Evaluation of hematological indices in terms of COVID-19 related mortality and ICU admission

Yıl 2021, Cilt: 4 Sayı: 5, 666 - 669, 05.09.2021

Özgür Yıldırım , Mehmet Bayram Raye Sevra Özmen Beyza Soylu Ahmet Said Dündar Ali Rıza Köksal Iskender Ekinci , Murat Akarsu , Ömür Tabak

https://doi.org/10.32322/jhsm.949299

Cited By: 7

Öz

Introduction: The COVID-19 pandemic has shown that patients should be categorized according to their risk group, patient follow-up and the use of health resources should be arranged according to this categorization. Therefore, practical and inexpensive biomarkers are needed. In this study, the relationship between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) and red blood cell distribution width (RDW) levels, which can be easily calculated by complete blood count, with mortality and intensive care unit (ICU) admission in COVID-19 disease was evaluated.
Materials and Methods: 748 inpatients with positive COVID-19 PCR test were evaluated retrospectively. The NLR, PLR, MPV and RDW levels calculated from the complete blood count parameters of the patients at hospital admissions and their relationship with the mortality and the ICU admission in COVID-19 disease were evaluated.
Results: In terms of mortality, a statistically significant difference was found between RDW levels in the evaluation performed in the patient groups who survived and died (p: 0.014). No statistically significant difference was found in NLR, PLR and MPV levels. In the evaluation made between ICU (+) and ICU (-) groups, a statistically significant difference was found in RDW and NLR levels (p: 0.042, p: 0.01, respectively). There was no statistically significant difference between PLR and MPV levels for ICU admission.
Conclusion: RDW level was found to be associated with COVID-19 related mortality and ICU admission.

Anahtar Kelimeler

COVID-19, mortality, ICU admission

Kaynakça

• Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.
• Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382: 727-33.
• Xiang N, Havers F, Chen T, et al. Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013. Emerg Infect Dis 2013; 19: 1784-90.
• Wang R, He M, Yin W, et al. The Prognostic nutritional index is associated with mortality of COVID-19 patients in Wuhan, China. J Clin Lab Anal 2020; 34: e23566.
• Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 2020; 5: 33.
• Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta 2020; 506: 145-8.
• Güçlü E, Kocayiğit H, Okan HD, et al. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992) 2020; 66: 1122-7.
• Lippi G, Mattiuzzi C, Cervellin G. Learning more and spending less with neglected laboratory parameters: the paradigmatic case of red blood cell distribution width. Acta Biomed 2016; 87: 323-8.
• Zhang L, Yu CH, Guo KP, Huang CZ, Mo LY. Prognostic role of red blood cell distribution width in patients with sepsis: a systematic review and meta-analysis. BMC Immunol 2020; 21: 40.
• Yang X, Yang Q, Wang Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost 2020; 18: 1469-72.
• 12.Li Q, Cao Y, Chen L, et al. Hematological features of persons with COVID-19. Leukemia 2020; 34: 2163-72.
• Jiang SQ, Huang QF, Xie WM, Lv C, Quan XQ. The association between severe COVID-19 and low platelet count: evidence from 31 observational studies involving 7613 participants. Br J Haematol 2020; 190: e29-e33.
• Wool GD, Miller JL. The Impact of COVID-19 Disease on Platelets and Coagulation. Pathobiology 2021; 88: 15-27.
• Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 2003; 6: 283-7.
• Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol 2020; 84: 106504.
• Mo P, Xing Y, Xiao Y, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis 2020; ciaa270.
• Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci 2020; 57: 389-99.
• Mazzoni A, Salvati L, Maggi L, et al. Impaired immune cell cytotoxicity in severe COVID-19 is IL-6 dependent. J Clin Invest 2020; 130: 4694-703.
• Ouyang Y, Yin J, Wang W, et al. Downregulated Gene Expression Spectrum and Immune Responses Changed During the Disease Progression in Patients With COVID-19. Clin Infect Dis 2020; 71: 2052-60.
• Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis 2020; 71: 762-8.
• Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020; 81: e6-e12.
• Pilkington V, Pepperrell T, Hill A. A review of the safety of favipiravir - a potential treatment in the COVID-19 pandemic?. J Virus Erad 2020; 6 : 45-51.
• Bommenahalli Gowda S, Gosavi S, Ananda Rao A, et al. Prognosis of COVID-19: red cell distribution width, platelet distribution width, and C-reactive protein. Cureus 2021; 13: e13078.
• Jelkmann W. Proinflammatory cytokines lowering erythropoietin production. J Interferon Cytokine Res 1998; 18: 555-9.
• Soliz J, Schneider-Gasser EM, Arias-Reyes C, et al. Coping with hypoxemia: Could erythropoietin (EPO) be an adjuvant treatment of COVID-19?. Respir Physiol Neurobiol 2020; 279: 103476.
• Yang M, Li CK, Li K, et al. Hematological findings in SARS patients and possible mechanisms (review). Int J Mol Med 2004; 14: 311-5.
• Hu ZD, Lippi G, Montagnana M. Diagnostic and prognostic value of red blood cell distribution width in sepsis: A narrative review. Clin Biochem 2020; 77: 1-6.
• Foy BH, Carlson JCT, Reinertsen E, et al. Association of red blood cell distribution width with mortality risk in hospitalized adults with SARS-CoV-2 infection. JAMA Netw Open 2020; 3: e2022058.