The Evaluation of Hematological Parameters and Their Correlation with Disease Prognosis in COVID-19 Disease in Iran

Farhad Shahi; Reza Safaee; Saba Fekrvand; Fatemeh Fathi; Mohammad Reza Dabir; Alireza Abdollahi; Hanieh Hosseini

doi:10.18502/ijhoscr.v17i2.12645

Farhad Shahi Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
Reza Safaee Department of Medical Oncology, Tehran University of Medical Sciences, Tehran, Iran
Saba Fekrvand Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
Fatemeh Fathi Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
Mohammad Reza Dabir Department of Medical Oncology, Tehran University of Medical Sciences, Tehran, Iran
Alireza Abdollahi Department of Pathology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Hanieh Hosseini Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijhoscr.v17i2.12645

Keywords: COVID-19; Hematological parameters; Disease prognosis; Final outcome; ICU admission

Abstract

Background: Since 2019, Coronavirus has been a highly contagious disease. The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020. Variable laboratory findings are reported in COVID-19 patients, among which elevated levels of D-dimer, lactate dehydrogenase, as well as lymphopenia, have been reported to be associated with increased severity of disease symptoms requiring ventilator support, intensive care unit admission, and mortality.

Materials and Methods: In the current study, inclusion criteria were: patient age above 18 years and hospitalization in the Imam Khomeini hospital with COVID-19 disease confirmed with nasopharyngeal swab polymerase chain reaction tests. Levels of white blood cells, neutrophils, lymphocytes, hemoglobin, platelets, D-dimer, C-reactive protein, LDH, and ferritin were measured and their correlation with the final patients’ outcome was evaluated.

Results: A total of 208 patients were included in the present study. Higher neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, and D-dimer were significantly related to O₂ dependency. Neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte and LDH were significantly related to higher rates of mortality. Higher Hb and lymphocyte count were significantly related to higher rates of survival.

Conclusion: Hematological parameters including neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, D-dimer, Hb, and lymphocyte count were significantly related to the prognosis of patients with COVID-19 disease. This could help decide which COVID-19 patients have priority for hospitalization and intensive medical care, particularly when the pandemic disease causes limitations in healthcare service.