Association of hematological and biochemical parameters with clinical profile of COVID-19 patients in Visakhapatnam, India

Abstract

Background: The cytokine cascade in COVID-19 is responsible for its clinical manifestations. Timely management of patients with dismal prognosis may improve their clinical outcome. The study aimed to analyze the hematological and biochemical parameters among COVID-19 patients and the factors associated with laboratory changes and COVID-19 infection. Materials and Methods: A retrospective, cross-sectional study was conducted in a designated district COVID hospital. COVID-19 patient’s medical records were converted into an electronic database which included demographic data, recent exposure history, existing co-morbidities, symptoms, and laboratory findings. Results: Out of the 1340 patients, 69.25% were males. Symptomatics accounted for 57.61%. The common co-morbidities among infected patients were diabetes mellitus (13.88%), hypertension (15%), and chronic obstructive pulmonary disease/asthma (2.16%), which had a significant positive correlation with COVID-19. The common symptoms were fever (50.39%), dry cough (46.24%), dyspnea (30.7%), and myalgia (28.5%). Leucocytosis, neutrophilia, lymphopenia, and thrombocytopenia were reported in 5.22%, 11.34%, 27.16%, and 3.41% of patients, respectively. Elevated aspartate aminotransferase, alanine aminotransferase, hypoalbuminemia, and hyperglobulinemia were observed in 13.88%, 19.4%, 24.77%, and 10% of patients, respectively. Symptomatics had significantly higher values for neutrophil percentage, neutrophil–lymphocyte ratio (NLR), derived NLR, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, lymphocyte–leucocyte ratio, systemic immune-inflammatory index, blood urea, and indirect bilirubin levels and significantly lower values for lymphocyte percentage, absolute lymphocyte count, and serum albumin. The logistic regression analysis revealed a significant association of deranged laboratory parameters among symptomatic COVID-19 patients and those with pre-existing co-morbidities. Conclusion: Neutrophilia, lymphopenia, and deranged liver function tests were significantly present in COVID-19 patients. The inflammation in COVID-19 is exhibited as remarkable hematological and laboratory changes whose careful interpretation can offer a clinical window for risk stratification and appropriate therapeutic interventions.