Related Experiment Video
Updated: Nov 7, 2025
Evaluation of a Point-of-Care Testing Analyzer for Measuring Peripheral Blood Leukocytes
Published on: March 22, 2022
Analysis of laboratory blood parameter results for patients diagnosed with COVID-19, from all ethnic group
Mandeep Marwah1, Sukhjinder Marwah2, Andrew Blann3
1Aston University, Birmingham, UK.
Insights
Routine blood tests like neutrophil/lymphocyte and urea/albumin ratios can predict COVID-19 mortality in both Caucasian and Black, Asian, and Minority Ethnic (BAME) patients. Monitoring these markers aids early intervention and reduces deaths.
Area of Science:
- Clinical Medicine
- Hematology
- Biochemistry
Background:
- Established COVID-19 prognostic factors like age and diabetes may vary across ethnic groups.
- Routine biochemistry and hematology indices were investigated for differences between Caucasian and Black, Asian, and Minority Ethnic (BAME) COVID-19 patients.
Purpose of the Study:
- To investigate potential ethnic differences in routine laboratory markers for COVID-19 prognosis.
- To identify simple metrics that predict mortality in COVID-19 patients across different ethnicities.
Main Methods:
- A cohort of 445 patients (229 Caucasian, 216 BAME) with confirmed COVID-19 infection was analyzed.
- Routine laboratory indices collected on admission were compared between survivors and non-survivors.
- Statistical models were used to identify predictors of mortality, including ethnicity interactions.
Main Results:
- Mortality rates within 28 days were similar between Caucasian (42.4%) and BAME (43.1%) groups.
- Ethnicity interacted significantly with mortality for fibrinogen, ferritin, and HbA1c.
- High neutrophil/lymphocyte ratio (>7.4) and urea/albumin ratio (>0.28) independently increased mortality odds in both groups.
- In BAME patients, age >60 and diabetes also increased mortality odds.
Conclusions:
- Neutrophil/lymphocyte ratio and urea/albumin ratio are valuable, simple metrics for predicting COVID-19 mortality.
- These ratios can guide clinicians in providing timely intensive interventions to reduce mortality.
- Enhanced monitoring for BAME patients, particularly younger individuals and those with diabetes, may further decrease COVID-19 associated mortality.
Introduction:
Although factors such as age, sex, diabetes, obesity and changes in certain laboratory investigations are important prognostic factors in COVID-19 infection, these may not apply to all ethnic/racial groups. We hypothesized differences in routine biochemistry and haematology indices in Caucasian and a combined group of Black, Asian and Minority Ethnic (BAME) patients who tested positive for COVID-19 who died, compared to survivors.
Methods:
We tested our hypothesis in 445 patients (229 Caucasian, 216 BAME) admitted to secondary care with proven COVID-19 infection, in whom standard routine laboratory indices were collected on admission.
Results:
After 28 weeks, 190 (42.7%) had died within 28 days of COVID diagnosis (97 Caucasians [42.4%], 93 BAMEs [43.1%], P = .923). A general linear model analysis found the ethnicity interaction with mortality to be significant for fibrinogen, ferritin and HbA1 c (after controlling for age). In a multivariate analysis, a neutrophil/lymphocyte ratio > 7.4 and a urea/albumin ratio > 0.28 increased the odds of death for both the Caucasian and the BAME group. Additional factors increasing the odds ratio in the BAME group included age >60 years and being diabetic.
Conclusion:
Neutrophil/lymphocyte ratio and urea/albumin ratio are simple metrics that predict death to aid clinicians in determining the prognosis of COVID-19 and help provide early intensive intervention to reduce mortality. In the BAME groups, intensive monitoring even at younger age and those with diabetes may also help reduce COVID-19 associated mortality.
