Harsha Jaykar, Mangala Nagare, Gauri Bhat,
Volume 16, Issue 6 (11-2022)
Abstract
Background and objectives: Coronavirus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical manifestations of COVID-19 vary from asymptomatic to acute respiratory distress syndrome. In severely-ill patients, neutrophil count is significantly increased. This study aimed to evaluate absolute neutrophil count (ANC) in patients with COVID-19 and healthy individuals.
Methods: This retrospective, cross-sectional study was carried out on patients admitted to the outpatient department of OBGY Rural Hospital (Maharashtra, India) from April 2021 to June 2021. A peripheral venous blood sample (3 ml) was taken from 143 patients with COVID-19 and 143 healthy controls. The blood samples were analyzed using a fully automated blood cell counter for the estimation of complete blood count. A peripheral blood smear was prepared and stained with Leishman stain for evaluation of morphological changes.
Results: The ANC of COVID-19 patients was significantly higher than that of healthy control subjects (p=0.00001). Toxic granules (48.9%) were the most common morphological neutrophil abnormality, followed by hypolobation, hypogranulation, Pseudo-Pelger-Huet anomaly (20.9%), and shift to left with the presence of immature myeloid series cells.
Conclusion: High ANC along with morphological changes in neutrophils could be used as a simple and inexpensive surrogate marker of COVID-19 and its severity.
Ifrah Jan, Rafiqa Eachkoti, Iqra Farooq, Sanah Farooq, Sadaf Saleem, Sabhiya Majid ,
Volume 18, Issue 1 (1-2024)
Abstract
Background: The complete blood count (CBC) profile has been found extremely useful in monitoring the growth of SARS-CoV-2 infection; however, predictive CBC parameters that could be used in the management of the disease may vary in different populations.
Methods: This study comparatively analyzed the CBC profile of SARS-CoV-2 patients (N = 75; confirmed positive by real-time polymerase chain reaction [PCR]) and healthy individuals (confirmed negative by real-time PCR) from Kashmir (north India).
Results: Compared with healthy individuals, most of the CBC parameters (hemoglobin levels [13.43 vs 10.9 g/dL; P = 0.0001], lymphocytes [16.04% vs 30.8%; P = 0.00001], monocytes [5.53% vs 7.53%; P = 0.009], and platelet count [150 vs 186 ×103 µL; P = 0.037]) were significantly low in SARS-CoV-2 infected patients, while neutrophilia was more common in infected patients (76.77% vs 59.26%). Among derived parameters, the neutrophil-to-lymphocyte ratio (NLR; 7.31 vs 2.04; P = 0.001) and derived NLR (d-NLR; 4.43 vs 1.5; P = 0.0002) were significantly high in SARS-CoV-2 patients. Further correlation analysis revealed a significant association of neutrophilia with the severity of the disease in SARS-CoV-2 infected patients. Moreover, receiver operating characteristic (ROC) analysis of derived CBC parameters (NLR, d-NLR, and platelet‐to-lymphocyte ratio [PLR] with disease severity and disease outcome) revealed d-NLR as better predictive marker of disease severity (area under the curve [AUC] = 0.658) and disease outcome (AUC = 0.766) compared to PLR with disease severity (AUC = 0.645) and disease outcome (AUC = 0.693).
Conclusion: We therefore conclude, of the CBC parameters neutrophilia as the marker of disease severity and among derived parameters, d-NLR as an early predictive biomarker of both disease severity and poor disease outcome in SARS-CoV-2 patients.
