scholarly journals COVID-19 mortality prediction model, 3C-M, built for use in resource limited settings - understanding the relevance of neutrophilic leukocytosis in predicting disease severity and mortality

2021 ◽  
Author(s):  
Niharika Agarwal ◽  
Devika Dua ◽  
Ritika Sud ◽  
Madhur Yadav ◽  
Aparna Agarwal ◽  
...  
Keyword(s):  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Hematological Parameters ◽  
Severe Disease ◽  
Absolute Lymphocyte Count ◽  
Mortality Prediction ◽  
Clinical Severity ◽  
Total Leukocyte Count ◽  
Lymphocyte Ratio

In this study, a combination of clinical and hematological information, collected on day of presentation to the hospital with pneumonia, was evaluated for its ability to predict severity and mortality outcomes in COVID-19. Ours is a retrospective, observational study of 203 hospitalized COVID-19 patients. All of them were confirmed RT-PCR positive cases. We used simple hematological parameters (total leukocyte count, absolute neutrophil count, absolute lymphocyte count, neutrophil to lymphocyte ration and platelet to lymphocyte ratio); and a severity classification of pneumonia (mild, moderate and severe) based on a single clinical parameter, the percentage saturation of oxygen at room air, to predict the outcome in these cases. The results show that a high absolute neutrophil count on day of onset of pneumonia symptoms correlated strongly with both severity and survival in COVID-19. In addition, it was the primary driver of an initial high neutrophil-to-lymphocyte ratio (NLR) observed in patients with severe disease. The effect of low lymphocyte count was not found to be very significant in our cohort. Multivariate logistic regression was done using Python 3.7 to assess whether these parameters can adequately predict survival. We found that clinical severity and a high neutrophil count on day of presentation of pneumonia symptoms could predict the outcome with 86% precision. This model is undergoing further evaluation at our centre for validation using data collected during the second wave of COVID-19. We present the relevance of an elevated neutrophil count in COVID-19 pneumonia and review the advances in research which focus on neutrophils as an important effector cell of COVID-19 inflammation.

scholarly journals Investigation of the Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in Patients with Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Author(s):  
Qingli SUN ◽  
Dongsheng FAN
Keyword(s):  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Roc Analysis ◽  
Absolute Lymphocyte Count ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Spectrum Disorders ◽  
Wbc Count ◽  
Inflammatory Changes

Abstract Background: This study aimed to explore the differences in the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with neuromyelitis optica spectrum disorders (NMOSDs) as well as their relationship with the onset of the diseases.Methods: The clinical data, laboratory findings, and imaging data of patients with NMOSD admitted to Perking University Third Hospital from January 2015 to December 2020 were retrospectively analyzed. Routine blood tests of patients performed within one week of the appearance of new clinical symptoms or imaging lesions were collected to calculate the NLR and PLR. The routine blood test of the patients in remission was performed more than 6 months after the patients stopped hormone use. The NLR and PLR of patients were compared with those of 100 healthy subjects undergoing physical examinations.Results: A total of 55 patients with NMOSD were enrolled. 44 patients with NMOSD were followed up. In patients with NMOSD, the white blood cell (WBC) count, absolute neutrophil count, and NLR were significantly higher than those in patients in remission and the controls, while the absolute lymphocyte count was significantly lower than that in patients in remission and the controls. In patients with NMOSD in remission, there were no statistically significant differences in the WBC count, absolute neutrophil count, absolute lymphocyte count, or NLR compared with the controls. The PLR of patients with NMOSD in the attack stage was significantly higher than that of the controls, while the PLR of patients with NMOSD in remission was not significantly different from that of the attack stage and the controls. There were no statistically significant differences between APQ4 (+) and APQ4 (-) in patients with NMOSD at the attack stage in the WBC count, absolute neutrophil count, absolute lymphocyte count, platelet count, NLR or PLR. ROC analysis of NLR and PLR for the diagnosis of inflammatory changes in NMOSD at the attack stage and controls: The ROC curve was plotted using NLR and PLR as dependent variables. In patients with NMOSD, the AUC was 0.806 for NLR and 0.612 for PLR. ROC analysis of NLR and PLR for the diagnosis of inflammatory changes in NMOSD at the attack stage and remission stage. The AUC was 0.728 for NLR and 0.594 for PLR.Conclusion: Patients with NMOSD had significantly higher WBC counts, absolute neutrophil counts and NLRs, and elevated NLRs were correlated with inflammatory activity in NMOSD.

