Abstract
The aim of this study is to investigate the routine blood parameters of COVID-19 patients at the time of admission to the emergency department and their relationship with the severity of the disease and prognosis. A total of 500 patients, who were diagnosed with severe COVID-19 and hospitalized in the intensive care unit between 01.04.2020 and 01.02.2021 in the emergency department of a pandemic hospital, were retrospectively analyzed. Demographic, clinical, and laboratory data of the patients were obtained from the hospital registry system. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were calculated using neutrophil, lymphocyte, monocyte, and platelet counts. These patients were divided into two groups: survivors and deceased. All parameters obtained from routine blood analysis were statistically compared between these two groups. While 280 out of 500 patients survived, 220 died. Of all patients, the mean age was 67 years and 51.8% were males. There was a significant difference between the two groups in terms of age, gender, length of hospital stay, need for mechanical ventilation, white blood cell, neutrophil, lymphocyte, monocyte, eosinophil, platelet counts, CRP, ferritin, procalcitonin values, NLR, MLR, and PLR (p < 0.001 for all). While NLR alone and MLR + NEU and NLR + PLR + MLR combinations had the highest AUC values (0.930, 0.947, and 0.939, respectively), MLR and PLR alone showed the lowest AUC values (0.875 and 0.797, respectively). The sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) in the prediction of death according to the cutoff values of the parameters have been determined. A significant correlation was determined between age, NLR, MLR, and PLR and duration of hospital stay (p < 0.001 for all). Routine blood parameters and NLR, MLR, and PLR can assist emergency physicians to identify the severity and early prognosis of COVID-19 patients.
Highlights
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2) has become an important health problem worldwide [1]
Recent studies indicate that severe COVID19 patients may have immune dysregulation that leads to the development of viral hyperinflammation. is hyperinflammatory response may result in multiple organ dysfunction syndrome (MODS) and death by causing cytokine storm [7, 8]
Values) at the time of admission to the emergency department, the PCR result, report of CT of the thorax, need for mechanical ventilation, total duration of hospital stay, and clinical outcomes were obtained retrospectively from the hospital’s registry system. e neutrophil-to-lymphocyte ratio (NLR), the monocyte-tolymphocyte ratio (MLR), and the platelet-to-lymphocyte ratio (PLR) were calculated using neutrophil, lymphocyte, monocyte, and platelet counts obtained from the blood analysis. ese patients were divided into two groups: survivors and deceased
Summary
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2) has become an important health problem worldwide [1]. A certain percent of patients may suffer from severe course of the infection [3]. COVID-19, which has rapidly spread worldwide, may lead to asymptomatic infection, viral pneumonia, acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome (MODS), shock, and even death [4]. Diagnosis and treatment of COVID-19 are of vital importance given its rapid spread and severe complications [5]. Recent studies indicate that severe COVID19 patients may have immune dysregulation that leads to the development of viral hyperinflammation. All COVID-19 patients should be screened for hyperinflammation by using laboratory parameters in order to decrease mortality [9]. Various abnormal hematological parameters including leukocytosis, neutrophilia, thrombocytopenia, lymphopenia, elevated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
