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New markers in the differentiation of Covid 19 disease and pneumonia: Neutrophil and platelet lymphocyte ratio

Year 2021, Volume: 11 Issue: 4, 478 - 482, 31.07.2021

Abstract

Background: COVID-19; It is a pandemic disease that starts like a simple upper respiratory infection and causes pneumonia and severe respiratory failure. Due to cytokine storm and hyperinflamation, some hematological and biochemical findings appear in the disease. Complete blood count (CBC) is a very simple and inexpensive test that can be used in many infectious diseases.
Methods: Eighty patients diagnosed with COVID-19 by RT-PCR were divided into two groups according to the presence of pneumonia in the Thorax CT (CT + 40 patients and CT- 40 patients). 40 healthy patients who had no previous disease were selected as the control group. The demographic and laboratory characteristics of COVID-19 patients with and without pneumonia in all three groups and control group patients were compared retrospectively.
Results: While there was a significant difference between the COVID-19 group and the control group in terms of Neutrophil lymphocyte ratio (NLR) and Mean platelet volume (MPV), no differences were observed in COVID patients with and without pneumonia in terms of NLR and MPV. There was no significant difference between the COVID-19 group and the control group and the COVID pneumonia group in terms of Platelet lymphocyte ratio (PLR).
Conclusion: NLR and MPV can be used as diagnostics for the diagnosis of COVID-19 disease, while PLR cannot be used. However, NLR and MPV values are not significant in evaluating COVID pneumonia and disease severity.

References

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  • [5] C. Sohrabi, Z. Alsafi, N. O’Neill, M. Khan, A. Kerwan, A. Al-Jabir, C. Iosifidis, R. Agha, World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)., Int. J. Surg. 76 (2020) 71–76. https://doi.org/10.1016/j.ijsu.2020.02.034.
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  • [7] B.M. Henry, M.H.S. De Oliveira, S. Benoit, M. Plebani, G. Lippi, Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis, Clin. Chem. Lab. Med. 58 (2020) 1021–1028. https://doi.org/10.1515/cclm-2020-0369.
  • [8] C. Huang, Y. Wang, X. Li, L. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet. 395 (2020) 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.
  • [9] S. Rachidi, K. Wallace, J.M. Wrangle, T.A. Day, A.J. Alberg, Z. Li, Neutrophil-to- lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma, Head Neck. 38 (2016) E1068–E1074. https://doi.org/10.1002/hed.24159.
  • [10] Q. Wang, J. Ma, Z. Jiang, L. Ming, Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis., Int. Angiol. 37 (2018) 4–11. https://doi.org/10.23736/S0392- 9590.17.03848-2.
  • [11] S.E. Park, Epidemiology, virology, and clinical features of severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2; Coronavirus Disease-19), Korean J. Pediatr. 63 (2020) 119–124. https://doi.org/10.3345/cep.2020.00493.
  • [12] L.L. Plesner, E. Dyrberg, I.V. Hansen, A. Abild, M.B. Andersen, [Diagnostic imaging findings in COVID-19]., Ugeskr. Laeger. 182 (2020). [13] M. Yang, M.H.L. Ng, K.L. Chi, Thrombocytopenia in patients with severe acute respiratory syndrome (review), Hematology. 10 (2005) 101–105. https://doi.org/10.1080/10245330400026170.
  • [14] P. Xu, Q. Zhou, J. Xu, Mechanism of thrombocytopenia in COVID-19 patients, Ann. Hematol. 99 (2020) 1205–1208. https://doi.org/10.1007/s00277-020-04019-0.
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  • [16] G. Lippi, M. Plebani, Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis, Clin. Chim. Acta. 505 (2020) 190–191. https://doi.org/10.1016/j.cca.2020.03.004.
  • [17] P. Paliogiannis, A.G. Fois, S. Sotgia et al. Neutrophil to lymphocyte ratio and clinical outcomes in copd: Recent evidence and future perspectives, Eur. Respir. Rev. 27 (2018). https://doi.org/10.1183/16000617.0113-2017.
  • [18] S.S. Faria, P.C. Fernandes, M.J.B. Silva, V.C. Lima, W. Fontes, R. Freitas-Junior, A.K. Eterovic, P. Forget, The neutrophil-to-lymphocyte ratio: a narrative review., Ecancermedicalscience. 10 (2016) 702. https://doi.org/10.3332/ecancer.2016.702.
  • [19] A. Bucak, S. Ulu, S. Oruc, F. Yucedag, M.S. Tekin, F. Karakaya, A. Aycicek, Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy., Laryngoscope. 124 (2014) 1678–81. https://doi.org/10.1002/lary.24551.
  • [20] B. Zhang, W. Du, K. Gan, Q. Fang, X. Zhang, Significance of the neutrophil-to- lymphocyte ratio in young patients with oral squamous cell carcinoma, Cancer Manag. Res. 11 (2019) 7597–7603. https://doi.org/10.2147/CMAR.S211847.
  • [21] J. Liu, S. Li, J. Liu, B. et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients, EBioMedicine. 55 (2020). https://doi.org/10.1016/j.ebiom.2020.102763.
  • [22] D. Postma, J. Schuurman, C. van Werkhoven, J.J. Oosterheert, L. van Elden, M. Bonten, The neutrophil/lymphocyte ratio in predicting outcome for hospitalized patients with community-acquired pneumonia, Eur. Respir. J. 44 (2014).
  • [23] The neutrophil/lymphocyte ratio in predicting outcome for hospitalized patients with community-acquired pneumonia | European Respiratory Society, (n.d.). https://erj.ersjournals.com/content/44/Suppl_58/P2489 (accessed June 28, 2020).

