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Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID-19): A multicenter,
Junnan Peng1, Di Qi1, Guodan Yuan2
1Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Insights
Hematologic markers like monocyte-to-lymphocyte ratio (MLR) can help differentiate COVID-19 from healthy individuals. Neutrophil-to-lymphocyte ratio (NLR) may predict disease severity, while low lymphocyte counts aid in early ARDS diagnosis in COVID-19 patients.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Hematology
Background:
- Hematologic markers are crucial for diagnosing infectious diseases.
- Understanding COVID-19's impact on blood parameters is essential for patient management.
Purpose of the Study:
- To evaluate the diagnostic utility of hematologic markers for COVID-19.
- To investigate the correlation between hematologic markers and COVID-19 severity.
Main Methods:
- Comparative analysis of COVID-19 patients, healthy subjects, and influenza pneumonia (IP) patients.
- Assessment of routine blood counts, biochemical indicators, and clinical severity scores (PSI, CURB-65, MuLBSTA).
- Utilized Spearman's correlation and Receiver Operating Characteristic (ROC) curve analysis.
Main Results:
- COVID-19 patients exhibited distinct differences in white blood cell (WBC), lymphocyte, neutrophil, monocyte, and platelet counts compared to healthy and IP groups.
- Monocyte-to-lymphocyte ratio (MLR) effectively distinguished COVID-19 from healthy controls but not from IP.
- Neutrophil-to-lymphocyte ratio (NLR) correlated positively with disease severity scores; lower lymphocyte counts were observed in ARDS patients.
Conclusions:
- MLR shows potential for differentiating COVID-19 from healthy states, but is less effective against influenza pneumonia.
- NLR serves as a reliable indicator for assessing COVID-19 disease severity.
- Lymphocyte count is a valuable marker for early Acute Respiratory Distress Syndrome (ARDS) detection in COVID-19.
Background:
To determine the diagnostic value of hematologic markers for coronavirus disease 2019 (COVID-19) and explore their relationship with disease severity.
Methods:
Subjects included 190 COVID-19 patients, 190 healthy subjects, and 105 influenza pneumonia (IP) patients. COVID-19 patients were divided into the ARDS and non-ARDS groups. Routine blood examination, biochemistry indicator, days in hospital, body temperature, pneumonia severity index (PSI), CURB-65, and MuLBSTA were recorded. Correlations between variables were assessed using Spearman's correlation analysis. Receiver operating characteristic (ROC) curves were used to study the accuracy of the various diagnostic tests.
Results:
Compared with healthy subjects, COVID-19 patients had lower white blood cell (WBC), lymphocyte, platelet, and hemoglobin levels; higher percentages of neutrophils and monocytes; lower percentages of lymphocytes and higher neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) values (P < .05). COVID-19 patients had higher WBC and neutrophil levels and lower percentages of lymphocytes compared to IP (P < .05). ROC curve analysis revealed that MLR had a high diagnostic value in differentiating COVID-19 patients from healthy subjects, but not from IP patients. NLR showed significant positive correlations with PSI, CURB-65, and MuLBSTA. Lymphocyte count was lower in the ARDS group and yielded a higher diagnostic value than the other variables.
Conclusions:
Monocyte-to-lymphocyte ratio showed an acceptable efficiency to separate COVID-19 patients from healthy subjects, but failed to rule out IP patients. NLR may be a reliable marker to evaluate the disease severity of COVID-19. Lymphocyte count may be useful to establish the early diagnosis of ARDS in the COVID-19 patients.