PATTERNS OF COMPLETE BLOOD COUNTS (CBC) IN PATIENTS WITH COVID19 INFECTION

2021 ◽  
pp. 51-53
Author(s):  
Chhavi Gupta ◽  
Subhash Bhardwaj
Keyword(s):  
Platelet Count ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Eosinophil Count ◽  
Lymphocyte Count ◽  
Severe Disease ◽  
Clinical Status ◽  
Clinical Severity ◽  
Monocyte Count ◽  
Wbc Count

Background: COVID-19 is an ongoing pandemic caused by virus SARS-CoV-2. Many studies worldwide have documented hematological alterations in COVID-19. The present study also aimed to assess the CBC parameters in COVID-19 patients. Material And Methods: It was an observational study conducted in the Department of Pathology, Govt. Medical College, Jammu. COVID-19 patients admitted in the hospital were included in the study. Demographic details and clinical status were noted. EDTA anticoagulated blood samples received were processed on automated 5-part hematology analyzer for CBC. Various parameters obtained were evaluated and also compared with clinical severity of the patients. Results were tabulated and analysed statistically. Results: The study included 304 hospitalized COVID-19 patients. Males were 219 (72%) and females were 85 (28%). Median 6 age of patients was 55 years. Mean hemoglobin concentration was 12.05 g/dl (SD-1.93), mean RBC count was 4.21x10 /µL (SD3 3 0.69). Mean WBC count was 9.66x10 /µL (SD-4.80), mean absolute neutrophil count was 7.87x10 /µL (SD-4.63), mean absolute 3 3 lymphocyte count was 1.22x10 /µL (SD-0.77), mean absolute monocyte count was 0.52x10 /µL (SD-0.29), mean absolute 3 eosinophil count was 0.04 x10 /µL(SD-0.10). Mean NLR was 10.03 (SD-12.27), mean LMR was 2.84 (SD-2.02), mean PLR was 3 220.16 (SD-208.46). Mean platelet count was 187x10 /µL (SD-97.78). Patients with severe disease show signicantly raised WBC count and absolute neutrophil count, signicantly decreased absolute lymphocyte count, signicantly higher eosinophil count, NLR, PLR and signicantly decreased LMR with no signicant difference in absolute monocyte count and platelet count. Conclusion: Routine monitoring of CBC parameters in COVID – 19 patients during the course of illness is a simple, rapid means to assess disease severity and progression in these patients.

scholarly journals Hematological parameters during concurrent chemoradiotherapy as potential prognosticators in patients with stage IIB cervical cancer

Tumor Biology ◽  
2017 ◽  
Vol 39 (2) ◽  
pp. 101042831769430 ◽  
Author(s):  
Oyeon Cho ◽  
O Kyu Noh ◽  
Young-Taek Oh ◽  
Suk-Joon Chang ◽  
Hee-Sug Ryu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Concurrent Chemoradiotherapy ◽  
Hematological Parameters ◽  
Progression Free Survival ◽  
Absolute Lymphocyte Count ◽  
Disease Specific Survival ◽  
Disease Specific

We hypothesized that hemoglobin levels, absolute neutrophil count, and absolute lymphocyte count were associated with radiotherapy response and cancer progression and that they might reflect tumor repopulation during concurrent chemoradiotherapy. This study aimed to investigate these hematological parameters as prognosticators of cervical cancer. We analyzed 105 stage IIB cervical cancer patients treated with concurrent chemoradiotherapy, using log-rank tests and multivariate analyses. Hazard ratios were calculated weekly to evaluate changes in hemoglobin, absolute neutrophil count, and absolute lymphocyte count that were associated with disease-specific survival. Patients were categorized into the high hematological risk (patients with low hemoglobin plus high absolute neutrophil count and/or low absolute lymphocyte count) and the low hematological risk (others) groups according to the median cutoff values. During the second week of concurrent chemoradiotherapy, hematological factors were significantly associated with survival. In multivariate analysis, hematological risk was independently associated with disease-specific survival and progression-free survival. The 5-year disease-specific survival and progression-free survival rates in the high hematological risk group were significantly lower compared with those in the low hematological risk group (81.6% vs 92.6%, p = 0.0297; 73.7% vs 89.3%, p = 0.0163, respectively). During the second week of concurrent chemoradiotherapy, the hematological parameters could predict treatment outcome in stage IIB cervical cancer.

The Prognostic Significance of Established Hematological Parameters and Inflammatory Biomarkers in Assessing Dengue Infection Severity and Progression among Patients Ages 5 to 14 in a Tertiary Government Hospital in Pampanga, Philippines

