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Comparison of hematologic parameters in severe and non-severe COVID-19 patients
Dwiputra V.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which has become a pandemic in various places. Apart from the respiratory system, COVID-19 also causes problems in other systems including the hematological system. Previous studies have found thrombocytopenia, lymphopenia, and elevation of neutrophil to lymphocyte ratio (NLR) as a hematological parameter in COVID-19. In COVID-19 with severe symptoms, there is excessive cytokine activation resulting in a cytokine storm which ultimately results in acute respiratory distress syndrome (ARDS), sepsis, and other complications including more severe hematological disorders. The aim of this atudy was to observe the comparison of hematological parameters in COVID-19 patients with severe and non-severe symptoms.METHODS: Observational study with a cross sectional approach using medical record data at Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi, Indonesia. The total sample was 100 people which were divided into 2, namely 50 in the COVID-19 patient group with severe symptoms and 50 in COVID-19 with non-severe symptoms. The COVID-19 patient was confirmed with a positive PCR nasopharyngeal swab examination. Platelet and lymphocyte values were recorded at the initial admission examination. The neutrophil lymphocyte ratio is calculated by comparing the neutrophil value divided by the lymphocyte value.RESULTS: It was found that Lymphocytes and Platelets had a lower median value in COVID-19 with severe symptoms and were statistically significant (P<0.05). The median NLR and age were found to be higher in COVID-19 with severe symptoms and statistically significant (P<0.05). In multivariate logistic regression analysis, a 3-step analysis was performed on the variables of platelets, lymphocytes and NLR. Platelets (OR 1.005 CI95% 1.001-1.008) were found to be the most influential variable on the severity of COVID-19.CONCLUSIONS: There are differences in hematological parameters in COVID-19 with severe symptoms compared to COVID-19 with non-severe symptoms where significantly in COVID-19 with severe symptoms there were lower levels of lymphocytes and platelets, and higher NLR levels compared to COVID-19 with non-severe symptoms. In the multivariate analysis, it was found that platelets were the most influential variable on the severity of COVID-19.