Eosinophil Levels, Neutrophil-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio in the Cytokine Storm Period of Patients with COVID-19

BACKGROUND: In the early stages of the COVID-19 pandemic, elevated inflammatory cytokine levels, particularly interleukin-6 (IL-6), were detected in patients with cytokine storm (CS). AIMS: This study aimed to investigate levels, diagnostic usefulness, and optimal cutoff values of monocyte, eosinophil, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in CS of patients with COVID-19 and also to identify risk factors for mortality. METHODS: Seventy-six patients with COVID-19 who developed CS and randomly chosen 150 COVID-19 patients who had no CS during their stay in the hospital were included in the study. RESULTS: Lymphocytes and eosinophil levels remained lower in the CS group. Patients with low lymphocyte levels had a higher risk for mortality (OR: 1.92). Neutrophil, D-dimer, ferritin, IL-6, NLR, and PLR were higher in the CS group. High levels of neutrophil, ferritin, D-dimer, and NLR and a history of coronary artery disease (CAD) and diabetes mellitus (DM) were identified as independent risk factors for mortality. CONCLUSION: In the light of the obtained results, COVID-19 patients with a decrease in lymphocyte levels and an increase in NLR and D-dimer levels and a history of CAD and DM have a higher risk of cytokine storm and mortality.