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Updated: May 8, 2025
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
[Hematologic indices as an available tool in the diagnosis of adverse course of COVID-19]
V I Podzolkov1, E V Volchkova1, A E Pokrovskaya1
1Sechenov First Moscow State Medical University (Sechenov University).
Insights
Hematologic ratios like neutrophils/lymphocytes (N/L) and platelets/lymphocytes (P/L) correlate with COVID-19 severity and endothelial dysfunction. These indices, along with lymphocytes/C-reactive protein (L/CRP), can predict cytokine storm development in patients.
Area of Science:
- Hematology
- Infectious Diseases
- Immunology
Context:
- COVID-19 presents with a wide spectrum of clinical severity.
- Hematologic parameters are increasingly recognized as potential biomarkers in infectious diseases.
- Endothelial dysfunction is a key feature of severe COVID-19.
Purpose:
- To investigate the prognostic value of neutrophils/lymphocytes (N/L), platelets/lymphocytes (P/L), and lymphocytes/C-reactive protein (L/CRP) ratios in COVID-19.
- To assess the correlation of these hematologic indices with COVID-19 severity and sVCAM-1, a marker of endothelial dysfunction.
- To determine the predictive capability of these ratios for cytokine storm development.
Summary:
- 103 COVID-19 patients were stratified into three groups based on CT scan findings.
- Elevated N/L and P/L ratios were observed in patients with more severe lung involvement (CT group 3).
- L/CRP ratios decreased with increasing lung lesion severity, while sVCAM-1 levels were higher in groups with greater lung damage.
Impact:
- Hematologic indices (N/L, P/L, L/CRP) are significantly correlated with COVID-19 severity markers.
- P/L and L/CRP indices show an association with sVCAM-1, indicating their role in endothelial dysfunction.
- N/L > 2.53 and L/CRP ≤ 0.043 are identified as predictors for cytokine storm in COVID-19 patients.
Aim:
To study the prognostic significance of hematologic indices: neutrophils/lymphocytes (N/L), platelets/lymphocytes (P/L) and lymphocytes/C-reactive protein (L/CRP) in relation to the complicated course of new coronavirus infection (COVID-19), as well as their correlation with COVID-19 course severity indices and endothelial dysfunction marker sVCAM-1.
Materials And Methods:
103 patients with new coronavirus infection (COVID-19) were included in the study. Based on the data of multispiral computed tomography (CT) of the chest organs, all patients were divided into 3 groups: CT group 1 - 30 patients, CT group 2 - 62 patients and CT group 3 - 11 patients.
Results:
The values of N/L and P/L were significantly higher in patients of CT group 3 compared to patients of CT group 1 and CT group 2. L/CRP index, on the contrary, significantly decreased with increasing CT-degree of lung lesion. The concentration of endothelial dysfunction marker sVCAM-1 was significantly higher in patients of CT-3 and 2 groups compared to patients of CT-1 group - 272.7 [267.4; 342.6] ng/mL and 212.5 [90.3; 335.6] ng/mL vs 120.0 [75.3; 189.2] ng/mL. Significant correlations of the studied hematologic indices with clinical, laboratory and instrumental characteristics of COVID-19 severity were found. P/L and L/CRP indices were associated with sVCAM-1 concentration in blood (r=0.28 and -0.33 respectively; p<0.05). The values of N/L>2.53 and L/CRP≤0.043 are predictors of the development of cytokine storm in the examined patients.
Conclusion:
Hematologic indices N/L, P/L and L/CRP are correlated with clinical, laboratory and instrumental characteristics of COVID-19 severity, presence of endothelial dysfunction (P/L and L/CRP) and allow predicting the development of cytokine storm (N/L and L/CRP).
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