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The Evaluation of Hematological Parameters and Their Correlation with Disease Prognosis in COVID-19 Disease in Iran
Farhad Shahi1, Sayyed Reza Safaee Nodehi2, Saba Fekrvand3
1Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Hematological markers like neutrophil-to-lymphocyte ratio and D-dimer can predict COVID-19 severity. Elevated levels indicate higher risk of mortality and oxygen dependency, while higher hemoglobin and lymphocyte counts suggest better survival outcomes.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is a highly contagious viral illness declared a pandemic in March 2020.
- Laboratory findings in COVID-19 patients vary, with elevated D-dimer, lactate dehydrogenase (LDH), and lymphopenia linked to severe disease, ICU admission, and mortality.
- Identifying prognostic markers is crucial for managing patient care during the pandemic.
Purpose of the Study:
- To evaluate the correlation between various hematological parameters and patient outcomes in COVID-19.
- To determine if specific hematological markers can predict disease severity, need for ventilation, ICU admission, and mortality in COVID-19 patients.
Main Methods:
- A cohort of 208 adult patients hospitalized with confirmed COVID-19 was studied.
- Measurements included white blood cell count, neutrophils, lymphocytes, hemoglobin, platelets, D-dimer, C-reactive protein, LDH, and ferritin.
- Statistical analysis assessed the relationship between these parameters and patient outcomes such as oxygen dependency, mortality, and survival.
Main Results:
- Higher neutrophil-to-lymphocyte ratio (NLR), (WBC count excluding lymphocyte)/lymphocyte ratio, LDH, platelet-to-lymphocyte ratio (PLR), ferritin, and D-dimer levels were significantly associated with oxygen dependency.
- NLR, (WBC count excluding lymphocyte)/lymphocyte ratio, and LDH were significantly related to increased mortality rates.
- Higher hemoglobin (Hb) and lymphocyte counts were significantly associated with improved survival rates.
Conclusions:
- Hematological parameters, including NLR, (WBC count excluding lymphocyte)/lymphocyte ratio, LDH, PLR, ferritin, D-dimer, Hb, and lymphocyte count, are significant predictors of COVID-19 prognosis.
- These markers can aid in prioritizing COVID-19 patients for hospitalization and intensive care, especially during healthcare service limitations.
Abstract:
Background: Since 2019, Coronavirus has been a highly contagious disease. The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020. Variable laboratory findings are reported in COVID-19 patients, among which elevated levels of D-dimer, lactate dehydrogenase, as well as lymphopenia, have been reported to be associated with increased severity of disease symptoms requiring ventilator support, intensive care unit admission, and mortality. Materials and Methods: In the current study, inclusion criteria were: patient age above 18 years and hospitalization in the Imam Khomeini hospital with COVID-19 disease confirmed with nasopharyngeal swab polymerase chain reaction tests. Levels of white blood cells, neutrophils, lymphocytes, hemoglobin, platelets, D-dimer, C-reactive protein, LDH, and ferritin were measured and their correlation with the final patients' outcome was evaluated. Results: A total of 208 patients were included in the present study. Higher neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, and D-dimer were significantly related to O2 dependency. Neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte and LDH were significantly related to higher rates of mortality. Higher Hb and lymphocyte count were significantly related to higher rates of survival. Conclusion: Hematological parameters including neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, D-dimer, Hb, and lymphocyte count were significantly related to the prognosis of patients with COVID-19 disease. This could help decide which COVID-19 patients have priority for hospitalization and intensive medical care, particularly when the pandemic disease causes limitations in healthcare service.
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