Abstract
Distinguishing between severe and nonsevere COVID-19 to ensure adequate healthcare quality and efficiency is a challenge for the healthcare system. The aim of this study was to assess the usefulness of CBC parameters together with analysis of FLC serum concentration in risk stratification of COVID-19. Materials and methods: CBC was analyzed in 735 COVID ICU, COVID non-ICU, and non-COVID ICU cases. FLC concentration was analyzed in 133 of them. Results: COVID ICU had neutrophils and lymphocytes with the greatest size, granularity, and nucleic acid content. Significant differences in concentrations of κ and λ FLCs were shown between COVID ICU and COVID non-ICU. However, no difference was found in the κ/λ ratio between these groups, and the ratio stayed within the reference value, which indicates the presence of polyclonal FLCs. FLC κ measurement has significant power to distinguish between severe COVID-19 and nonsevere COVID-19 (AUC = 0.7669), with a sensitivity of 86.67% and specificity of 93.33%. The κ coefficients’ odds ratio of 3.0401 was estimated. Conclusion: It can be concluded that the results obtained from the measure of free light immunoglobulin concentration in serum are useful in distinguishing between severe and nonsevere COVID-19.
Highlights
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) belongs to the coronavirus family, along with MERS-CoV and SARS-CoV [1]
COVID-19 patients hospitalized in the ICU had the highest neutrophil concentration and the lowest number of lymphocytes, which resulted in the highest neutrophil-to-lymphocyte ratio (NLR) ratio
Patients infected with SARS-CoV-2 who were treated in the ICU and those treated in other departments had extremely different numbers of eosinophils: those from ICU had the lowest, and those from non-ICU had the highest eosinophil count from all studied groups (Table 1)
Summary
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) belongs to the coronavirus family, along with MERS-CoV and SARS-CoV [1]. The first cases of disease caused by SARS-CoV-2 were noted in Wuhan, Hubei, China, in November 2019. In February 2020, the disease induced by SARS-CoV-2 was named coronavirus disease 2019 (COVID-19). Patients infected with SARS-CoV-2 may show the symptoms of fever, dry cough, fatigue, less often muscle pain, sore throat, diarrhea, conjunctivitis, headache, loss of taste or smell, and skin rash. For SARS-CoV-2 infected patients, the following significant changes in laboratory test results have been demonstrated in previously published manuscripts [5]. In SARS-CoV-2 infection, an increase in the concentration of fibrin decay product (FDP) D-dimer is observed, which correlates with the advancement of the disease process. In infected patients, the levels of FDP and fibrinogen increase as the disease progresses. Lymphopenia and neutrophilia are frequently observed in patients infected with SARS-CoV-2. The ratio of absolute neutrophils to lymphocytes (NLR) in relation to patients without infection increases significantly
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