Abstract:

Objective: Severe inflammatory response of the immune system has a serious role in the progression of Coronavirus disease 2019 (COVID-19). The clinical benefits of early diagnosis of immune activation of COVID-19 have been emphasized repeatedly in the trials to this date. In this study, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), derived neutrophil-to-lymphocyte ratio (d-NLR), lymphocyte-to-C reactive protein ratio (LCR), leukocyte-to-C reactive protein ratio (LeCR), neutrophil-to-monocyte ratio (NMR) biomarkers were evaluated for predicting clinical course of COVID-19. Materials and Methods: In this retrospective cohort study, 383 laboratory-confirmed COVID-19 cases, who had been hospitalized in a tertiary care hospital between April and November 2020, were included. Patients, including 279 mild and 104 severe cases, were sequentially selected. Blood tests, conducted at the time of admission, were examined. Data was analyzed and ROC analysis was performed by using SPSS 22.0 program. Results: 44.3% of the patients included in the study were female, 99.2% of the patients had viral pneumonia, 27.2% met clinical criteria for severe disease and median age was 58 years. Age, duration of hospitalization, white blood cell count, neutrophil count, ferritin, CRP, procalcitonin, D-dimer, troponin levels were higher and lymphocyte, monocyte counts were lower in the group with clinically severe disease. The diagnostic sensitivities of LCR, CRP, d-NLR, NLR, LeCR were found to be high (AUC> 0.8) for the prediction of clinical severity with cut-off values of 15, 74.65, 2.55, 4, 133 respectively. Conclusion: High CRP, d-NLR, NLR and low LCR, LeCR are early predictors of the clinical severity, these patients should be under hospital follow-up for close monitoring and early intervention.