Characteristics of peripheral blood differential counts in hospitalized patients with COVID-19

Eur J Haematol. 2020 Dec;105(6):773-778. doi: 10.1111/ejh.13509. Epub 2020 Sep 20.

Abstract

Background: A lot remains unknown about the features and laboratory findings that may predict worse outcomes in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the difference in complete blood count parameters and differential counts in patients hospitalized with COVID-19 who survived compared to those who died.

Design: We performed a single-center retrospective study including 242 patients with confirmed COVID-19. We described the characteristics of the complete blood count parameters in these patients. Mann-Whitney U test was used to compare hematologic parameters of patients who died and those who survived; multivariate logistic regression was used to look for associations with mortality.

Results: Patients with COVID-19 who died had significantly lower median absolute monocyte count (AMC) (0.4 vs 0.5, P = .039) and median platelet count (169 vs 213, P = .009) compared to those who survived. Patients who died had a significantly higher neutrophil-to-lymphocyte ratio (6.4 vs 4.5, P = .001). The NLR was positively associated with death (OR = 1.038; 95% CI, 1.003-1.074, P = .031), while AMC was inversely associated with death (OR = 0.200; 95% CI, 0.052-0.761, P = .018).

Conclusion: Among patients with COVID-19, a lower AMC and higher NLR are associated with higher mortality.

Keywords: COVID-19; lymphopenia; monocytes; novel coronavirus.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Betacoronavirus / pathogenicity*
  • Blood Cell Count
  • Blood Platelets / pathology*
  • Blood Platelets / virology
  • COVID-19
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / pathology
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Lymphocytes / pathology*
  • Lymphocytes / virology
  • Male
  • Middle Aged
  • Neutrophils / pathology*
  • Neutrophils / virology
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • Survival Analysis