Covid 19 hastalığı ile pnömoninin farklılaşmasında yeni belirteçler: Nötrofil ve trombosit lenfosit oranı

Year 2021, Volume: 11 Issue: 4, 478 - 482, 31.07.2021

Abstract

Arka plan: COVID-19; Basit bir üst solunum yolu enfeksiyonu gibi başlayıp zatürreye ve ciddi solunum yetmezliğine neden olan pandemik bir hastalıktır. Hastalıkta sitokin fırtınası ve hiperinflamasyon nedeniyle bazı hematolojik ve biyokimyasal bulgular ortaya çıkar. Tam kan sayımı (CBC), birçok bulaşıcı hastalıkta kullanılabilen çok basit ve ucuz bir testtir.
Yöntemler: RT-PCR ile COVID-19 tanısı alan 80 hasta Toraks BT'de pnömoni varlığına göre iki gruba ayrıldı (CT + 40 hasta ve CT- 40 hasta). Kontrol grubu olarak daha önce hastalığı olmayan 40 sağlıklı hasta seçildi. Her üç gruptaki pnömonili ve pnömonisiz COVID-19 hastaları ile kontrol grubu hastalarının demografik ve laboratuvar özellikleri retrospektif olarak karşılaştırıldı.
Bulgular: COVID-19 grubu ile kontrol grubu arasında Nötrofil lenfosit oranı (NLO) ve Ortalama trombosit hacmi (MPV) açısından anlamlı fark varken, pnömonili ve pnömonisiz COVID hastalarında NLO açısından farklılık gözlenmedi ve MPV. Platelet lenfosit oranı (PLR) açısından COVID-19 grubu ile kontrol grubu ve COVID pnömoni grubu arasında anlamlı fark yoktu.
Sonuç: NLR ve MPV, COVID-19 hastalığının teşhisi için tanı olarak kullanılabilirken, PLR kullanılamaz. Bununla birlikte, NLR ve MPV değerleri COVID pnömonisi ve hastalık şiddetinin değerlendirilmesinde anlamlı değildir.

