Loggetto Sandra Regina, Vilela Thiago de Souza, Beatrice Julia Maimone, Grizante-Lopes Priscila, Emerenciano Janahyna Gomes, Angel Andrea, Braga Josefina Aparecida Pellegrini
Department of Pediatric Hematology, Sabará Hospital Infantil, São Paulo, Brazil.
Division of Pediatric Hematology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil.
Clin Pediatr (Phila). 2025 Jun;64(5):695-702. doi: 10.1177/00099228241288715. Epub 2024 Oct 13.
Blood count abnormalities are frequent in patients with severe COVID-19 disease and there is still a lack of information in pediatric complete blood count (CBC) results. Thus, this study aims to correlate the CBC in the emergency room of children with COVID-19 between 0 and 10 years old and the clinical severity of the disease. A retrospective cohort study was performed in children with COVID-19 who collected at the emergency room CBC, C-reactive protein (CRP), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), lymphocyte to neutrophil ratio (LNR), lymphocyte to monocyte ratio (LMR), monocyte to neutrophil ratio (MNR) and monocyte to lymphocyte ratio (MLR). In total, demographic data from 93 children with median age of 19 months (0.3-126), 60.2% males, were included. The main changes in the CBC were atypical lymphocytes (51.6%) and eosinopenia (49.5%). From 69 hospitalized children, 21 were considered severe. There was no association between age, gender, and CRP value with clinical severity. The presence of underlying disease was five times higher (odds ratio [OR] = 5.08) in patients who required hospitalization and a higher NLR value was 54% (OR = 1.54) more likely to occur. Eosinopenia was three times more frequent in inpatients with disease severity criteria (OR = 3.05). In conclusion, children younger than 10 years of age with COVID-19 have changes in the CBC collected in the emergency room, mainly atypical lymphocytes and eosinopenia. The presence of a comorbidity or a higher NLR increases the chance of hospitalization. In addition, eosinopenia was a predictor of severity in inpatient children due to COVID-19.
血细胞计数异常在重症新型冠状病毒肺炎（COVID-19）患者中很常见，而儿科全血细胞计数（CBC）结果方面仍缺乏相关信息。因此，本研究旨在关联0至10岁COVID-19患儿在急诊室的CBC结果与疾病的临床严重程度。对在急诊室采集了CBC、C反应蛋白（CRP）、血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）、中性粒细胞与单核细胞比值（NMR）、淋巴细胞与中性粒细胞比值（LNR）、淋巴细胞与单核细胞比值（LMR）、单核细胞与中性粒细胞比值（MNR）以及单核细胞与淋巴细胞比值（MLR）的COVID-19患儿进行了一项回顾性队列研究。总共纳入了93名儿童的人口统计学数据，中位年龄为19个月（0.3 - 126个月），男性占60.2%。CBC的主要变化为异型淋巴细胞（51.6%）和嗜酸性粒细胞减少（49.5%）。69名住院患儿中，21名被认为病情严重。年龄、性别和CRP值与临床严重程度之间无关联。有基础疾病的患者住院的可能性高出五倍（比值比[OR]=5.08），且较高的NLR值出现的可能性高54%（OR = 1.54）。在符合疾病严重程度标准的住院患者中，嗜酸性粒细胞减少的发生率高出三倍（OR = 3.05）。总之，10岁以下的COVID-19患儿在急诊室采集的CBC有变化，主要是异型淋巴细胞和嗜酸性粒细胞减少。合并症的存在或较高的NLR会增加住院几率。此外，嗜酸性粒细胞减少是COVID-19住院患儿病情严重程度的一个预测指标。
