Prognostic biomarkers in COVID-19 infection: value of anemia, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and D-dimer

Abstract

Background Being highly infectious disease, COVID-19 exhausts most of efficient healthcare systems worldwide. Simple and rapid risk stratification methods are mandatory to recognize severe patients. This study aims to highlight the simple available laboratory biomarkers of good predictive value for COVID-19 severity. Results Three hundred fifty-one COVID-19 positive patients admitted to two University Hospitals between the 1st of June and the 31st of July 2020 were retrospectively collected and classified to severe and non-severe COVID-19 patients according to need for ICU admission. All basic laboratory biomarkers at time of admission were recorded. Of included patients, 145 (41.3%) needed ICU admission. Anemia, leukocytosis, lymphopenia, NLR, and PLR together with liver enzymes, INR, ferritin, CRP, and D-dimer were significantly higher in patients needed ICU admission (p < 0.001). However, by applying multivariate logistic regression, only anemia, high NLR, high PLR, and high D-dimer levels showed significant risk for ICU admission with OR equal 3.6 (95% CI 1.8–7.0), 9.0 (95% CI 3.6–22.6), 3.0 (95% CI 1.3–7.1), and 2.5 (95% CI 1.3–4.7), respectively. Conclusion Anemia, increased neutrophil-to-lymphocyte ratio (> 8), platelet-to-lymphocyte ratio (> 192), and D-dimer level (> 0.9 mg\L) at time of admission could be simple available predictors for severe COVID-19 infection requiring ICU admission.

A comparative analysis of serial measurements of Soluble Urokinase-type Plasminogen Activator Receptor (suPAR) and C-reactive protein in patients with moderate COVID-19: a single center study from India

“…Our result is consistent with the study by Hashem et al, 2021, wherein the authors reported that CRP was not a predictor for severity [18]. CRP has low sensitivity and unable to distinguish be-tween viral and bacterial sepsis [19]. A recent pre-print by Ji W and team, reports that Se-rum Amyloid A was a better prognostic marker than CRP during SARS-Cov-2 infection.…”

“…During the second wave of Novel Corona Virus disease 2019 (COVID- 19), the delta variant had intensely affected on healthcare systems globally. In India, at the time of writ-ing this manuscript, there had been 40 million confirmed cases of COVID-19 with more than four lakh deaths (WHO COVID-19) [1].…”

Prognostic accuracy of inflammatory markers in predicting risk of ICU admission for COVID-19: application of time-dependent receiver operating characteristic curves

“…30 but do not agree with other previous findings. 9 Further, Yufei et al. showed that the AUC of combined NLR and CRP improved diagnostic accuracy in predicting COVID-19.…”

Changes of LipoxinA4 Levels Following Early Hospital Management of Patients with Non-Severe COVID-19: A Pilot Study

“…Up to now, no specific biomarkers have been identified to assess the clinical response in patients with a mild to moderate disease. Moreover, the common biomarkers used to detect the severity of COVID-19 such as erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and ferritin, are not of high prognostic values [8, 9].…”