scholarly journals The Relationship between Routine Blood Parameters and the Prognosis of COVID-19 Patients in the Emergency Department

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Birsen Ertekin ◽  
Mehmet Yortanlı ◽  
Ozan Özelbaykal ◽  
Ali Doğru ◽  
A. Sadık Girişgin ◽  
...  

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.

2019 ◽  
Vol 65 (9) ◽  
pp. 1182-1187 ◽  
Author(s):  
Emrah Erdal ◽  
Mehmet İnanir

SUMMARY OBJECTIVE To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.


2021 ◽  
Vol 8 (10) ◽  
pp. 619-622
Author(s):  
Hasan Atlı ◽  
Erhan Önalan ◽  
Burkay Yakar ◽  
Deccane Duzenci ◽  
Emir Dönder

Objective: Obesity has recently been recognized as a chronic low-grade inflammation condition. We aimed to compare the predictive values of insulin resistance and inflammatory indices in individuals with obesity. Materials and Methods: 124 people who had a health check for obesity-related risk factors in our hospital between June 2018 and September 2019 were included in the study. Inflammatory markers of the patients were evaluated. Results: The study group consists of a total of 224 people, and we compared the demographic data and laboratory parameters of the individuals. C-reactive protein (CRP) levels of obese individuals were statistically higher than those with normal body mass index (p <0.001). There was no statistically significant difference between the groups in terms of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values, among other inflammation markers. A positive and statistically significant correlation was found between body mass index and CRP level (r = 0.334, p <0.001). There was no significant correlation between body mass index and NLR and PLR. Conclusion: As a result, CRP levels of obese individuals were statistically higher than individuals with normal body mass index. No statistically significant difference was found between the groups in terms of NLR and PLR values among other inflammation markers.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17049-e17049
Author(s):  
Katherine Emilie Rhoades Smith ◽  
Limeng Wan ◽  
Yuan Liu ◽  
Jacqueline T Brown ◽  
Greta Russler ◽  
...  

e17049 Background: There is limited biomarker data available for metastatic hormone sensitive prostate cancer (mHSPC). Inflammatory markers found on routine clinical lab data, including leukocyte to lymphocyte ratios calculated from complete blood counts (CBC), is associated with clinical outcomes (CO) in different malignancies. We investigated the association between basophil-to-lymphocyte ratio (BLR) and CO in a racially diverse patient population with mHSPC. Methods: We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014 – 2020). Demographics, disease characteristics, and laboratory data were collected at the start of upfront therapy with either docetaxel (DOC) or abiraterone (ABI). Overall survival (OS) and progression-free survival (PFS) were used to measure CO. Results: Included were 165 patients with mHSPC with a median follow-up time of 22.6 months. 89 (53.9%) were Black and 76 (46.1%) were Non-Black (White, Asian, or Hispanic). 106 (63%) had Gleason scores of 8-10 and 105 (63.6%) were classified as high-volume disease (per CHAARTED trial criteria). 92 (55.8%) received DOC and 73 (44.2%) received ABI. Worse CO were associated with high BLR at an optimal cut of 0.0265 (range 0 – 0.81 , mean of 0.03, standard deviation 0.09). Elevated BLR is associated with decreased OS (HR 3.51, 1.79 – 6.91, p <0.001) and PFS (HR 1.85, 1.14 – 3.00, p 0.013) in multivariable analyses (MVA). High BLR and low BLR groups were similar except for age as a continuous variable, which was associated with high BLR. Otherwise, there were no significant difference for all reported clinical characteristics, including drug (DOC vs ABI), race (Black vs Non-Black), Gleason, disease volume (per CHARRTED criteria), ECOG, or BMI. Conclusions: In mHSPC, high baseline BLR is associated with worse OS and PFS. Our results are the first to identify that BLR is associated with CO in mHSPC. Further study is needed to validate BLR as a potential biomarker.[Table: see text]


Author(s):  
Yue-qiang Fu ◽  
Yue-lin Sun ◽  
Si-wei Lu ◽  
Yang Yang ◽  
Yi Wang ◽  
...  

