Predictive Ability of Complete Blood Count, Mean Platelet Ratio, Mean Platelet Volume, and Neutrophil/Lymphocyte Ratio for Severe Pneumonia among RT-PCR or Radiologically Proven COVID-19 Patients

Abstract

In Rajasthan, the picture of COVID-19 has been very gloomy and on 21st December 2020 there were 12,422 active cases, and 283,957 cumulative cases which included either discharged or cured or migrated to other places. Disease may start with milder clinical manifestation, but it may suddenly progress to acute respiratory failure or acute respiratory distress syndrome or septic shock or metabolic acidosis or coagulopathies. There is an association of neutrophil/lymphocyte ratio (NLR), Mean Platelet Volume (MPV), Mean Platelet Ratio (MPR) and with the progression of the COVID-19 infection and it can be utilized by the physicians for identification of high risk or deteriorating patients at an early stage. In the context of this background, the present study was undertaken to study the predictive ability of these hematological parameters (especially MPV, MPR, NLR) in progression of COVID-19 infection to severe pneumonia among RT-PCR or radiologically proven COVID-19 patients. Materials and method: Analytical cross sectional Hospital based study of 729 COVID-19 patients enrolled between 1st April 2020 to 30th Nov 2021 conducted in Bangur hospital of Pali district, Rajasthan. Socio-demographic information, clinical profile, investigation reports and clinical outcome were collected from the electronic medical records. WHO’s definition for severe pneumonia of COVID-19 (17) was utilized to categorize patients with severe pneumonia. Data was entered in Microsoft Excel and checked for errors. The analyses were done using Jamovi and SPSS v.23.0. Results: It was found that neutrophil/lymphocyte ratio was significantly higher among those participants with evere pneumonia, but there was no such significance appreciated for mean platelet ratio.. Parameters related to acute infection (Total WBC count, granulocyte (%), absolute granulocyte count) were directly correlated with N/L ratio and Mean Platelet ratio (except granulocyte (%)).From multivariable analysis, it was found that increase in N/L ratio and decrease in albumin were significant predictors of severe pneumonia. Conclusion: N/L ratio is good predictor marker of COVID 19 severe pneumonia. MPV, MPR, and PC are nit the good predictive markers of COVID 19 severe pneumonia.