The Clinical Implication of Dynamic Hematological Parameters in COVID-19: A Retrospective Study in Chongqing, China

Figures & data

Table 1 Clinical Characteristic of COVID-19 Patients in Chongqing

	Total (N=78)	Non-Severe (N=61)	Severe (N=17)	P value
Sex-n. (%)
Male	37 (47.4)	27 (44.3)	10 (58.8)	0.288
Female	41 (52.6)	34 (55.7)	7 (41.2)
Age-year	45.5 (34.0–55.8)	43.0 (29.0–50.0)	59.0 (51.0–68.0)	0.000
Smoke-no. (%)	17 (21.8)	13 (21.3)	4 (23.5)	0.845
Alcohol-no. (%)	21 (26.9)	14 (23.0)	7 (41.2)	0.234
Days from Onset/first nucleic acid positive to Admission	3.0 (2.0–5.0)	3.0 (2.0–4.0)	5.0 (4.0–6.0)	0.001
Days from Admission to Discharge	21.5 (14.3–29.0)	20.0 (13.0–27.0)	27.0 (20.0–35.0)	0.019
Days from Onset/first nucleic acid positive to Discharge	25.0 (17.3–32.8)	22.0 (17.0–29.0)	31.0 (26.0–37.0)	0.001
Acute Phase	4.0 (3.0–6.0)	4.0 (3.0–5.0)	7.0 (5.0–7.0)	0.000
Progressive Phase	11.0 (9.0–13.0)	11.0 (9.0–12.0)	13.0 (12.0–14.0)	0.002
Convalescent Phase	24.5 (17.0–29.0)	22.0 (16.0–29.0)	27.0 (25.0–29.0)	0.021
Symptom-no. (%)
Fever	45 (57.7)	29 (47.5)	16 (94.1)	0.001
Cough	41 (52.6)	27 (44.3)	14 (82.4)	0.005
Expectoration	24 (30.8)	15 (24.6)	9 (52.9)	0.025
Pharyngalgia	11 (14.1)	10 (16.4)	1 (5.9)	0.479
Headache	15 (19.2)	7 (11.5)	8 (47.1)	0.003
Fatigue	23 (29.5)	10 (16.4)	13 (76.5)	0.000
Diarrhea	19 (24.4)	14 (23.0)	5 (29.4)	0.819
Chest tightness	16 (20.5)	7 (11.5)	9 (52.9)	0.001
Rash	6 (7.7)	3 (4.9)	3 (17.6)	0.220
Basic diseases-no. (%)
Hypertension	7 (9.0)	5 (8.2)	2 (11.8)	1.000
Diabetes	5 (6.4)	0 (0.0)	5 (29.4)	0.000
Hematological System diseases	4 (5.1)	2 (3.3)	2 (11.8)	0.435
Digestive system diseases	9 (11.5)	6 (9.8)	3 (17.6)	0.644
Cardiovascular system diseases	3 (3.8)	1 (1.6)	2 (11.8)	0.228
Respiratory system diseases	1 (1.3)	0 (0.0)	1 (5.9)	0.492
Other Metabolic diseases	3 (3.8)	2 (3.3)	1 (5.9)	1.000
Comorbidity-no. (%)
Respiratory system	20 (25.6)	5 (8.2)	15 (88.2)	0.000
Digestive system	11 (4.1)	7 (11.5)	4 (23.5)	0.385
Metabolic diseases	2 (2.6)	2 (3.3)	0 (0.0)	1.000
Hematological System	5 (6.4)	4 (6.6)	1 (5.9)	1.000
Immune system	4 (5.1)	1 (1.6)	3 (17.6)	0.043
Urinary system	1 (1.3)	0 (0.0)	1 (5.9)	0.492
Neuropsychological system	2 (2.6)	1 (1.6)	1 (5.9)	0.911
Skin diseases	3 (3.8)	0 (0.0)	3 (17.6)	0.008
Cardiovascular system	2 (2.6)	1 (1.6)	1 (5.9)	0.911
Other diseases	4 (5.1)	1 (1.6)	3 (17.6)	0.043
Chest CT-no. (%)
Chest radiographs abnormalities	59 (75.6)	42 (68.9)	17 (100.0)	0.020

Table 2 The Correlation of Hematological Parameters During the Course of Acute Phase with the Severity of COVID-19 in Chongqing

Baseline Variables	Total (N=78)	Non-Severe (N=61)	Severe (N=17)	P value
WBC (10^9/L)	5.3 (4.2–6.7)	5.4 (4.2–6.8)	4.9 (3.9–5.9)	0.189
Neutrophil (10^9/L)	3.1 (2.4–4.4)	3.2 (2.2–4.4)	3.0 (2.7–4.4)	0.961
Lymphocyte (10^9/L)	1.4 (1.0–2.0)	1.6 (1.2–2.1)	1.0 (0.8–1.3)	0.003
Monocyte (10^9/L)	0.4 (0.3–0.5)	0.4 (0.3–0.5)	0.3 (0.2–0.5)	0.059
NLR	2.2 (1.6–3.3)	2.1 (1.5–3.0)	3.3 (2.0–4.3)	0.028
LMR	3.7 (2.6–4.8)	3.8 (2.7–5.4)	3.7 (2.5–4.3)	0.374

Abbreviations: NLR, neutrophil–lymphocyte ratio; LMR, lymphocyte–monocyte ratio.

Figure 1 Dynamic changes of blood analyzing items of COVID-19 between the severe and non-severe groups (A-F). The levels of white blood cell (A), neutrophil (B), lymphocyte (C), monocyte (D), NLR (E), and LMR (F) on three different phases (the acute, progressive, and convalescent-phase) between the severe and non-severe group. *P<0.05, **P<0.01, ***P<0.001.

Table 3 The Value of Lymphocyte, NLR, Monocyte, LMR, and Neutrophil in the Diagnosis of COVID-19

Item	Sensitivity (%)	Specificity (%)	Positive Predictive Value (%)	Negative Predictive Value (%)	Cut-off Value
Lymphocyte	70.59	80.33	50.00	90.74	1.14
NLR	76.47	67.21	39.39	91.11	2.36
Monocyte	35.29	95.08	66.67	84.06	0.25
LMR	88.24	32.79	26.79	90.91	4.75
Neutrophil	82.35	36.07	26.42	88.00	2.64

Figure 2 The receiver operation curves of hematological parameters for disease severity classification of COVID-19. ROC analysis of lymphocyte, monocyte, NLR, LMR, and neutrophil for discriminating 17 severe cases from 61 non-severe cases.