Pujani Mukta, Raychaudhuri Sujata, Verma Nikhil, Kaur Harnam, Agarwal Shivani, Singh Mitasha, Jain Manjula, Chandoke R K, Singh Kanika, Sidam Dipti, Chauhan Varsha, Singh Aparna, Katarya Khushbu
Department of Pathology, ESIC Medical College & Hospital Faridabad, India.
Department of Medicine, ESIC Medical College & Hospital Faridabad, India.
Am J Blood Res. 2021 Apr 15;11(2):180-190. eCollection 2021.
COVID-19 is a systemic viral infection with a significant impact on the hematopoietic system, hemostasis as well as immune system. It would be of utmost importance to explore if the most routinely used tests could serve as an aid in determining patient's clinical status or predicting severity of the disease.
A prospective cross-sectional study was conducted on 506 Covid-19 positive patients and 200 controls over a period of two months (June and July 2020). The cases were sub-classified based on disease severity into mild to moderate (n=337), severe (n=118) and very severe (n=51) and based on survivor status into survivors (n=473) and non-survivors (n=33).
There were statistically significant differences in WBC count, Absolute neutrophil count (ANC), Absolute lymphocyte count (ALC), absolute monocyte count (AMC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR) Red blood cell distribution width (RDW-SD) and RDW CV between covid cases vs controls; among the clinical subgroups and among the survivors and non-survivors. There was a significant strong positive correlation between various parameters, that is, NLR and MLR (r: 0.852, P=0), MPV and PDW (r: 0.912, P=0), MPV and PLCR (r: 0.956, P=0), PDW and PLCR (r: 0.893, P=0). NLR (AUC: 0.676, P=0) was the best single parameter and NLR+RDW-CV was best combination parameter as per area under curve (0.871) of ROC to distinguish severe from mild to moderate disease.
Leucocytosis, neutrophilia, lymphopenia and monocytosis were characteristic findings in covid cases while NLR and NLR+RDW-CV emerged as the most effective single and combination CBC parameters in distinguishing mild to moderate and severe cases respectively.
新型冠状病毒肺炎（COVID-19）是一种全身性病毒感染，对造血系统、止血功能以及免疫系统均有重大影响。探究最常用的检测方法是否有助于确定患者的临床状态或预测疾病严重程度至关重要。
在两个月（2020年6月和7月）期间，对506例COVID-19阳性患者和200例对照进行了一项前瞻性横断面研究。病例根据疾病严重程度分为轻度至中度（n = 337）、重度（n = 118）和极重度（n = 51），并根据存活状态分为存活者（n = 473）和非存活者（n = 33）。
COVID-19病例与对照之间、临床亚组之间以及存活者与非存活者之间，白细胞计数、绝对中性粒细胞计数（ANC）、绝对淋巴细胞计数（ALC）、绝对单核细胞计数（AMC）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、红细胞分布宽度标准差（RDW-SD）和红细胞分布宽度变异系数（RDW CV）存在统计学显著差异。各参数之间存在显著的强正相关，即NLR与MLR（r：0.852，P = 0）、平均血小板体积（MPV）与血小板分布宽度（PDW）（r：0.912，P = 0）、MPV与血小板大型比率（PLCR）（r：0.956，P = 0）、PDW与PLCR（r：0.893，P = 0）。根据区分重度与轻度至中度疾病的受试者工作特征曲线（ROC）下面积（0.871），NLR（AUC：0.676，P = 0）是最佳单一参数，NLR + RDW-CV是最佳组合参数。
白细胞增多、中性粒细胞增多、淋巴细胞减少和单核细胞增多是COVID-19病例的特征性表现，而NLR和NLR + RDW-CV分别成为区分轻度至中度和重度病例最有效的单一和组合血常规参数。
