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A Comparative Study of Absolute Lymphocyte Count (Alc), Neutrophil Lymphocyte Ratio (Nlr) and Red Cell Distribution
Mahesh Dave1, Abhishek Nyati1, Ravi Kumar1
1RNT Medical College, Jhajjar, Udaipur.
Insights
Decreased Absolute Lymphocyte Count (ALC) and elevated Neutrophil-Lymphocyte Ratio (NLR) indicate a higher risk of mortality in COVID-19 patients. Red Cell Distribution Width (RDW) levels did not show a significant relationship with disease outcomes.
Area of Science:
- Medical Research
- Infectious Diseases
- Hematology
Background:
- The COVID-19 pandemic, caused by a novel coronavirus, necessitated the identification of biomarkers for predicting severe disease and mortality.
- Early identification of high-risk patients is crucial for timely and effective intervention.
Purpose of the Study:
- To identify indicators for stratifying COVID-19 patients based on their risk of developing severe disease and mortality.
- To analyze hematological parameters as potential predictors of COVID-19 outcomes.
Main Methods:
- A retrospective analysis of 4304 COVID-19 patients admitted between April 2020 and March 2021.
- Random selection of 400 patients each from death and survival groups for comparative analysis.
- Evaluation of Absolute Lymphocyte Count (ALC), Neutrophil-Lymphocyte Ratio (NLR), and Red Cell Distribution Width (RDW).
Main Results:
- The median age in the death group (62.03 years) was higher than in the survival group (47.18 years).
- Mean ALC was lower in the death group (0.88) compared to the survival group (0.93).
- Mean NLR was significantly higher in the death group (8.37) versus the survival group (4.34).
- Mean RDW-CV was higher in the death group (1.86) but showed no significant difference compared to the survival group (1.67).
Conclusions:
- Decreased ALC and elevated NLR are reliable indicators of mortality in COVID-19 patients.
- RDW was elevated in COVID-19 patients but did not correlate significantly with disease outcome.
Abstract:
At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread throughout the world. Identifying patients at highest risk for severe disease is important to facilitate early, aggressive intervention and to mitigate the crises occurring throughout the world. Biomarkers were needed for patient stratification into those likely to develop severe disease and with high risk of mortality. Present study aims to find out those indicators.
Material:
Total patients admitted over a period of 1 year from 1st April 2020 to 31th March 2021 in Dedicated COVID Hospital of RNT Medical College and MB hospital Udaipur was 4304 out of which 620 died and 3498 got discharged, 186 couldn't be followed up as they took leave against medical advise. From death group (620 patients) and Survival group (3498 patients), 400 patients were selected randomly from each group and were analysed and comparison was made between both the groups including parameters like ALC(Absolute lymphocyte count), NLR(Neutrophil Lymphocyte)ratio and RDW(Red cell distribution width).
Observation:
Median age in death and survival group was 62.03 and 47.18 respectively. Mean Absolute lymphocyte count was 0.88 and 0.93 in death and survival group respectively. Mean Neutrophil -Lymphocyte ratio in death and survival group was 8.37 and 4.34 respectively. Mean RDW- CV was 1.86 and 1.67 in death and survival group respectively.
Conclusion:
From the present study we conclude that Decreased ALC and Elevated NLR are a reliable indicator of death as an outcome in COVID 19 disease whereas RDW was high in COVID19 patients but had no significant relationship with outcome of the disease.
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