Hematologic Profiles and Correlation Between Absolute Lymphocyte Count and Neutrophil/Lymphocyte Ratio with Markers of Inflammation of COVID-19 in an Indonesian National Referral Hospital

Figures & data

Table 1 Study Subject's Characteristics

Variables	Result
Number of patients (N)	41
Age (years), mean (SD)	48.44 (SD 14.76)
Sex (n, %)
• Male	23 (56.1)
• Female	18 (43.9)
COVID-19 Severity (n, %)
• Non severe	33 (80.5)
• Severe	8 (19.5)
Comorbidities (n, %)
• No comorbidity	14 (34.1)
• Hypertension	7 (17.1)
• Type 2 diabetes	6 (14.6)
• Hypertension and type 2 diabetes	5 (12.2)
• Obese/overweight	3 (7.3)
• Chronic heart failure	3 (7.3)
• Prior lung tuberculosis	2 (4.9)
• Atrial fibrillation	1 (2.4)

Abbreviation: SD, standard deviation.

Table 2 Hematologic Profiles Between Non-Severe and Severe COVID-19 Patients

Variables	Units	Non-Severe (n = 33)	Severe (n = 8)	p value
Age (years), mean (SD)	Years	46.8 (SD 14.6)	55.3 (SD 14.1)	0.15
Sex (n,%)
• Male		18 (54.5)	5 (62.5)
• Female		15 (45.5)	3 (37.5)
Comorbidities (n,%)
• No comorbidity		12 (36.4)	2 (25)
• One or more comorbidities		21 (63.6)	6 (75)
Haemoglobin	g/dL	Mean 13.94 (SD 1.31)	Mean 13.06 (SD 2.09)	0.143
Haematocrit	%	Mean 40.06 (SD 3.55)	Mean 37.55 (SD 6.14)	0.298
White blood cells count	cells/μL	Median 5510 (IQR 3210)	Median 9040 (IQR 4903)	0.049*
Platelet count	cells/μL	Mean 255,576 (SD 79,807.6)	Mean 376,875 (SD 171,719.4)	0.088
WBC relative differential count
• Basophils	%	Median 0.3 (IQR 0.2)	Median 0.2 (IQR 0.4)	0.176
• Eosinophils	%	Median 0.1 (IQR 0.9)	Median 0.05 (IQR 0.2)	0.391
• Neutrophils	%	Mean 66.38 (SD 10.67)	Mean 78.8 (SD 9.42)	0.005*
• Lymphocytes	%	Mean 23.75 (SD 8.59)	Mean 13.1 (SD 7.99)	0.003*
• Monocytes	%	Mean 8.82 (SD 3.44)	Mean 7.8 (SD 2.44)	0.424
Neutrophil to lymphocyte ratio (NLR)		Median 2.62 (IQR 2.12)	Median 7.06 (IQR 6.41)	0.004*
Absolute lymphocyte count	cells/μL	Median 1380 (IQR 390)	Median 1020 (IQR 875)	0.146
C-reactive protein	mg/L	Median 14 (IQR 50.7)	Median 84.6 (IQR 86.9)	0.011*
Lactate dehydrogenase	U/L	Median 280 (IQR 80)	Median 360.5 (IQR 180)	0.128
Ferritin	ng/mL	Median 513.84 (IQR 612,75)	Median 772.44 (IQR 271.42)	0.073

Note: *p<0.05.

Abbreviation: SD, standard deviation.

Figure 1 Comparison of hematologic profiles between non-severe and severe COVID-19 patients. (A) Haemoglobin; (B) haematocrit; (C) white blood cells count; (D) platelet count; (E) relative neutrophils (%); (F) relative lymphocytes (%); (G) neutrophil to lymphocyte ratio (NLR); (H) absolute lymphocyte count; (I) C-reactive protein; (J) lactate dehydrogenase; (K) ferritin. ºDenotes outlier values outside the Q1-Q3 range. *Denotes extreme outlier values which is defined as distance to the median >1.5 times the IQR.

Figure 2 Scatter plot showing correlation between neutrophil to lymphocyte ratio and C-reactive protein.

Table 3 Correlation Between NLR, Absolute Lymphocyte Count, CRP, LDH and Ferritin in Hospitalized COVID-19 Patients

Variables	r	p value	Remarks
NLR and absolute lymphocytes	−0.414	0.004*	Moderate correlation
NLR and CRP	0.738**	<0.001*	Strong correlation
NLR and LDH	0.349	0.013*	Fair correlation
NLR and ferritin	0.324	0.019*	Fair correlation
Absolute lymphocytes and CRP	−0.386	0.006*	Fair correlation
Absolute lymphocytes and LDH	−0.502	<0.001*	Moderate correlation
Absolute lymphocytes and CRP	−0.038	0.407	No correlation
CRP and LDH	0.568	<0.001*	Moderate correlation
CRP and ferritin	0.427	0.003*	Moderate correlation
LDH and ferritin	0.358	0.011*	Fair correlation

Notes: *p<0.05, **Strong correlation.

Abbreviations: NLR, neutrophil to lymphocyte ratio; CRP, C-reactive protein; LDH, lactate dehydrogenase.