ABSTRACTIntroductionThis retrospective study investigated the implications of changes in blood parameters and cellular immune function in patients with 2019-coronavirus infected disease (COVID-19).MethodsRecords were reviewed of 85 patients with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital mortality at 28 days.ResultsFourteen patients died. The baseline leukocyte count, neutrophil count and hemoglobin was significantly higher in non-survivors compared with survivors, while the reverse was true of lymphocyte count, platelet, PaO2/FiO2, CD3+ count and CD4+ count. The percentage of neutrophil count > 6.3×109/L in death group was significantly higher than that in survival group, and multivariate logistic regression showed neutrophil count was independently associated with mortality. However, there were not significant difference in IgG, IgM, IgA, C3, C4 and the percentage of IgE > 100 IU/ml between the death group and survival group. Areas under the receiver operating characteristic curves of the following at baseline could significantly predict mortality: leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts.ConclusionsFor patients with COVID-19, lymphocyte, CD3+ and CD4+ counts that marked decrease suggest a poor outcome. A high neutrophil count is independently associated with mortality. At admission, leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts should receive added attention.


Author(s):  
Nurahmi Nurahmi ◽  
Budi Mulyono ◽  
Windarwati Windarwati

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.


2020 ◽  
Author(s):  
Duanlu Hou ◽  
Chunjie Wang ◽  
Xiaofei Ye ◽  
Ping Zhong ◽  
Danhong Wu

Abstract Background-Thrombolysis has become an effective therapy for acute cerebral infarction (AIS) within 4.5 hours. Thrombolysis improves prognosis by increasing perfusion of the ischemic penumbra. Inflammation as one of the mechanisms of cerebral infarction, the role of thrombolysis is the topic of our exploration. Methods-From August 1, 2017 and September 1, 2019, 493 consecutive patients with AIS were prospectively enrolled in this cohort. 170 patients received thrombolytic therapy and 323 patients did not have thrombolysis. Clinical evaluation, laboratory data before and after thrombolysis and 3-month modified Rankin scale (mRS) scores were compared. Neutrophil-to-lymphocyte ratio (NLR), which represents inflammatory response, was divided into quartiles for comparison. Multivariate regression analysis was used to determine independent factors of 3-month prognosis. The receiver operating characteristic curve was used to evaluate the predictability of NLR for good prognosis that was defined as 3-month mRS scores < 3. Results-The NLR after thrombolysis was higher than that before thrombolysis (p < 0.001) and in non-thrombolytic patients (p < 0.001). NLR after thrombolysis is an independent predictor of 3-month functional outcome (odds ratio (OR) = 1.20, 95% confidence interval (CI), 1.01–1.42, p = 0.03). Also, a cutoff value of 4.51 for NLR was detected in predicting post-thrombolysis 3-month functional outcome with a sensitivity of 65.7% and a specificity of 73.1% (area under curve [AUC], 0.85; 95% CI, 0.77–0.92). We also found a significant difference (62% vs 88%, p < 0.001) in the proportion of good 3 months prognosis between the higher and lower group. Conclusions-This study showed that NLR increase after thrombolysis better predict post-thrombolytic unfavorable functional outcome in AIS patients. Clinical Trial Registration-URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800018315. URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800019615.


Author(s):  
M. U. Ali ◽  
A. A. Panda ◽  
S. M. Yahaya ◽  
U. A. Umar ◽  
M. S. Inuwa ◽  
...  

Background: Changes in blood cell profile were common findings in malaria. In the rural community of Kano State, Nigeria, information on haematological changes in human malaria was scanty in spite of their role in the pathophysiology of malaria. This cross-sectional study was undertaken to determine blood cell profiles in malaria patients attending a rural hospital in malaria-endemic region. Methods: Blood samples (3 ml each) were collected in EDTA-containers from 150 randomly selected outpatients attending Gaya General Hospital, screened for malaria using RDT kit (CareStart Malaria HRP 2, Access Bio Inc., USA) based on Histidine-rich protein 2 (PfHRP-2), and blood cell profiles determined using automated Sysmex haematologic analyser. Data on socio-demographics and medical history related to the study objectives, such as taking antimalarial regimen and/or haematinic, and direct involvement in blood transfusion, were obtained by questionnaire administration supplemented with oral interview. Findings: The study revealed a malaria prevalence of 67.33%, with highest in 11-20years (80.95%) and lowest (55.00%) in 1-10years age-groups; slightly higher in females (68.25%) than in males (66.67%) without significant difference (P<0.05). For blood parameters, malaria positive patients have a significantly lower mean PCV of 32.2% as compared to 38.18% obtained for malaria negative patients (P<0.05). The mean Hb was 10.76±2.27g/dL and 12.65±2.38g/dL (P<0.05), while WBC revealed 6.91×109/L and 6.56×109/L in malaria positive and negative patients, respectively. Platelet counts recorded 179.24×109/L and 230.47×109/L (P<0.05). Socio-demographic factors such as level of education, occupation and marital status did not significantly influence malaria prevalence. Interpretation: Low PCV and Hb in malaria patients indicate mild anaemia due to malaria-related haemolysis. The occurrence of thrombocytopenia may be due to other underlying pathology as further studies with larger sample size are needed to ascertain the cause of low platelet counts in malaria patients in the study area.


