Department of Medicine, College of Medicine University of Lagos; Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Nigeria.
Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Idi-Araba, Nigeria.
Ann Afr Med. 2023 Apr-Jun;22(2):204-212. doi: 10.4103/aam.aam_111_22.
This study aims to evaluate the use of haematological indices and coagulation profiles as possible low-cost predictors of disease severity and their associations with clinical outcomes in COVID-19-hospitalized patients in Nigeria.
We carried out a hospital-based descriptive 3-month observational longitudinal study of 58 COVID-19-positive adult patients admitted at the Lagos University Teaching Hospital, Lagos, Nigeria. We used a structured questionnaire to obtain the participants' relevant sociodemographic and clinical data, including disease severity. Basic haematologic indices, their derivatives, and coagulation profile were obtained from patients' blood samples. Receiver Operating Characteristic (ROC) analysis was used to compare these laboratory-based values with disease severity. A P < 0.05 was considered statistically significant.
The mean age of the patients was 54.4 ± 14.8 years. More than half of the participants were males (55.2%, n = 32) and most had at least one comorbidity (79.3%, n = 46). Significantly higher absolute neutrophil count (ANC), neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lower absolute lymphocyte count (ALC) and lymphocyte-monocyte ratio (LMR) were associated with severe disease (P < 0.05). Patients' hemoglobin concentration (P = 0.04), packed cell volume (P < 0.001), and mean cell hemoglobin concentration (P = 0.03) were also significantly associated with outcome. Receiver operating characteristic (ROC) analysis of disease severity was significant for the ANC, ALC, NLR, LMR, and SII. The coagulation profile did not show any significant associations with disease severity and outcomes in this study.
Our findings identified haematological indices as possible low-cost predictors of disease severity in COVID-19 in Nigeria.
本研究旨在评估血液学指标和凝血谱是否可作为尼日利亚 COVID-19 住院患者疾病严重程度的低成本预测指标，并探讨其与临床结局的关系。
我们进行了一项基于医院的 3 个月描述性纵向研究，纳入了 58 名在尼日利亚拉各斯大学教学医院住院的 COVID-19 阳性成年患者。我们使用结构化问卷获取参与者的相关社会人口学和临床数据，包括疾病严重程度。从患者的血液样本中获得基本的血液学指标、其衍生物和凝血谱。使用受试者工作特征（ROC）分析比较这些实验室值与疾病严重程度的关系。P 值<0.05 为统计学显著。
患者的平均年龄为 54.4±14.8 岁。超过一半的参与者为男性（55.2%，n=32），大多数至少有一种合并症（79.3%，n=46）。中性粒细胞绝对值（ANC）、中性粒细胞与淋巴细胞比值（NLR）、全身性免疫炎症指数（SII）较高，而淋巴细胞绝对值（ALC）和淋巴细胞与单核细胞比值（LMR）较低与严重疾病相关（P<0.05）。患者的血红蛋白浓度（P=0.04）、红细胞压积（P<0.001）和平均红细胞血红蛋白浓度（P=0.03）也与结局显著相关。疾病严重程度的 ROC 分析显示 ANC、ALC、NLR、LMR 和 SII 具有显著预测价值。在本研究中，凝血谱与疾病严重程度和结局无显著相关性。
我们的发现表明，血液学指标可能是尼日利亚 COVID-19 疾病严重程度的低成本预测指标。
