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    Hematological and biochemical parameters as diagnostic and prognosticmarkers in SARS-COV-2 infected patients of Pakistan: A retrospective comparative analysis
    (Taylor & Francis Ltd, 2021) Khalid, Atiqa; Jaffar, Muhammad Ali; Khan, Tabinda; Lail, Raees Abbas; Ali, Sana; Aktaş, Gülali
    Objectives:This study was conducted to investigate alteration in blood parameters and theirassociation with the presence, severity, and mortality of COVID-19 patients as the data onhematological abnormalities associated with the Pakistani COVID-19 patients is limited.Methodology:A double-centered, hospital-based comparative retrospective case study wasconducted, to include all the admitted patients (n= 317) having COVID-19 Polymerase chainreaction (PCR) positive. The control group (n= 157) tested negative for COVID-19.Results:Of 317 admitted cases, the majority were malesn= 198 (62.5%). Associatedcomorbidities, lower lymphocytes, platelets, and higher White blood cells, neutrophil,neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were found inCOVID-19 cases as compared to healthy controls (p< 0.001 for all). The biochemicalparameters of cases including Ferritin, D-Dimer, CRP, IL-6, LDH, ALT, AST, and APTT alsoshowed a statistically significant difference compared with standard values (p< 0.001 forall). However, their comparison with a severity level of the severe and non-severe groupsshowed significance for WBCs, neutrophils, NLR (p< 0.001 for all), and PLR (p= 0.06) only.Receiver operating characteristic curve analysis showed that NLR had the highest area undercurve (0.84) followed by 1/lymphocyte (0.82), neutrophils (0.74), PLR (0.67),1/platelets (0.68)and WBC’s (0.65). Comparison of cases and controls with recommended cut-offvaluesderived from sensitivity and 1-specificity was also done (p< 0.001).Conclusion:Monitoring all the hematological and biochemical parameters including novelhemograms NLR, PLR can aid clinicians to identify potentially severe cases at early stagesand initiate effective management in time which may reduce the overall mortality of COVID-19 patients.Abbreviations: ALT, Alanine Aminotransferase; APTT, Activated Partial Thromboplastin Time;AST, Aspartate Aminotransferase; CBCs, complete blood counts; COVID-19, coronavirusdisease 2019; CRP, C-Reactive Protein; GRA, granulocytes; HGB, hemoglobin; LDH, Lactatedehydrogenase; Lymph, lymphocyte; MLR, Monocyte to Lymphocyte ratio.; NLR, Neutrophilto Lymphocyte ratio; PLR, Platelet to lymphocyte ratio; PLTs, platelets count; PT,Prothrombin time; RBCs, red blood cells; SARS-CoV-2, Severe acute respiratory syndromecoronavirus 2; WBCs, white blood cells