Identification of hematological and inflammatory parameters associated with disease severity in hospitalized patients of COVID-19

BACKGROUND AND OBJECTIVES: India has emerged as the second worst hit nation by the Coronavirus pandemic in terms of total number of cases. Our data on hematological and inflammatory markers associated with COVID-19 is very limited. This study was conducted to assess the utility of various biomarkers in identifying severe disease. MATERIALS AND METHODS: All confirmed cases of COVID-19 admitted in our tertiary care centre from 1(st) March 2021 to 31(st) March 2021 were enrolled in the study. They were categorized into severe and non-severe disease categories based on pre-decided criteria. Their complete blood count parameters, D-dimer levels, serum C-reactive protein (CRP), ferritin and Lactate dehydrogenase (LDH) values were retrieved. STATISTICAL ANALYSIS: All parameters were expressed as Mean ± Standard deviation for the two groups of patients. Student's t-test was used to test significance of the above markers between severe and non- severe disease. (P value < 0.05 was taken as statistically significant). RESULTS: A total of 150 COVID RT-PCR positive patients were evaluated. The patients with higher Absolute Neutrophil Count (ANC), Neutrophil to lymphocyte Ratio (NLR), Platelet to lymphocyte ratio (PLR), D-dimer levels and raised serum CRP, LDH, ferritin along with lymphocytopenia were associated with severe disease (P < 0.05). Hemoglobin, total leucocyte count and platelet count showed no correlation with disease severity. CONCLUSION: These biomarkers associated with disease severity especially NLR, PLR, D-dimer and serum CRP levels could be used to triage patients at the time of admission thereby identifying those requiring intensive care and enabling optimal resource utilization.