Association of Neutrophilia with Disease Severity in Patients with COVID-19

Aiman Mahmood Minhas, Nimrah Ishaque, Ayisha Imran, Nauman Aslam Malik, Akhtar Sohail Chughtai
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Abstract

COVID-19 has become a global pandemic with limited data on prediction of disease severity and management of critically-ill patients. Objective: To assess associations between routine Haematologica parameters especially neutrophil counts and severity in COVID-19 patients. Methods: The study was a cross-sectional study involving 133 non-severe and 120 severe category patients. This study was conducted at Chughtai Institute of Pathology from 1st June till 31st August, 2020. The association of severity with parameters was determined using Chi-square and Fisher´s Exact test. Results: Absolute Neutrophil Count (ANC) and NLR were significantly higher in Severe Group category. Neutrophilia and raised NLR were observed in 81.7% and 93% of the severe group respectively. Lymphopenia was observed in only 36.7% of Severe Group. Comorbidities such as, hypertension (82,1%), diabetes (85.5%), IHD (100%) and COPD (83.9%) had significantly high frequency of increased NLR. Also, clinical symptoms like fever (77.9%), cough (80.9%), shortness of breath (94.3%) and abdominal symptoms (88.2%) also had same significant association. Conclusions: It was observed that high NLR ≥ 3 was associated with severe disease along with high ANC. However, lymphopenia as expected, was not observed in significant population. Instead, neutrophilia was a more consistent finding in the concerned group.
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COVID-19患者中性粒细胞增多与疾病严重程度的关系
COVID-19已成为全球大流行,但在疾病严重程度预测和危重患者管理方面的数据有限。目的:探讨新冠肺炎患者常规血液学参数尤其是中性粒细胞计数与病情严重程度的关系。方法:采用横断面研究方法,纳入133例非重症患者和120例重症患者。本研究于2020年6月1日至8月31日在中台病理研究所进行。使用卡方检验和Fisher精确检验确定严重程度与参数的关系。结果:重症组绝对中性粒细胞计数(ANC)和NLR明显增高。重度组中性粒细胞增多率为81.7%,NLR升高率为93%。重度组淋巴细胞减少率仅为36.7%。合并症如高血压(82.1%)、糖尿病(85.5%)、IHD(100%)和COPD(83.9%)的NLR升高频率较高。临床症状如发热(77.9%)、咳嗽(80.9%)、呼吸短促(94.3%)和腹部症状(88.2%)也有同样显著的相关性。结论:观察到高NLR≥3与严重疾病以及高ANC相关。然而,正如预期的那样,在显著人群中没有观察到淋巴细胞减少。相反,中性粒细胞在相关人群中是一个更一致的发现。
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