Abnormalities of Peripheral Blood Parameters in Hospitalized Patients with COVID-19: A Temporal Change Analysis in Relation to Survival

Abnormalities of peripheral blood parameters in hospitalized patients with COVID-19: A temporal change analysis in relation to survival. Sea. 2021;5(3):391-400. ABSTRACT Aim: This study aimed to investigate the abnormalities and temporal changes in peripheral blood parameters, with particular emphasis on platelet indices, in relation to survival status among hospitalized COVID-19 patients. Material and Methods: A total of 149 patients hospitalized with the diagnosis of COVID-19 were included. Laboratory parameters were recorded on initial admission, 3 rd , 7 th and last day of hospitalization, and post-discharge first month and included hemoglobin (Hb, g/dL), hematocrit (%), white blood cell (WBC) (x109/L), platelet (cells/mm 3 ) and lymphocyte counts (cells/μL), mean platelet volume (MPV, fL), platelet distribution width (PDW, %), plateletcrit (PCT,%) and platelet-to-lymphocyte ratio ( PLR), and analysed. Results: Overall, 139 (93.9%) patients survived. Survivors vs. non-survivors had significantly higher median levels for Hb at initial admission (13.3 vs. 12.2 g/dL, p=0.023), 3 rd day (12.6 vs. 11.7 g/dL, p=0.033) and 7 th day of hospitalization (12.5 vs. 9.8 g/dL, p=0.014) and for lymphocyte counts at initial admission (1200 vs. 800 cells/μL, p=0.014) and 3 rd day (1400 vs. 1200 cells/μL, p=0.043) of hospitalization. They also had significantly lower WBC counts at initial admission (5800 vs. 7900 x109/L, p=0.014), 3 rd day (5400 vs. 6047 x109/L, p=0.007) and 7 th day (6100 vs. 8400 x109/L, p=0.040) and last day (6200 vs. 17700 x109/L, p=0.018) of hospitalization and lower PLR at initial admission (165 vs. 294.5, p=0.002) and 3 rd hospitalization day (150 vs. 223, p=0.003). Conclusion: In conclusion, our findings emphasize clinical significance of dynamic monitoring of peripheral blood parameters, as combined with PLR, in assisting clinicians to identify COVID-19 patients with increased risk of worse outcomes.