Assessment Of Severity Of Covid-19 Vs D-Nlr And Rdw, Plr: A Retrospective Study Of Our Centre.

Background: We know turnaround time for the complete blood count is much faster than that of various inflammatory markers like LDH, CRP, interleukins like IL-6, D-dimer. Thus using cell counts as a marker of severity and the prognosis is need of the hour. This will reduce the burden of the health care facilities. Complete blood count including the variation in RBC, WBC and platelets changes has been thoroughly studied. Various retrospective studies have shown that the absolute lymphocyte count can be taken as a marker of severity in COVID 19 patients. In December 2019, several cases of new corona virus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARSCoV-2) have been emerged from Wuhan, China, which was later declared as a global pandemic by World Health Organisation (WHO) on March 11th 2020. Aim: In our study, we analyse and assess the severity of Covid-19 Vs d-NLR and RDW, PLR at our centre. Method and materials: This is the retrospective observational study. We actually collected the data of 300 cases but out of 300 cases only 268 laboratory confirmed COVID-19 cases, Age, neutrophil to lymphocyte ratio (NLR), derived-NLR (d-NLR), platelet to lymphocyte ratio (PLR) and red cell distribution width (RDW) of 268 laboratory confirmed COVID-19 patients, at the time of admission, belonging to clinical category B and C were recorded and compared in this single-center, retrospective observational study. The receiver operating characteristic (ROC) curve was applied to determine the thresholds for bio-markers and their prognostic values were assessed. Results and Observations: A statistically significant elevated NLR (P=0.001), d-NLR ( P=0.001), PLR (P=0.001) and RDW (P=0.026) were noticed in Category C (severe) group when compared to Category B group. From the ROC curve, it was established that d-NLR, NLR and WBC count proved to be a fair distinguisher (area under the curve between 0.7- 0.8) in predicting the clinical severity in COVID-19 patients. NLR and WBC count was found to be having the highest sensitivity of 82%, while d-NLR proved to be highly specific. Elevated age was also significantly associated with illness severity (P=0.001). Conclusion: COVID-19 is giving rise to tremendous challenges in the entire world and over pressurised the health care system and as of yet, efforts have been devoted to artificial intelligence based analysis of HRCT and x-rays have been used to indicate severity in the patients of SARSCoV2. Elevated age, WBC count, NLR, d-NLR, RDW and PLR may be considered as useful prognostic biomarkers for predicting the severity of COVID-19 infection and adverse outcome, with NLR and WBC count showing the highest sensitivity and d-NLR with the highest specificity. [ABSTRACT FROM AUTHOR]