References

  • [1] Coronavirus disease 2019, (n.d.). https://www.who.int/emergencies/diseases/novel- coronavirus-2019?gclid=CjwKCAjw_-D3BRBIEiwAjVMy7KCPF_NAu5wuPuhxP0- cKOi119RpbxkXB9eYHKnQ0pY8WUtkdiRohhoCfosQAvD_BwE (accessed June 28, 2020).
  • [2] S.E. Park, Epidemiology, virology, and clinical features of severe acute respiratory syndrome -coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19)., Clin. Exp. Pediatr. 63 (2020) 119–124. https://doi.org/10.3345/cep.2020.00493.
  • [3] Coronavirus Update (Live): 10,123,769 Cases and 502,025 Deaths from COVID-19 Virus Pandemic - Worldometer, (n.d.). https://www.worldometers.info/coronavirus/ (accessed June 28, 2020).
  • [4] W.-C. Dai, H.-W. Zhang, J. Yu, H.-J. Xu, H. Chen, S.-P. Luo, H. Zhang, L.-H. Liang, X.-L. Wu, Y. Lei, F. Lin, CT Imaging and Differential Diagnosis of COVID-19., Can. Assoc. Radiol. J. = J. l’Association Can. Des Radiol. 71 (2020) 195–200. https://doi.org/10.1177/0846537120913033.
  • [5] C. Sohrabi, Z. Alsafi, N. O’Neill, M. Khan, A. Kerwan, A. Al-Jabir, C. Iosifidis, R. Agha, World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)., Int. J. Surg. 76 (2020) 71–76. https://doi.org/10.1016/j.ijsu.2020.02.034.
  • [6] B.E. Fan, V.C.L. Chong, S.S.W. Chan, G.H. Lim, K.G.E. Lim, G.B. Tan, S.S. Mucheli, P. Kuperan, K.H. Ong, Hematologic parameters in patients with COVID‐19 infection, Am. J. Hematol. 95 (2020) E131–E134. https://doi.org/10.1002/ajh.25774.
  • [7] B.M. Henry, M.H.S. De Oliveira, S. Benoit, M. Plebani, G. Lippi, Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis, Clin. Chem. Lab. Med. 58 (2020) 1021–1028. https://doi.org/10.1515/cclm-2020-0369.
  • [8] C. Huang, Y. Wang, X. Li, L. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet. 395 (2020) 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.
  • [9] S. Rachidi, K. Wallace, J.M. Wrangle, T.A. Day, A.J. Alberg, Z. Li, Neutrophil-to- lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma, Head Neck. 38 (2016) E1068–E1074. https://doi.org/10.1002/hed.24159.
  • [10] Q. Wang, J. Ma, Z. Jiang, L. Ming, Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis., Int. Angiol. 37 (2018) 4–11. https://doi.org/10.23736/S0392- 9590.17.03848-2.
  • [11] S.E. Park, Epidemiology, virology, and clinical features of severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2; Coronavirus Disease-19), Korean J. Pediatr. 63 (2020) 119–124. https://doi.org/10.3345/cep.2020.00493.
  • [12] L.L. Plesner, E. Dyrberg, I.V. Hansen, A. Abild, M.B. Andersen, [Diagnostic imaging findings in COVID-19]., Ugeskr. Laeger. 182 (2020). [13] M. Yang, M.H.L. Ng, K.L. Chi, Thrombocytopenia in patients with severe acute respiratory syndrome (review), Hematology. 10 (2005) 101–105. https://doi.org/10.1080/10245330400026170.
  • [14] P. Xu, Q. Zhou, J. Xu, Mechanism of thrombocytopenia in COVID-19 patients, Ann. Hematol. 99 (2020) 1205–1208. https://doi.org/10.1007/s00277-020-04019-0.
  • [15] J.L. Frater, G. Zini, G. d’Onofrio, H.J. Rogers, COVID-19 and the clinical hematology laboratory, Int. J. Lab. Hematol. 42 (2020) 11–18. https://doi.org/10.1111/ijlh.13229.
  • [16] G. Lippi, M. Plebani, Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis, Clin. Chim. Acta. 505 (2020) 190–191. https://doi.org/10.1016/j.cca.2020.03.004.
  • [17] P. Paliogiannis, A.G. Fois, S. Sotgia et al. Neutrophil to lymphocyte ratio and clinical outcomes in copd: Recent evidence and future perspectives, Eur. Respir. Rev. 27 (2018). https://doi.org/10.1183/16000617.0113-2017.
  • [18] S.S. Faria, P.C. Fernandes, M.J.B. Silva, V.C. Lima, W. Fontes, R. Freitas-Junior, A.K. Eterovic, P. Forget, The neutrophil-to-lymphocyte ratio: a narrative review., Ecancermedicalscience. 10 (2016) 702. https://doi.org/10.3332/ecancer.2016.702.
  • [19] A. Bucak, S. Ulu, S. Oruc, F. Yucedag, M.S. Tekin, F. Karakaya, A. Aycicek, Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy., Laryngoscope. 124 (2014) 1678–81. https://doi.org/10.1002/lary.24551.
  • [20] B. Zhang, W. Du, K. Gan, Q. Fang, X. Zhang, Significance of the neutrophil-to- lymphocyte ratio in young patients with oral squamous cell carcinoma, Cancer Manag. Res. 11 (2019) 7597–7603. https://doi.org/10.2147/CMAR.S211847.
  • [21] J. Liu, S. Li, J. Liu, B. et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients, EBioMedicine. 55 (2020). https://doi.org/10.1016/j.ebiom.2020.102763.
  • [22] D. Postma, J. Schuurman, C. van Werkhoven, J.J. Oosterheert, L. van Elden, M. Bonten, The neutrophil/lymphocyte ratio in predicting outcome for hospitalized patients with community-acquired pneumonia, Eur. Respir. J. 44 (2014).
  • [23] The neutrophil/lymphocyte ratio in predicting outcome for hospitalized patients with community-acquired pneumonia | European Respiratory Society, (n.d.). https://erj.ersjournals.com/content/44/Suppl_58/P2489 (accessed June 28, 2020).
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Aydın Balcı 0000-0002-6723-2418

Erkan Yıldız 0000-0002-0265-7327

Okan Selendili This is me 0000-0002-4902-974X

Publication Date July 31, 2021
Acceptance Date April 6, 2021
Published in Issue Year 2021 Volume: 11 Issue: 4

Cite

AMA Balcı A, Yıldız E, Selendili O. New markers in the differentiation of Covid 19 disease and pneumonia: Neutrophil and platelet lymphocyte ratio. J Contemp Med. July 2021;11(4):478-482. doi:10.16899/jcm.892114