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. 2020 Aug:507:174-180.
doi: 10.1016/j.cca.2020.04.024. Epub 2020 Apr 24.

Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China

Suyu Sun  1 , Xuejiao Cai  2 , Huaguo Wang  3 , Guiqing He  4 , Yin Lin  5 , Bibi Lu  5 , Chaoyue Chen  5 , Yong Pan  6 , Xingzhong Hu  7
Affiliations

Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China

Suyu Sun et al. Clin Chim Acta. 2020 Aug.

Abstract

Background: In December 2019, coronavirus disease 2019 (COVID-19) was first found in Wuhan, China and soon was reported all around the world.

Methods: All confirmed cases with COVID-19 in Wenzhou from January 19 to February 20, 2020, were collected and analyzed. Of the 116 patients with COVID-19, 27 were diagnosed as severe cases. Among severe cases, 9 were treated in ICU. The data of blood routine examination were analyzed and compared among common patients (as common group), severe patients admitted to intensive care unit (as severe ICU group) and severe patients not admitted to ICU (as severe non-ICU group). The blood routine examination results were dynamically observed in the above groups after admission.

Results: Patients with COVID-19 have lower counts of leucocytes, lymphocytes, eosinophils, platelets, and hemoglobin, but have higher neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), which were compared with controls (P < 0.001). In severe ICU group, patients have the lowest count of lymphocytes, but the highest neutrophil count and NLR among the above three groups (all P values < 0.05); NLR and MLR indicators were combined for diagnostic efficacy analysis of severe COVID-19, and its area under the curve reached 0.925. The odds ratio of the delay in days to the start of the increase of eosinophil count for predicting the outcome of patients with severe COVID-19 was 2.291 after age adjusted.

Conclusions: Patients with COVID-19 have abnormal peripheral blood routine examination results. Dynamic surveillance of peripheral blood system especially eosinophils is helpful in the prediction of severe COVID-19 cases.

Keywords: COVID-19; Eosinophils; Lymphocyte; Neutrophil-Lymphocyte ratio; Peripheral blood.

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Figures

Fig. 1
Fig. 1
The ROC curves of various parameters of blood routine in the diagnosis of severe COVID-19 on admission. NLR: Neutrophils-to-lymphocytes ratio; MLR: Monocyte-to- lymphocytes ratio; PLR: Platelet-to-lymphocytes ratio; MLR + NLR: the integration parameters of MLR and NLR; COVID-19 = coronavirus disease 2019.
Fig. 2
Fig. 2
Changes in peripheral blood routine parameters in three groups of COVID-19 after admission to hospital. The time is used as the abscissa, and the median values of the blood routine parameters of each group are plotted as the ordinate. Severe ICU group: severe patients admitted to intensive care unit (ICU); Severe non-ICU group: severe patients not admitted to intensive care unit (ICU); Common group: Common cases; COVID-19 = coronavirus disease 2019.
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