DOI: http://dx.doi.org/10.18203/2349-3933.ijam20212770

Study to determine the correlation of platelet-lymphocyte ratio in COVID 19 positive and negative severe acute respiratory infections cases

Kavya S. T., Akash G. Nair, Sanjay Kumar H. R., Siddesh N.

Abstract


Background: Severity of COVID 19 disease is related to the systemic inflammatory response triggered by the respiratory virus. Hematological alterations triggered by inflammation can be used as a marker to predict the severity of COVID 19 infection.

Methods: 155 patients of severe acute respiratory infections (SARI) defined by World Health Organization (WHO) criteria of which 65 were COVID positive and 90 COVID negative were taken for the study. Demographic profile of the population and platelet count, lymphocyte count and platelet lymphocyte ratio was compared between COVID 19 positive and negative SARI cases using appropriate descriptive statistics. Correlation analysis done for the same parameters between severe and moderate COVID 19 SARI cases.

Results: Median platelet count in COVID positive group (2.47 L) was lower than that of COVID negative group (2.65 L) and was not statistically significant between 2 groups. Median lymphocyte count in COVID positive group (651) was lower compared to the negative group (1250) and difference was statistically significant. PLR in COVID positive group was higher (353) than COVID negative group (198) and was statistically significant (p value 0.00). PLR was higher in severe COVID disease compare to moderate disease but difference was not statistically significant. No significant correlation was found in platelet count, lymphocyte count in moderate and severe COVID positive SARI cases.

Conclusions: Lower lymphocyte counts was observed in SARI caused by COVID 19 infection than other causes of SARI. No significant correlation was found in platelet count between COVID positive and negative SARI cases. PLR was significantly higher in COVID positive SARI cases as compared to COVID negative SARI cases. Platelet lymphocyte ratio (PLR) was higher in severe COVID disease when compared to moderate disease but levels did not reach statistical significance.


Keywords


Platelet-lymphocyte ratio, COVID 19, Severe acute respiratory infections

Full Text:

PDF

References


Gong J, Dong H, Xia SQ, Huang YZ, Wang D, Zhao Y, et al. Correlation analysis between disease severity and inflammation-related parameters in patients with COVID-19 pneumonia. MedRxiv. 2020.

Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, Deng G. Association of inflammatory markers with the severity of COVID-19: a meta-analysis. Int J Infect Dis. 2020;96:467-74.

Scapini P, Cassatella MA. Social networking of human neutrophils within the immune system. Blood. 2014;124(5):710-9.

Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008;75(3):291-4.

Rayes J, Bourne JH, Brill A, Watson SP. The dual role of platelet‐innate immune cell interactions in thrombo‐inflammation. Res Pract Thrombosis Haemostasis. 2020;4(1):23-35.

Fu H, Qin B, Hu Z, Ma N, Yang M, Wei T, et al. Neutrophil-and platelet-to-lymphocyte ratios are correlated with disease activity in rheumatoid arthritis. Clin Lab. 2015;61(3-4):269-73.

Zeb A, Khurshid S, Bano S, Rasheed U, Zammurrad S, Khan MS, et al. The role of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as markers of disease activity in ankylosing spondylitis. Cureus. 2019;11(10).

Hao X, Li D, Wu D, Zhang N. The relationship between hematological indices and autoimmune rheumatic diseases (ARDs), a meta-analysis. Sci Rep. 2017;7(1):1-9.

Zheng J, Cai J, Li H, Zeng K, He L, Fu H, et al. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as prognostic predictors for hepatocellular carcinoma patients with various treatments: a meta-analysis and systematic review. Cell Physiol Biochem. 2017;44(3):967-81.

World Health Organization. Clinical management: living guidance. 2021. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1. Accessed on 25 January 2021.

Mattiuzzi C, Lippi G. Which lessons shall we learn from the 2019 novel coronavirus outbreak. Ann Transl Med. 2020;8:48.

Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1334-49.

Reiss LK, Schuppert A, Uhlig S. Inflammatory processes during acute respiratory distress syndrome: a complex system. Curr Opin Crit Care. 2018;24(1):1-9.

Qu R, Ling Y, Zhang YH, Wei LY, Chen X, Li XM, et al. Platelet‐to‐lymphocyte ratio is associated with prognosis in patients with coronavirus disease‐19. J Med Virol. 2020;92(9):1533-41.

Chan AS, Rout A. Use of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in COVID-19. J Clin Med Res. 2020;12(7):448.