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Prognostic biomarkers in COVID-19 infection: value of anemia, neutrophil-tolymphocyte ratio, platelet-to-lymphocyte ratio, and D-dimer

Research Authors
Maiada K. Hashem , Eman M. Khedr, Enas Daef, Aliae Mohamed-Hussein, Ehab F. Mostafa, Sahar M. Hassany, Hanan Galal, Shimaa Abbas Hassan, Islam Galal, Mariam Taher Amin and Hebatallah M. Hassan
Research Date
Research Department
Research Journal
The Egyptian Journal of Bronchology
Research Publisher
Springer Nature
Research Website
https://www.readcube.com/articles/10.1186/s43168-021-00075-w
Research Year
2021
Research_Pages
9
Research Abstract

Abstract
Background: Being highly infectious disease, COVID-19 exhausts most of efficient healthcare systems worldwide.
Simple and rapid risk stratification methods are mandatory to recognize severe patients. This study aims to
highlight the simple available laboratory biomarkers of good predictive value for COVID-19 severity.
Results: Three hundred fifty-one COVID-19 positive patients admitted to two University Hospitals between the 1st
of June and the 31st of July 2020 were retrospectively collected and classified to severe and non-severe COVID-19
patients according to need for ICU admission. All basic laboratory biomarkers at time of admission were recorded.
Of included patients, 145 (41.3%) needed ICU admission. Anemia, leukocytosis, lymphopenia, NLR, and PLR together
with liver enzymes, INR, ferritin, CRP, and D-dimer were significantly higher in patients needed ICU admission
(p < 0.001). However, by applying multivariate logistic regression, only anemia, high NLR, high PLR, and high Ddimer
levels showed significant risk for ICU admission with OR equal 3.6 (95% CI 1.8–7.0), 9.0 (95% CI 3.6–22.6), 3.0
(95% CI 1.3–7.1), and 2.5 (95% CI 1.3–4.7), respectively.
Conclusion: Anemia, increased neutrophil-to-lymphocyte ratio (> 8), platelet-to-lymphocyte ratio (> 192), and Ddimer
level (> 0.9 mg\L) at time of admission could be simple available predictors for severe COVID-19 infection
requiring ICU admission.
Keywords: COVID-19, SARS-CoV-2, Severity, ICU admission, Neutrophil-to-lymphocyte ratio, NLR, Platelets-tolymphocyte
ratio, PLR, Anemia, D-dimer