Shahid Muhammad F, Malik Asma, Siddiqi Fuad Ahmad, Fazal Imran, Hammad Muhammad, Saeed Asad, Abbas Naveed
Internal Medicine, Pak Emirates Military Hospital (PEMH), Rawalpindi, PAK.
Internal Medicine, Combined Military Hospital, Rawalpindi, PAK.
Cureus. 2022 Mar 5;14(3):e22863. doi: 10.7759/cureus.22863. eCollection 2022 Mar.
Background and objectives In comparison to real-time polymerase chain reaction (RT-PCR) testing, blood-related parameters including absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) carry an indeterminate potential in the assessment of corona virus disease 2019 (COVID-19). Our main objective was to assess their efficacy in timely identification of COVID-19 patients and to determine whether these biomarkers can be employed as an early diagnostic tool in patients presenting with symptoms suggestive of COVID-19. Methodology This cross-sectional study was conducted at the Emergency Department of a Tertiary Care Hospital in Rawalpindi, Pakistan from November 2020 to March 2021. Patients suspected to have COVID-19 on a clinical basis (fever, cough or shortness of breath) were selected by using convenience non-probability sampling. RT-PCR was used to diagnose COVID-19 after evaluating NLR and ALC of the sample population. An NLR = 3.5 and ALC < 1 x 10 cells/mm was considered as the cut-off value. Statistical analysis was conducted via SPSS 23.0 (IBM Corp., Armonk, NY). Chi-square and independent t-tests were used to correlate various data variables, while p-value <0.05 was considered significant. Results Out of the 172 subjects included in the study, the mean age was 40.6 ± 10.0 years, while 51% of individuals were males. Fever was found to be the most prevalent complaint (94%). Double RT-PCR testing showed that 51.2% of the population was RT-PCR positive, having a mean ALC of 1.4 ± 0.9 x 10/mm, significantly lower than RT-PCR negative cases (p < 0.001). In addition, NLR was drastically elevated for RT-PCR-positive individuals (p < 0.001) while it also had a distinctly high specificity of 91.7% among COVID-19 patients. Additionally, NLR did not correlate with any of the baseline patient-related parameters (presenting complaint, age, and gender). Conclusion NLR and ALC are potentially efficacious measures for an early diagnosis of COVID-19, and can be possibly utilized for an early diagnosis of COVID-19 suspects.
背景与目的 与实时聚合酶链反应（RT-PCR）检测相比，包括绝对淋巴细胞计数（ALC）和中性粒细胞与淋巴细胞比值（NLR）在内的血液相关参数在2019冠状病毒病（COVID-19）评估中具有不确定的潜力。我们的主要目的是评估它们在及时识别COVID-19患者方面的功效，并确定这些生物标志物是否可作为出现COVID-19疑似症状患者的早期诊断工具。方法 本横断面研究于2020年11月至2021年3月在巴基斯坦拉瓦尔品第一家三级护理医院的急诊科进行。通过便利非概率抽样选择临床上疑似患有COVID-19（发热、咳嗽或呼吸急促）的患者。在评估样本人群的NLR和ALC后，使用RT-PCR诊断COVID-19。NLR = 3.5且ALC < 1×10⁹细胞/mm³被视为临界值。通过SPSS 23.0（IBM公司，纽约州阿蒙克）进行统计分析。使用卡方检验和独立t检验来关联各种数据变量，p值<0.05被认为具有统计学意义。结果 在纳入研究的172名受试者中，平均年龄为40.6±10.0岁，其中51%为男性。发热是最常见的主诉（94%）。双重RT-PCR检测显示，51.2%的人群RT-PCR呈阳性，平均ALC为1.4±0.9×10⁹/mm³，显著低于RT-PCR阴性病例（p < 0.001）。此外，RT-PCR阳性个体的NLR大幅升高（p < 0.001），而在COVID-19患者中其特异性也明显高达91.7%。此外，NLR与任何基线患者相关参数（主诉、年龄和性别）均无相关性。结论 NLR和ALC可能是COVID-19早期诊断的有效指标，并可能用于COVID-19疑似患者的早期诊断。
