Differences in neutrophil-to-lymphocyte, platelet-to-lymphocyte, and white blood cell-to-mean platelet volume ratios in pulmonary embolism patients with and without COVID-19

COVID-19 and pulmonary embolism are diseases that can have a fatal course. Thromboembolic complications are frequently observed after COVID-19. Pulmonary embolism patients treated as inpatients at Süleyman Demirel University Hospital were included, in our study. The patients were retrospectively reviewed through our hospital's data system. Our study included 61 COVID-19-positive and 63 COVID-19-negative patients of similar age range and gender. Data on age, gender, the date of embolism occurrence, treatment location (ward, intensive care unit [ICU], or ward-to-ICU transfer), comorbidities, risk factors (history of surgery, malignancy, history of fracture, history of immobilization, use of oral contraceptives, long-term travel etc.) were recorded. Additionally, information on the patients' history of COVID-19 infection, date of PCR positivity, pulmonary CT angiography, ventilation-perfusion scintigraphy, hemogram, CRP, d-Dimer, troponin levels, disease severity (massive, submassive, or non-massive), length of hospital stay, treatment applied, embolism extent, echocardiography findings (if available), lower extremity color Doppler ultrasound results, and survival status were analyzed. The average age of the patients was found to be 67.81±15.61 years (min: 21, max: 95). Of the cases, 53.2% (n=66) were female, and 46.8% (n=58) were male 50.8% (n=63) of the cases were PCR-negative, while 49.2% (n=61) were PCR-positive. When patients were examined according to their treatment locations, the rate of ICU treatment was significantly higher in patients who had COVID-19 (p=0.030). When comorbidities were analyzed separately in our study, cardiovascular diseases (CVD) were found to be significantly higher in both groups (p=0.017). The d-Dimer level was found to be 5167 ± 699 ng/mL in patients with a history of COVID-19 and 3026 ± 274 ng/mL in those without a history of COVID-19. d-Dimer levels were significantly higher in patients with a history of COVID-19 (p<0.001). The PLR value in patients with a history of COVID-19 was significantly lower compared to those without (p=0.045). In the group with echocardiographic findings supporting embolism, NLR was statistically significantly higher (p=0.003). In cases where thrombosis was detected in RDUS, NLR and PLR results were significantly higher (NLR p=0.045; PLR p<0.001). The rate of ICU follow-up due to pulmonary embolism was found to be significantly higher in patients with a history of COVID-19 (p=0.030). It can be stated that pulmonary embolism developing after COVID-19 has a more severe course. Embolism prophylaxis should be initiated in all high-risk patients hospitalized due to COVID-19.