28.4%) in the Omicron wave were admitted to ICU. The average length of hospital stay was seven days in the Delta wave and nine days in the Omicron wave. No significant association was found between presenting cell count and ICU admission (p>0.05). Significant associations were found between different cell counts on admission and discharge and death in Delta waves except Hgb and platelets on admission. However, in the Omicron variant, a significant association was found only between WBC on admission and discharge, and Hgb and neutrophil on discharge with death in the univariate model. Conclusion:Comparative study of different clinical parameters betwee...

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Section: Discussionmentioning

confidence: 99%

Retrospective Observational Study of Complete Blood Count (CBC) Parameters and ICU Mortality of COVID-19 Disease in Delta Variant and Omicron Variant in a Community-Based Hospital in New York City

Yadav¹,

Yadav²,

Pokhriyal³

et al. 2023

Cureus

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“…The high PCT group patients had a higher neutrophil count and a lower lymphocytic count. These hematological parameters are known to be associated with severe COVID-19 infection [ 23 ]. Although neutrophilia is usually associated with bacterial infection, in COVID-19, it is usually linked to disease severity without clear evidence of associated bacterial co-infection.…”

Section: Discussionmentioning

confidence: 99%

The Association between Admission Procalcitonin Level and The Severity of COVID-19 Pneumonia: A Retrospective Cohort Study

et al. 2022

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Background and Objectives: An elevated procalcitonin level has classically been linked to bacterial infections. Data on the association between elevated procalcitonin and the outcome of coronavirus disease 2019 (COVID-19) are conflicting. Some linked it to associated bacterial co-infections, while others correlated the elevation with disease severity without coexisting bacterial infections. We aimed to investigate the association between high procalcitonin and the severity of COVID-19. Materials and Methods: Hospitalized patients with confirmed COVID-19 pneumonia were divided into two groups: the normal-procalcitonin group and the high-procalcitonin group (>0.05 ng/mL). Patients with concomitant bacterial infections on admission were excluded. The primary outcomes were the need for intensive care unit (ICU) admission, progression to invasive mechanical ventilation (IMV), and in-hospital 28-day mortality. Results: We included 260 patients in the normal procalcitonin group and 397 patients in the high procalcitonin group. The mean age was 55 years and 49% were females. A higher number of patients in the elevated procalcitonin group required ICU admission (32.7% vs. 16.2%, p < 0.001) and IMV (27.2% vs. 13.5%, p < 0.001). In-hospital mortality was significantly higher in the elevated procalcitonin group (18.9% vs. 8.5%, p < 0.001). After adjusting for other covariates, procalcitonin > 0.05 ng/mL was an independent predictor of progression to IMV (OR, 1.71; 95% CI, 1.08–2.71; p = 0.022), ICU admission (OR, 1.73; 95% CI, 1.13–2.66; p = 0.011), and in-hospital mortality (OR, 1.99; 95% CI, 1.14–3.47; p = 0.015). An elevated procalcitonin level was the strongest predictor of in-hospital mortality. Conclusions: Measurement of procalcitonin can have a prognostic role among COVID-19 patients. The admission procalcitonin level can identify patients at risk of ICU admission, progression to IMV, and in-hospital mortality.

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“…A value of <12g/dl is considered as anemia, so the cutoff point was taken as 12g/dl for the analysis of hemoglobin concentration. 5 Leucopenia is defined as a value of TLC <4×10 9 /L and leukocytosis is defined as a value of >10×10 9 /L, so the reference range forthe analysis of TLC was taken 4-10×10 9 /L. A value of ANC <2×10 9 /L is defined as neutropenia while a value of >7×10 9 /L is defined as neutrophilia so the reference range was taken as 2-7×10 9 /L for the analysis of ANC.…”

Section: Cutoff Points and Interpretation Of Hematological Parametersmentioning

confidence: 99%

Role of hematological parameters and biochemical markers as a predictor of severity of COVID-19 patients

et al. 2022

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Background: The etiological agent for pandemic COVID-19 is severe acute respiratory syndrome corona virus 2. Hematological and biochemical parameters are the indicators of inflammation and coagulopathy. Aims and Objectives: The present study aimed to determine how effectively the hematological parameters and biochemical markers can help predict the severity of critically ill COVID-19 patients. Materials and Methods: The current retrospective cohort study was conducted among 200 COVID-19 patients admitted in the Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India. In our lab’s computerized system, certain hematological and biochemical parameters of the patients were retrieved and recorded. Receiver operating characteristics (ROC) curve analysis was done to evaluate the diagnostic accuracy of hematological and biochemical parameters. Results: Total leukocyte count (TLC), absolute lymphocyte count (ALC), neutrophil to lymphocyte ratio (NLR), D-dimer, and serum ferritin had a significant relationship with severity among ICU patients (P<0.05). ALC, D-dimer, and serum ferritin can be used to predict the severity of COVID patients with area under the ROC-AUC curve values of 0.717, 0.725, and 0.710, respectively. Platelet to lymphocyte ratio, lymphocyte to monocyte ratio, and C-reactive protein were not useful to predict the severity of COVID illness. Conclusion: Hb concentration, TLC, NLR, D-dimer, and serum ferritin were significantly raised in critically ill COVID patients. ROC curve analysis showed that ALC, serum ferritin, and D-dimer were able to predict the severity of COVID illness effectively. Conclusively, these parameters can be used to track the prognosis of patients.

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Evaluation of Hematological Parameters in Predicting Intensive Care Unit Admission in COVID-19 Patients

Cited by 15 publications

References 24 publications

Retrospective Observational Study of Complete Blood Count (CBC) Parameters and ICU Mortality of COVID-19 Disease in Delta Variant and Omicron Variant in a Community-Based Hospital in New York City

Retrospective Observational Study of Complete Blood Count (CBC) Parameters and ICU Mortality of COVID-19 Disease in Delta Variant and Omicron Variant in a Community-Based Hospital in New York City

The Association between Admission Procalcitonin Level and The Severity of COVID-19 Pneumonia: A Retrospective Cohort Study

Role of hematological parameters and biochemical markers as a predictor of severity of COVID-19 patients

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