Shaimaa Hani Fouad1, Mohamed Farouk Allam2, Sara Ibrahim Taha3, Ahmed Ashraf Okba4, Amr Hosny5, Mayada Moneer1, Sylvia Wefky Roman1. 1. Departments of Internal Medicine and Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 3. Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 4. Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 5. Department of Anesthesiology and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
BACKGROUND: Anemia can negatively affect the outcome of many diseases, including infections and inflammatory conditions. AIM: To compare the prognostic value of hemoglobin level and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease 2019 (COVID-19) severity. METHODS: In this retrospective cohort study, clinical data from patients with laboratory-confirmed COVID-19 were collected from hospital records from 10 April 2020 to 30 July 2020. RESULTS: The proportions of patients with mild, moderate, and severe COVID-19 differed significantly in association with hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total leukocyte counts. Patients with severe COVID-19 had significantly lower hemoglobin levels than those with moderate or mild COVID-19. There were statistically significant negative associations between hemoglobin and D-dimer, age, and creatinine. The optimal hemoglobin cut-off value for prediction of disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher negative predictive value and sensitivity than NLR (92.4% and 51.3%, respectively). The specificity of hemoglobin as a prognostic marker was 79.3%. CONCLUSION: Both NLR and hemoglobin level are of prognostic value for predicting severity of COVID-19. However, hemoglobin level displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon admission in all patients and closely monitored throughout the disease course.
BACKGROUND:Anemia can negatively affect the outcome of many diseases, including infections and inflammatory conditions. AIM: To compare the prognostic value of hemoglobin level and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease 2019 (COVID-19) severity. METHODS: In this retrospective cohort study, clinical data from patients with laboratory-confirmed COVID-19 were collected from hospital records from 10 April 2020 to 30 July 2020. RESULTS: The proportions of patients with mild, moderate, and severe COVID-19 differed significantly in association with hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total leukocyte counts. Patients with severe COVID-19 had significantly lower hemoglobin levels than those with moderate or mild COVID-19. There were statistically significant negative associations between hemoglobin and D-dimer, age, and creatinine. The optimal hemoglobin cut-off value for prediction of disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher negative predictive value and sensitivity than NLR (92.4% and 51.3%, respectively). The specificity of hemoglobin as a prognostic marker was 79.3%. CONCLUSION: Both NLR and hemoglobin level are of prognostic value for predicting severity of COVID-19. However, hemoglobin level displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon admission in all patients and closely monitored throughout the disease course.
Authors: Jordi Mayneris-Perxachs; Maria Francesca Russo; Rafel Ramos; Ana de Hollanda; Arola Armengou Arxé; Matteo Rottoli; María Arnoriaga-Rodríguez; Marc Comas-Cufí; Michele Bartoletti; Ornella Verrastro; Carlota Gudiol; Ester Fages; Marga Giménez; Ariadna de Genover Gil; Paolo Bernante; Francisco Tinahones; Jordi Carratalà; Uberto Pagotto; Ildefonso Hernández-Aguado; Fernando Fernández-Aranda; Fernanda Meira; Antoni Castro Guardiola; Geltrude Mingrone; José Manuel Fernández-Real Journal: Front Endocrinol (Lausanne) Date: 2021-11-02 Impact factor: 5.555