Study of hematological and biochemical parameters in a cohort of Indian COVID-19 patients admitted in a tertiary care centre

Authors

  • Abhishek Agrawal Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • Princy Tyagi Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • Sunil Mahavar Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • Subrata Banerjee Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • Raman Sharma Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • Sudhir Bhandhari Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • Prakash Keswani Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20205045

Keywords:

COVID-19, Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio, Symptomatic, Lymphopenia

Abstract

Background: In this study authors retrospectively analyzed the record of 102 patients with confirmed COVID-19 infection to determine factors associated with severity of disease.  

Methods: Clinical, biochemical, radiological and hematological profiles of 102 patients with confirmed SARS-CoV-2 RNA testing were obtained and analyzed.  

Results: A total of 102 patients were enrolled, with median age of patients of 32.5 years (range 10-85 years), of which 83.3% (85/102) were asymptomatic and 16.67% (17/102) symptomatic. Eighteen (17.6%) patients had co-existing illnesses. Clinical spectrum among COVID-19 patients varied from being asymptomatic to having symptoms like fever, dry cough, breathlessness with few progressing to respiratory failure and multi-organ failure. In our study, 97.05% (99/102) recovered while 2.94% (3/102) died. Mean age, total leucocyte count (TLC), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) of severely ill patients were significantly higher than those of patients with non-severe illness.

Conclusions: Elevated NLR, TLC, PLR, LDH and lymphopenia were seen in the symptomatic patients especially manifesting severe disease. Early intervention and periodic monitoring of these parameters in patients, especially with severe disease may help in improving disease outcome.

Author Biography

Princy Tyagi, Department of Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India

SENIOR RESIDENT DEPARTMENT OF MEDICINE SMS MEDICAL COLLEGE JAIPUR RAJASTHAN INDIA

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Eng J Medic. 2020;382(8):727-33.

The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-44.

Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):11.

Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible?. Lancet Gastroenterol Hepatol. 2020;5(4):335-7.

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. N Engl J Medic. 2020;382(13):1199-207.

Ministry of health and family welfare, Government of India. [Internet] Guidelines on the clinical management of COVID-19. Available at: https://www.mohfw.gov.in/pdf/GuidelinesonClinicalManagementofCOVID1912020.pdf. Accessed on 12 May 2020.

Şimşek yavuz S, Ünal S. Antiviral treatment of COVID-19. Turk J Med Sci. 2020;50(SI-1):6119.

Huang L, Zhang X, Zhang X, Wei Z, Zhang L, Xu J et al. Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study. J Infect. 2020;80(6):e1-13.

Richardson S, Hirsch J, Narasimhan M, Crawford J, McGinn T, Davidson K et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. J Am Med Assoc. 2020.

Zhang C, Shi L, Wang F. Liver injury in COVID-19: management and challenges. Lanc Gastroenterol Hepatol. 2020;5(5):428-30.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Medic. 2020;382(18):1708-20.

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis T, Politou M et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;

Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lanc Infect Diseas. 2020;20(4):425-34.

Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. J Am Med Assoc. 2020;323(15):1488–94.

Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immuno pharmacol. 2020;84:106504.

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8.

Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis. 2020;34:101663.

Guidance for discharge and ending isolation in the context of widespread community transmission of COVID-19 - first update [Internet]. European Centre for Disease Prevention and Control. 2020. Available at: https://www.ecdc.europa.eu/en/ publications-data/covid-19-guidance-discharge-and-ending-isolation. Accessed on 12 May 2020.

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Published

2020-11-23

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Original Research Articles