Hematologic Profiles and Correlation Between Absolute Lymphocyte Count and Neutrophil/Lymphocyte Ratio with Markers of Inflammation of COVID-19 in an Indonesian National Referral Hospital

Abstract

INTRODUCTION: COVID-19 is a pandemic with significant mortality and it is important to differentiate severe and non-severe cases. We conducted a study to evaluate hematologic profiles with inflammation markers in COVID-19 patients and to determine the correlation of neutrophil-lymphocyte ratio (NLR) with disease severity. METHODS: A cross-sectional study involving hospitalized COVID-19 patients confirmed with a positive SARS-CoV-2 PCR test in Dr. Cipto Mangunkusumo Hospital. Lymphocyte count, NLR, C-reactive protein (CRP) and ferritin were evaluated in severe and non-severe COVID-19 cases at hospital admission. Data was analyzed using Spearman correlation. RESULTS: There were 41 patients aged 20 to 79 years with COVID-19; 33 (80.5%) were non-severe, and 8 (19.5%) were severe cases. There is a statistically significant difference in WBC, relative neutrophils and lymphocytes, NLR, and CRP between non-severe and severe cases. There is a strong correlation between NLR and CRP (r = 0.738; p < 0.001). Our findings show that NLR and absolute lymphocyte count, but not ferritin, play a role in differentiating between non-severe and severe COVID-19 cases. CONCLUSION: In COVID-19 cases, a strong correlation between NLR and CRP might suggest the use of NLR to differentiate between non-severe and severe cases, especially in a remote healthcare facility.