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

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.