Neutrophil to Lymphocyte Ratio in Hospitalized COVID 19 Patients – A Study in a Tertiary Care Covid Centre in Eastern India

Abstract

Background Corona Virus Disease -2019 (COVID-19) has jeopardised human life globally for last more than one year due to its high infectivity and tendency to develop sudden deterioration of cases by complicated pathophysiology. Some cost effective markers are necessary to predict severity so that timely appropriate management can be given. Neutrophil to lymphocyte ratio (NLR) in blood is such a common parameter that has been previously used to predict severity in various conditions like cardiovascular diseases and sepsis. Our objective was to estimate total White blood cell count (TC) and NLR in hospitalised COVID-19 patients and to find out their role to predict severity. Methods This observational cross sectional study was done on hospitalized COVID-19 adult patients where patients were categorized into moderate and severe cases as per guideline of Govt. of India. TC and Differential count were estimated by automated cell counter and NLR was compared in these two groups by unpaired t test to find out their significance. Results Out of total 175 cases, 49(28%) were categorized as severe while rest 126 (72%) patients were in moderate category of disease. The mean ± standard deviations of TC (X103/µl) and NLR for moderate disease were 8.85±4.60 and 5.57±6.80 respectively while those for severe disease were 12.78±6.54 and 12.99±12.21 respectively. Both the parameters have statistically significant difference between two groups (p <0.001). Conclusion TC and NLR were significantly higher in severe cases compared to moderate cases and hence they can be utilised to triage COVID-19 cases at an early stage.