Can the Systemic Inflammatory Index, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Detect Pediatric Covid-19 Variants?

Abstract

Background: Covid-19 has undergone many mutations over time. The most prominent variants have been the Alpha, Beta, Delta, Gamma, and finally, the Omicron variants. This study aims to determine the availability of neutrophil/lymphocyte rate (NLR), platelet/lymphocyte rate (PLR) and Systemic Inflammatory Index (SII), prog-nostic and diagnostic significance, in the differentiation of variants in pediatric Covid-19 patients. Materials and Methods: In this retrospective study, 141 pediatric patients who were found to be positive for Covid-19 in Harran University Medical Faculty Hospital between January 2021 and April 2022 were included. A control group was formed from 107 healthy children selected from among those who applied to the general pediatric outpatient clinic for routine health evaluations. Results: When the age distribution of the patients was examined, the median was 7.0 (0.1-18) years. When the variants were compared, there was a significant difference between lymphocyte values, while leukocyte, neu-trophil, C-reactive protein (CRP) and Mean Platelet Volume (MPV) did not change significantly. At the same time, there was a statistically significant difference between NLR, PLR and SII variants in Covid-19 positive patients (p<0.05); It was found that CRP, CRP/albumin rate (CAR), and MPV values did not change significantly between variants (p>0.05). It was observed that the NLR, PLR and SII delta variants increased significantly compared to the omicron variant (p<0.05). CRP and CAR were significantly increased in the severe clinical course compared to the asymptomatic group (p<0.05). Conclusions: In our study, it was seen that patients with delta variant had higher NLR, PLR and SII values compared to omicron variant when viewed from the point of view of Covid-19 variants. Therefore, we think that during the diagnosis of Covid-19 accompanied by these parameters, variant analysis can be performed, especially in terms of the delta variant, and it will shed light on the differential diagnosis, appropriate treatment, and measures to be taken by early and simple means.

Keywords

• Covid-19
• delta variant
• Neutrophil/Lymphocyte Ratio
• Platelet/Lymphocyte Ratio
• Systemic Inflammatory Index

Sistemik İnflamatuar İndeks, Nötrofil-Lenfosit Oranı ve Trombosit-Lenfosit Oranı Pediatrik Covid-19 Varyantlarını Saptayabilir mi?

Abstract

Amaç: Covid-19 zaman içinde pek çok mutasyona uğradı. En öne çıkan varyantlar Alfa, Beta, Delta, Gamma ve son olarak Omicron varyantları olmuştur. Bu çalışma, pediatrik Covid-19 hastalarında varyantların ayrımında NLR, PLR ve SII'nin varlığını, prognostik ve tanısal önemini belirlemeyi amaçlamaktadır. Materyal ve metod: Bu retrospektif çalışmaya Ocak 2021-Nisan 2022 tarihleri arasında Harran Üniversitesi Tıp Fakültesi Hastanesi'nde Covid-19 pozitif olduğu tespit edilen 141 çocuk hasta dahil edildi. Genel pediatri polikliniğine rutin sağlık kontrolleri için başvuranlar arasından seçilen 107 sağlıklı çocuktan kontrol grubu oluşturuldu. Bulgular: Hastaların yaş dağılımı incelendiğinde ortancanın 7,0 (0,1-18) yıl olduğu görüldü. Varyantlar karşılaştırıldığında lenfosit değerlerinde anlamlı fark bulunurken lökosit, nötrofil, CRP ve MPV'de anlamlı değişiklik olmadı. Aynı zamanda Covid-19 pozitif hastalarda NLR, PLR ve SII varyantları arasında istatistiksel olarak anlamlı fark mevcuttu (p<0,05); CRP, CAR ve MPV değerlerinin varyantlar arasında anlamlı farklılık göstermediği belirlendi (p>0,05). NLR, PLR ve SII delta varyantlarının omikron varyantına göre anlamlı düzeyde arttığı görüldü (p<0,05). Ağır klinik seyirde asemptomatik gruba göre CRP ve CAR anlamlı düzeyde arttı (p<0,05). Sonuç: Çalışmamızda Covid-19 varyantları açısından bakıldığında delta varyantlı hastaların NLR, PLR ve SII değerlerinin omicron varyantına göre daha yüksek olduğu görüldü. Dolayısıyla bu parametreler eşliğinde Covid-19 tanısı sırasında özellikle delta varyantı açısından varyant analizi yapılabileceğini, erken ve basit yollarla ayırıcı tanı, uygun tedavi ve alınacak önlemler açısından ışık tutacağını düşünmekteyiz.

Keywords

• Covid-19
• Nötrofil/Lenfosit Oranı
• Trombosit/Lenfosit Oranı
• delta varyantı
• Sistemik İnflamatuar İndeks

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