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S103-S104
Author(s):  
J R Cai ◽  
I B Camacho ◽  
E M Caras ◽  
J A Carayugan ◽  
K H Carmona ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Hematological Parameters ◽  
Dengue Infection ◽  
Prognostic Significance ◽  
Absolute Lymphocyte Count ◽  
Warning Signs ◽  
Inflammatory Biomarkers ◽  
Severe Dengue ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Introduction/Objective Dengue virus (DENV) is an arthropod-borne virus which imposes a significant burden on the health system in most tropical and subtropical countries. In 2009, WHO classified Dengue into Dengue Without Warning Signs (DNWS), Dengue With Warning Signs (DWWS), and Severe Dengue (SD). This study aims to establish the prognostic value of predetermined hematological parameters and inflammatory biomarkers in assessing severity and progression of dengue infection among ages 5-14. Methods/Case Report A retrospective study was conducted to evaluate the Complete Blood Count, Inflammation biomarkers, and severity of dengue patients (5-14 of age). The diagnosis must be serologically confirmed by a positive NS1/IgM. Results (if a Case Study enter NA) A total of 36 patients participated in the study, having 18 from each groups of DWWS and SD. The mean age of Dengue cohort was 13.9 years with 59% (19/36) being male. Laboratory findings reveal SD to have lower platelet count (<100.00x109/L) during day 1-3 (p<0.001). Low WBC count (<4.00x109/L), Relative Eosinophil (<2.00%), and Absolute Lymphocyte count (<1.52x109/L) were evident on days 1-3 among DWWS and SD cases (p=0.023; p=0.045; p=0.033). Low relative neutrophil (<0.45%) was a constant finding in both clinical types throughout disease progression. SD group had significantly higher Neutrophil to Lymphocyte ratio (NLR) values among SD cases on days 4-6 (p<0.001). In contrast, Platelet to Lymphocyte ratio (PLR) was significantly lower among DWWS cases on days 4-6 (p=0.020). Monocyte to Lymphocyte (MLR) ratio had poor discriminative power (p=0.560). Conclusion The findings highlight decreased platelet, WBC, relative eosinophil, and absolute lymphocyte count to be common among Dengue patients. NLR and PLR were found to be good predictors of dengue severity during the initial phase of infection. Evaluating these values may aid clinicians in early diagnosis of severe dengue. However, larger samples are needed to further validate the predictive values of these parameters.

scholarly journals The hemocyte counts as a potential biomarker for predicting disease progression in COVID-19: a retrospective study

2020 ◽  
Vol 58 (7) ◽  
pp. 1106-1115 ◽  
Author(s):  
Yufen Zheng ◽  
Ying Zhang ◽  
Hongbo Chi ◽  
Shiyong Chen ◽  
Minfei Peng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Disease Progression ◽  
Neutrophil Count ◽  
Calibration Curve ◽  
Lymphocyte Count ◽  
Severe Disease ◽  
Clinical Impact ◽  
Predictive Tool ◽  
Potential Biomarker

AbstractObjectivesIn December 2019, there was an outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, and since then, the disease has been increasingly spread throughout the world. Unfortunately, the information about early prediction factors for disease progression is relatively limited. Therefore, there is an urgent need to investigate the risk factors of developing severe disease. The objective of the study was to reveal the risk factors of developing severe disease by comparing the differences in the hemocyte count and dynamic profiles in patients with severe and non-severe COVID-19.MethodsIn this retrospectively analyzed cohort, 141 confirmed COVID-19 patients were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang Province, China, from January 17, 2020 to February 26, 2020. Clinical characteristics and hemocyte counts of severe and non-severe COVID patients were collected. The differences in the hemocyte counts and dynamic profiles in patients with severe and non-severe COVID-19 were compared. Multivariate Cox regression analysis was performed to identify potential biomarkers for predicting disease progression. A concordance index (C-index), calibration curve, decision curve and the clinical impact curve were calculated to assess the predictive accuracy.ResultsThe data showed that the white blood cell count, neutrophil count and platelet count were normal on the day of hospital admission in most COVID-19 patients (87.9%, 85.1% and 88.7%, respectively). A total of 82.8% of severe patients had lymphopenia after the onset of symptoms, and as the disease progressed, there was marked lymphopenia. Multivariate Cox analysis showed that the neutrophil count (hazard ratio [HR] = 4.441, 95% CI = 1.954–10.090, p = 0.000), lymphocyte count (HR = 0.255, 95% CI = 0.097–0.669, p = 0.006) and platelet count (HR = 0.244, 95% CI = 0.111–0.537, p = 0.000) were independent risk factors for disease progression. The C-index (0.821 [95% CI, 0.746–0.896]), calibration curve, decision curve and the clinical impact curve showed that the nomogram can be used to predict the disease progression in COVID-19 patients accurately. In addition, the data involving the neutrophil count, lymphocyte count and platelet count (NLP score) have something to do with improving risk stratification and management of COVID-19 patients.ConclusionsWe designed a clinically predictive tool which is easy to use for assessing the progression risk of COVID-19, and the NLP score could be used to facilitate patient stratification management.

Pretreatment Absolute Lymphocyte Count and Neutrophil-to-lymphocyte Ratio Are Prognostic Factors for Stage III Breast Cancer

2021 ◽  
Vol 41 (7) ◽  
pp. 3625-3634
Author(s):  
KOSHO YAMANOUCHI ◽  
SHIGETO MAEDA ◽  
DAIKI TAKEI ◽  
YOICHI KOGA ◽  
MANPEI YAMASHITA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stage Iii ◽  
Lymphocyte Ratio ◽  
Stage Iii Breast Cancer
Sign in / Sign up

Export Citation Format

Share Document