Retrospective analysis of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratios (MLR), eosinopenia frequency and factors affecting their course in patients diagnosed with COVİD-19

COVID-19, which started in Wuhan, China and is still ongoing, has a very wide clinical spectrum. Since it can progress very rapidly, the need for early diagnosis of severe disease has arisen, and fast and inexpensive markers have gained greater importance. Many markers are being studied in order to predict the severe disease at admission. The aim of this study is to investigate whether parameters such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (LMR), platelet-lymphocyte ratio (PLR), eosinophil-lymphocyte ratio (ELR), lymphocyte, eosinophil count, CRP, ferritin in patients with COVID-19 differ according to the need for intensive care and the severity of the disease. Patients over the age of 18 who were hospitalized in Gazi University Research and Practice Hospital between May 2020 and July 2020 due to COVID-19 PCR positivity and met the study criteria were included in this study. Study data were obtained from the medical records, and demographic characteristics and laboratory results were recorded. The need for intensive care and severe illness were chosen as endpoints. NLR at the time of diagnosis in COVID-19 disease was associated with severe illness and need for intensive care (p=0.003 and p<0.001). Elevated PLR and MLR were shown to be associated with severe disease (p<0.001 and p=0.003), but not with the need for intensive care (p=0.051 and p=0.133). Eosinopenia was associated with the need for intensive care (p=0.001) and was evaluated as an independent risk factor for the severe disease (OR=4.217; 95% CI=1.196-14.875; p=0.025). Low ELR was associated with both severe illness and need for intensive care (p<0.001 and p=0.004). In the course of the disease, there is a significant increase in platelet, fibrinogen, CRP and ferritin values in the first 7 days. Elevated CRP and ferritin at diagnosis have been shown to be independent risk factors for the need for intensive care (for CRP OR=15.71; 95% CI=1.93-127.57; p=0.01; for ferritin OR=12.8; % 95 CI=1.62-101.16; p=0.016). NLR, ELR, PLR and MLR obtained from routine hemogram values may be useful to predict severe disease. Eosinopenia was related to the need for intensive care and evaluated as an independent risk factor for the severe disease. Platelets, fibrinogen, CRP and ferritin can be used in the first 7 days of the disease course. CRP and ferritin at the time of diagnosis are independent risk factors for the need for intensive care. More studies are needed on the reliability of all these markers and the determination of appropriate threshold values.