2020 ◽  
Author(s):  
Yayun Yang ◽  
Zhe Zhu ◽  
Lingyan Fan ◽  
Shuyuan Ye ◽  
Kehong Lou ◽  
...  

Abstract Background: Recently, dyslipidaemia was observed in patients with coronavirus disease 2019 (COVID-19), especially in severe cases. This study aimed to explore the predictive value of blood lipid levels for COVID-19 severity.Methods: All patients with COVID-19 admitted to HwaMei Hospital, University of Chinese Academy of Sciences, from January 23 to April 20, 2020, were included in this retrospective study. General clinical characteristics and laboratory data (including blood lipid parameters) were obtained, and their predictive values for the severity were analysed.Results: In total, 142 consecutive patients with COVID-19 were included. The non-severe group included 125 cases, and 17 cases were included in the severe group. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein A1 (ApoA1) at baseline were significantly lower in the severe group. ApoA1 and interleukin-6 (IL-6) were recognized as independent risk factors for COVID-19 severity. ApoA1 had the highest area under the receiver operator characteristic curve (AUC) among all the single markers (AUC: 0.896, 95% CI: 0.834-0.941). Moreover, the risk model established using ApoA1 and IL-6 enhanced the predictive value (AUC: 0.977, 95% CI: 0.932-0.995). On the other hand, ApoA1 levels were elevated in the severe group during treatment, and there was no significant difference between the severe and non-severe groups during the recovery stage of the disease.Conclusion: The blood lipid profile in severe COVID-19 patients is quite different from that in non-severe cases. Serum ApoA1 could severe as a good indictor to reflect the severity of COVID-19.


2018 ◽  
Vol 5 (4) ◽  
pp. 974
Author(s):  
Vijeth S. B. ◽  
Mohamed Murtuza Kauser ◽  
Vijayalaxmi Mangasuli ◽  
Vagesh Kumar S. R. ◽  
Suba Sree ◽  
...  

Background: Dengue is a global public health problem and thrombocytopenia associated with it is a serious complication for which there is no specific treatment available. This study was done to assess the effect of Carica papaya Leaf Extract (CPLE) on thrombocytopenia associated with Dengue and to study other clinical parameters of dengue.Methods: A longitudinal study conducted in Department of General Medicine, BMCH, Chitradurga, from September 2017 to March 2018. All the participants were randomized into two groups by simple randomization by lot method. Study group was given Carica papaya Leaf Extract (CPLE) and routine supportive treatment for other group. The patients were followed from the day of admission till their discharge from hospital. The platelet counts and other baseline hematological investigations, duration of hospital stay in both the groups were compared statistically by unpaired t-test.Results: There were total 127 males and 73 females. Age groups were comparable in both the groups. Most common presenting complaints were fever (100%) followed by headache (85%), myalgia (81.4%), fatigue (75%), arthralgia (65%). On admission baseline investigations were done and mean levels of both groups were compared. It was found that there was only significant difference of mean RBC levels (p=0.045). When followed up with daily platelet counts of both the groups, it was seen that there was increase in platelet counts in study group compared to placebo group and on third day there was significant difference between both (p=0.002). It was also found that discharge rate is earlier in study group than placebo group.Conclusions: Carica papaya leaf extract accelerates the increase in platelet count and reduces the hospital stay. So, it can be used as supplementary drug to reduce complications.


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