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Jan I, Eachkoti R, Farooq I, Farooq S, Saleem S, Majid S. D-NLR, and neutrophil count as early predictive biomarkers of disease severity and poor disease outcome in SARS-CoV-2 infected patients from Kashmir. mljgoums 2024; 18 (1) :4-8
URL: http://mlj.goums.ac.ir/article-1-1630-en.html
1- Department of Clinical Biochemistry University of Kashmir, Hazratbal, Srinagar, Kashmir, J&K India , ifrahreshi9@gmail.com
2- Department of Biochemistry Govt Medical College and associated hospitals, Karan Nagar, Srinagar, Kashmir, J&K India
Abstract:   (358 Views)
Background: The complete blood count (CBC) profile has been found extremely useful in monitoring the growth of SARS-CoV-2 infection; however, predictive CBC parameters that could be used in the management of the disease may vary in different populations.
Methods: This study comparatively analyzed the CBC profile of SARS-CoV-2 patients (N = 75; confirmed positive by real-time polymerase chain reaction [PCR]) and healthy individuals (confirmed negative by real-time PCR) from Kashmir (north India).
Results: Compared with healthy individuals, most of the CBC parameters (hemoglobin levels [13.43 vs 10.9 g/dL; P = 0.0001], lymphocytes [16.04% vs 30.8%; P = 0.00001], monocytes [5.53% vs 7.53%; P = 0.009], and platelet count [150 vs 186 ×103 µL; P = 0.037]) were significantly low in SARS-CoV-2 infected patients, while neutrophilia was more common in infected patients (76.77% vs 59.26%). Among derived parameters, the neutrophil-to-lymphocyte ratio (NLR; 7.31 vs 2.04; P = 0.001) and derived NLR (d-NLR; 4.43 vs 1.5; P = 0.0002) were significantly high in SARS-CoV-2 patients. Further correlation analysis revealed a significant association of neutrophilia with the severity of the disease in SARS-CoV-2 infected patients. Moreover, receiver operating characteristic (ROC) analysis of derived CBC parameters (NLR, d-NLR, and platelet‐to-lymphocyte ratio [PLR] with disease severity and disease outcome) revealed d-NLR as better predictive marker of disease severity (area under the curve [AUC] = 0.658) and disease outcome (AUC = 0.766) compared to PLR with disease severity (AUC = 0.645) and disease outcome (AUC = 0.693).
Conclusion: We therefore conclude, of the CBC parameters neutrophilia as the marker of disease severity and among derived parameters, d-NLR as an early predictive biomarker of both disease severity and poor disease outcome in SARS-CoV-2 patients.

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Research Article: Research Article | Subject: Biochemistry
Received: 2023/02/20 | Accepted: 2023/10/15 | Published: 2024/01/21 | ePublished: 2024/01/21

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