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 1st March 2021 to 31st 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 Hest 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.