HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19

Year 2021, Volume: 22 Issue: 6, 473 - 478, 18.10.2021

Yeter Düzenli Kar , Konca Altınkaynak Emine Hafize Erdeniz

https://doi.org/10.18229/kocatepetip.821471

Cited By: 1

Abstract

OBJECTIVE: The coronavirus-2 (SARS-CoV-2) outbreak, reported in Wuhan, China at the end of 2019, has a clinical picture with acute respiratory failure, currently affecting more than 100 countries. In our study, evaluation of hematological findings of children with COVID-19 positive mild-moderate clinic was performed and the diagnostic role of various hematological indices-leukocyte, neutrophil, monocyte, lymphocyte and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR)- was examined.
MATERIAL AND METHODS: The study included 15 children diagnosed with COVID-19 from nasopharyngeal swab samples by RT-PCR, and a control group of 21 healthy children of similar age and sex. The patients' age, gender, admission complaints, COVID-19 contact history, and first complete blood count parameters were recorded retrospectively from information of the patient files.
RESULTS: The ages of the children diagnosed with COVID-19 (median±SD) were 8.7±5.7 years and the female/male ratio was 8/7, the healthy control group's age (median±SD) was 7.4±2.8 years, and the female/male ratio was 11/10. The most common complaints of patients with positive COVID-19 tests were fever and cough. A statistically significant difference was found between neutrophil, lymphocyte, and NLR between the COVID-19 positive children and the healthy control group (p=0.048, p=0.040, p=0.024, respectively). In the ROC analysis, when the predictive value for NLR is taken as 1.02, it predicts area under the curve (AUC) of 0.724, 95%CI (0.549-0.899), sensitivity 73%, specificity 62% for the diagnosis of COVID-19 in children.
CONCLUSIONS: Abnormalities were detected in hematological parameters and indexes of children diagnosed with COVID-19 compared to healthy controls. The most prominent of these are lymphopenia and an increase in the NLR rate. We think that the evaluation of peripheral blood parameters can be considered as an important reference value in evaluating the prognosis of COVID-19.

Keywords

Children, Coronavirus disease, Monocyte/lymphocyte ratio, Neutrophil/lymphocyte ratio, Platelet/lymphocyte ratio

COVİD 19 TANILI ÇOCUKLARIN HEMATOLOJİK BULGULARI VE COVİD 19 TANISINDA HEMATOLOJİK İNDEKSLERİN TANISAL ROLÜ

Abstract

AMAÇ: Çin’in Wuhan kentinde 2019 yılı sonunda bildirilen koronavirüs 2 (SARS-CoV-2) salgını, şu anda 100’den fazla ülkenin etkilendiği, akut solunum yetmezliği ile giden bir tablodur. Çalışmamızda; COVID-19 pozitif hafif-orta şiddette kliniğe sahip çocukların hematolojik bulgularının değerlendirilmesi ve bu hastalığı öngörmede çeşitli hematolojik indekslerin - lökosit, nötrofil, monosit, lenfosit ve trombosit sayıları, nötrofil/lenfosit oranı (NLR) and platelet/lenfosit oranı (PLR), monosit/lenfosit oranı (MLR)- diagnostik rolü araştılmıştır.
GEREÇ VE YÖNTEM: Çalışmaya nazofarengeal sürüntü örneklerinden RT-PCR ile COVID-19 tanısı konulan 15 çocuk ile benzer yaş ve cinsiyette 21 sağlıklı çocuktan oluşan kontrol grubu alındı. Hastaların dosya bilgilerinden retrospektif olarak yaşları, cinsiyetleri, başvuru şikayetleri, COVID-19 temas öyküsü, başvurularında alınan ilk tam kan sayımı parametreleri kayıt edildi.
BULGULAR: COVID-19 tanısı konulan çocukların yaşları (median±SD) 8.7±5.7 yıl ve kız/erkek oranı 8/7, sağlıklı kontrol grubunun yaşları (median±SD) 7.4±2.8 yıl ve kız/erkek oranı 11/10 idi. COVID-19 testi pozitif saptanan hastaların en sık başvuru şikayeti ateş ve öksürüktü. COVID-19 pozitif çocuklarla sağlıklı kontrol grup arasında nötrofil, lenfosit ve NLR arasında istatistiksel anlamlı fark tespit edildi (p=0.048, p=0.040, p =0.024, sırasıyla). ROC analizinde, NLR için kestirim değeri 1.02 alındığında eğri altındaki alan (AUC) of 0.724, %95 CI (0,549-0,899), sensivite %73, spesifite %62 olarak çocuklarda COVID-19 tanısını predikte etmektedir.
SONUÇ: COVID-19 tanılı çocukların hematolojik parametre ve indekslerinde sağlıklı kontrollere göre anormallikler tespit edilmiştir. Bunlardan en belirgin olanları lenfopeni ve NLR oranında artıştır. Periferik kan parametrelerinin değerlendirilmesinin COVID-19'un prognozunu değerlendirmesinde önemli referans değer olarak değerlendirilebileceğini düşünmekteyiz

Keywords

Çocuk, Koronavirus hastalığı, Monosit/lenfosit oranı, Nötrofil/lenfosit oranı, Platelet/lenfosit oranı

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