Abstract

Acute respiratory distress syndrome (ARDS) and multiorgan dysfunction that results in death are significant in COVID-19 infection, with a greater mortality risk in elderly people with comorbidities. Along with inflammatory markers (like C-reactive protein, Pro-calcitonin, Lactate-dehydrogenase, Ferritin, D-Dimer, Interleukin-6), neutrophil-lymphocyte ratio(NLR), platelet-lymphocyte ratio(PLR), and absolute-lymphocyte count(ALC) are new adjuncts in COVID-19 management.
STUDY DESIGN: Retrospective cross-sectional study at a tertiary care hospital of Indore.
METHOD:
The study included patients in third-wave who tested positive (RT-PCR/RAT) for SARS-CoV2 and hospitalized with routine blood investigations like complete blood count and differential values of serum biochemical tests C-reactive protein, D-dimers, liver-function test, renal-function test and ABG were done at admission.
STATISTICAL ANALYSIS: chi square and fisher’s exact test.
RESULTS:
A value >= 4.94 for NLR and >=263 for PLR was suggestive of severe COVID-19 disease. While absolute-lymphocyte count (<= 1210 lymphocytes/mcl) was suggestive of severe COVID-19 disease along with D-Dimer value of >0.6 ngFEU/l and C-reactive protein of > 16.6 mg/l.
CONCLUSION:
As COVID-19 pneumonia is secondary to inflammation, we showed that a more severe inflammation, as evaluated through inflammatory markers, correlates with more severe disease via different grading scores/systems (ARDS Grading, APACHE-2 Scoring, Covid-19 infection severity and Final outcome). Higher levels in NLR, PLR, CRP and D-Dimer while lower absolute-lymphocytes count should prompt the clinician to proceed aggressively in management of Covid-19 patients.